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Nursing students learn the PHQ-9. They can walk you through the questions. What takes more practice: asking a patient directly if they intend to end their life, holding the space for the answer, and navigating what comes next with composure. A 2025 systematic review of nursing simulation studies found significant improvements in clinical decision-making across 12 of 15 studies. The transfer from classroom to clinical setting remains the persistent challenge. Repeated, feedback-rich practice is what closes that distance. Noodle's "High-Stakes Conversations in Human Services Education Practice Guide for Programs in Nursing, Health Sciences, Criminal Justice, Social Work, Mental Health, and Education" covers the highest-stakes conversation types in nursing and what structured simulation looks like when it's designed well. Link in comments.

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