Simulation-Based Training for Therapeutic Relationship Competencies in Mental Health Nursing: A Cross-Sectional...

Background/Objectives: Therapeutic communication is a core competency in mental health nursing, yet clinical placements often offer limited opportunities for undergraduate students to practise relational skills in a safe and structured way. Simulation, particularly when aligned with the Healthcare Simulation Standards of Best Practice™ (INACSL), may provide a useful context for fostering empathy, emotional presence, and professional communication. This study aimed to evaluate undergraduate nursing students' satisfaction and self-confidence following participation in a standardised-patient simulation designed to address therapeutic relationship competencies. Methods: A descriptive cross-sectional study was conducted with 142 third-year nursing students at a public university. Participants completed two INACSL-aligned simulation encounters involving psychiatric scenarios that required therapeutic engagement. After the sessions, students completed a questionnaire based on the Student Satisfaction and Self-Confidence in Learning Scale, adapted to the context of the simulation. Data were analysed using descriptive statistics. Results: Students reported high levels of satisfaction and self-confidence following the simulation experience. Between 88.0% and 92.9% of participants agreed or strongly agreed with items related to realism, relevance, and motivation. High levels of agreement were also observed for items related to therapeutic communication, critical thinking (98.6%), clinical competence (95.8%), and teamwork (93.6%). Lower levels of agreement were found for the usefulness of video-based debriefing (61.9%) and the adequacy of material resources (57.1%), suggesting areas for improvement in future implementation. Conclusions: Standardised-patient simulation was positively evaluated by nursing students and was associated with high levels of satisfaction and self-confidence in learning. The findings suggest that this type of educational strategy may support students' perceived development of therapeutic communication and relational skills in mental health nursing education. However, these results are based on self-reported data collected using an adapted measurement approach and should be interpreted with caution. Further research using validated instruments and performance-based measures is needed to assess competence development more directly.