1107 - Choose your Own Adventure Video Simulation for Teenage Suicidal Ideation

In order to address pediatric LGBTQ+ mental health in a non-threatening way, a video based scenario was developed that allows students to choose different actions or communications and see how it turns out. This takes the performance aspect out and allows for more reflective and collaborative discussion with intermittent debriefing.

Mental health is always a difficult simulation topic as it involves a lot of uncertainty for students. They often express that they don’t want to “get it wrong and make it worse”. However, it is a necessary topic in a time in which teens are experiencing suicidal ideation and eating disorders at twice the rate they were three years ago. Our LGBTQ+ patients are at even higher risk and should be included in our scenarios.

Ideally these scenarios might be done in person with a standardized patient. However teens with the time and interest to do this regularly for students are in short supply. To address these issues and gaps in knowledge a scenario was developed in collaboration with a teen standardized patient. Video clips were filmed and then embedded in a ppt presentation that allows students to choose their course of action and see it play out. This could be done for any number of other scenarios.

This particular scenario included a15-year old patient who self identifies as non binary on day one of their inpatient adolescent unit admission post intentional overdose. Students were expected to work through conducting a SI screening for risk of harm on the unit and communicate results to the physician. Prep materials were available two weeks prior to the scenario to demonstrate asking about pronouns, apologizing and recognizing bias.

Objectives for the students included the following items. Determine assessment skills to provide identification of suicide risk and prevention. Utilize therapeutic communication concepts to complete the PHQ 9 tool.

Provide for the patient's physical and emotional safety during interaction using developmentally appropriate interventions. Students were able to achieve these objectives by choosing appropriate steps in the scenario to complete and then debriefing at intervals to optimize communication and safety.