Effects of de-escalation training on student nurses' skills and confidence

Abstract

Background: De-escalation training is widely recommended for reducing violent incidents in the workplace, but is rarely included in nursing curriculums. Research suggests that nursing students should learn skills that enable them to respond to violence in a calm manner. Objective: To test whether a de-escalation training session could improve nursing students' de-escalation skills and their confidence in coping with patient aggression. Method: The study was designed as a cluster randomised controlled trial that included three clusters (classes) of third-year nursing students allocated either to the intervention group (two classes, n=35) or the control group (one class, n=10). Data were collected at a Norwegian university college of nursing in February, August and November 2019. For each class, all data were collected over a period of five hours in one day. All participants were exposed to two simulation scenarios. The intervention group participated in a 50-minute de-escalation training session in between scenarios. The primary outcome was de-escalation skills, and the secondary outcome was confidence in coping with patient aggression. To measure de-escalation skills, videos of participants during the two simulation scenarios were used to collect data pre- and post-intervention. The English Modified De-escalating Aggressive Behaviour Scale (EMDABS) was applied to code videos. Confidence in coping with patient aggression was obtained through a validated self-report questionnaire before and after the two simulation scenarios, pre- and post-intervention. Results: After participating in the de-escalation training session, the students in the intervention group demonstrated positive changes in de-escalation skills compared to those of the control group. With regard to confidence in coping with patient aggression, both groups' scores improved after they had attended simulation scenarios, but the largest improvements occurred after they had participated in the de-escalation training session. Conclusion: The results suggest that de-escalation training has the potential to increase nursing students' de-escalation skills and their confidence level in coping with patient aggression. Given the limitations of this study, replication with larger sample sizes is needed.