Michelle Kelly

Arbour, R. & Kelly, M.A. 2008, 'Nursing management: respiratory failure and acute respiratory distress syndrome' in Brown, D; Edwards, H. (eds), Lewis's medical-surgical nursing : assessment and management of clinical problems (2nd ed.)., Elsevier Australia, Sydney, pp. 1903-1924.

Bucher, L. & Kelly, M.A. 2008, 'Nursing management: Critical care environment' in Brown, D; Edwards, H. (eds), Lewis's medical-surgical nursing : assessment and management of clinical problems (2nd ed.)., Elsevier Australia, Sydney, pp. 1836-1875.

Cuthbertson, S. & Kelly, M.A. 2007, 'Support of respiratory function' in Elliott, D; Aitken, L; Chaboyer,W. (eds), ACCCN's critical care nursing, Mosby Elsevier, Sydney, Australia, pp. 263-305.
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This is an original Australian-based critical care nursing text relevant to both specialty post-graduate and senior undergraduate students in Australia and New Zealand. Developed in conjunction with the Australian College of Critical Care Nurses (ACCCN), this 13 chapter text has been written and edited by the most senior and experienced critical care nursing clinicians and academics across Australia and New Zealand.

Arbour, R.B. & Kelly, M.A. 2005, 'Nursing management: respiratory failure and acute respiratory distress syndrome' in Brown, D. & Edwards, H. (eds), Lewis's medical surgical nursing: assessment and management of clinical problems, Elsevier Mosby Australia, Sydney, Australia, pp. 1822-1842.

Bucher, L. & Kelly, M.A. 2005, 'Nursing management: Critical care environment' in Brown, D. & Edwards, H. (eds), Lewis's medical surgical nursing: assessment and management of clinical problems, Elsevier Mosby Australia, Sydney, Australia, pp. 1756-1793.

Phillips, J.K. & Kelly, M.A. 2005, 'Nursing management: Shock and multiple organ dysfunction syndrome' in Brown, D. & Edwards, H. (eds), Lewis's medical-surgical nursing : assessment and management of clinical problems, Elsevier Mosby Australia, Sydney, Australia, pp. 1794-1821.

Henderson, A., Nulty, D., Mitchell, M., Jeffrey, C.A., Kelly, M.A., Groves, M., Glover, P. & Knight, S. 2013, 'An implementation framework for using OSCEs in nursing curricula', Nurse Education Today, vol. in press.
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OSCEs are a regular component of nursing, midwifery and medical programs in Australia and internationally. Best practice guidelines have been established to assist with their incorporation into the curriculum (Nulty, et al., 2011). They can be a valuable strategy for determining 'fitness to practice' in the clinical setting, however, there is little guidance about how to effectively implement them. This commentary draws on the experience of trialling best practice guidelines that were used to review OSCEs currently being used across three diverse education programs (post registration rural and remote nursing, undergraduate midwifery, and undergraduate nursing). Trialling of guidelines was funded by the Australian Learning and Teaching Council (Australian Government Office of Learning and Teaching,2012). The proposed implementation framework emerged through shared experiences of the project leader, project officer, participating leads from education facilities offering the programs, and observations and feedback from project members familiar with OSCEs.

Kelly, M.A. & Fry, M. 2013, 'Masters Nursing Students' Perceptions of an Innovative Simulation Education Experience', Clinical Simulation in Nursing, vol. In Press, pp. e1-e7.
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Background: Simulation was introduced into a master of nursing course, embedded within patient safety and clinical practice contexts. Student groups developed, enacted, and debriefed simulation scenarios from lived experiences. The study aimed to explore masters students perceptions of the innovative simulation education strategy. Method: A 2-year qualitative, exploratory study retrospectively analyzed students written reflections about the innovative educational strategy and application of simulation for clinical practice. Results: The study enrolled 21 participants. Five themes emerged from the analysis: a new awareness of the extent and range of simulation activities; building teams and meaningful work; supported, realistic, and extended learning; sharing and reconstructing clinical stories; and using simulation in practice. Masters nurses highly valued the innovative simulation education strategy to develop authentic scenarios and identified a wide range of clinical applications and ways to initiate simulation in the workplace.

Brown, R., Guinea, S., Crookes, P., McAllister, M., Levett-Jones, T., Kelly, M.A., Reid-Searl, K., Churchouse, C., Andersen, P., Chong, N. & Smith, A. 2012, 'Clinical simulation in Australia and New Zealand: Through the lens of an advisory group', Collegian, vol. 19, no. 3, pp. 177-186.
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Summary: Across Australia, innovations in simulation to enhance learning in nursing have been occurring for three decades and nursing is, and needs to be, a leading player in simulation knowledge diffusion. However, expertise is unevenly distributed across health services and education providers. Rather than build on the expertise and achievements of others, there is a tendency for resource duplication and for trial and error problem solving, in part related to a failure to communicate achievements for the bene´¼ ts of the professional collective. For nursing to become a leader in the use of simulation and drive ongoing development, as well as conducting high quality research and evaluation, academics need to collaborate, aggregate best practice in simulation learning, and disseminate that knowledge to educators working in health services and higher education sectors across the whole of Australia and New Zealand. To achieve this strategic intent, capacity development principles and committed action are necessary. In mid 2010 the opportunity to bring together nurse educators with simulation learning expertise within Australia and New Zealand became a reality. The Council of Deans of Nursing and Midwifery (CDNM) Australia and New Zealand decided to establish an expert reference group to re-ect on the state of Australian nursing simulation, to pool expertise and to plan ways to share best practice knowledge on simulation more widely. This paper re-ects on the achievements of the ´¼ rst 18 months since the groups establishment and considers future directions for the enhancement of simulation learning practice, research and development in Australian nursing.

Kelly, M.A. & Jeffries, P. 2012, 'Clinical simulation in health care - Contemporary learning for safety and practice', Collegian, vol. 19, no. 3.
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Editorial There has been enormous growth over the last decade in the use ofÔ++simulation in nursing and other health professional education for both students and practicing clinicians. The volume of literature published each week is testament to how educators are embracing this learning strategy. Although some may consider we have been using simulation within nursing education for decades, advances in equipment technology (i.e. manikins, task trainers and virtual platforms) has propelled simulation, in its contemporary forms, into the higher education and hospital arenas.

Kelly, M.A., Forbes, J.R. & Carpenter, C. 2012, 'Extending Patient Simulation A Novel Prototype To Produce Tympanic Thermal Output', Simulation in Healthcare, vol. 7, no. 3, pp. 192-195.
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Introduction: Despite technologic advances in task trainers and manikins, there persists an inability to replicate key clinical skills as would occur in clinical settings. This report provides details of a project to develop a functional and reliable tym

Kelly, M.A., Forbes, J.R. & Carpenter, C. 2012, 'Extending patient simulation: A novel prototype to produce tympanic thermal output', Simulation in Healthcare, vol. 7, no. 3, pp. 192-195.
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Despite technological advances in task trainers and manikins, there persists an inability to replicate key clinical skills as would occur in clinical settings. This report provides details of a project to develop a functional and reliable tympanic thermal simulator prototype which could be embedded into the ear of a manikin to enable tympanic thermometers to be used during simulation encounters. Methods: A simple electrical circuit was built using: i) a standard 9 V battery; ii) a switch; iii) 5 x 62+® resistors in parallel for circuit stability; iv) a 62+® resistor in parallel with v) a 1 k+® potentiometer to vary the IRLED intensity; and vi) two IRLEDs. After confirming reliability of circuit performance, the IRLEDs were implanted into the ear of a manikin. Over 3 consecutive days, 3033 samples were recorded simulating a range of human body temperatures, controlled by altering current flow. Results: Initial testing of the thermal simulator prototype indicates that a range of human temperatures (34.0 -41.9 degrees C) can be generated using high intensity IRLEDs. Although at higher applied current levels, the variation in measured temperature was larger (2.4 degrees C) that at lower applied currents (0.2 degrees C), reasonably precise temperatures were achieved. Discussion: Testing and reporting initial prototype results is an important first step in developing and refining a useful product to enhance manikin capabilities associated with patient physical assessment in the simulation setting. Despite the undesired variation, the current design could still be employed for teaching purposes in educational settings. Retrieving tympanic temperatures during patient assessment of the simulator benefits nursing, midwifery and other health care students by enabling authentic practice. Further development of this prototype is required to improve the reliability, precision and accuracy of the device.

Rochester, S.F., Kelly, M.A., Disler, R.T., White, H.L., Forber, J. & Matiuk, S. 2012, 'Providing simulation experiences for large cohorts of 1st year nursing students: Evaluating quality and impact', Collegian, vol. 19, no. 3, pp. 117-124.
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To provide each student within a large cohort the opportunity to participate in a small group simulation that meets recognised quality indicators is a challenge for Bachelor of Nursing programmes in Australia. This paper, as part of a larger longitudinal study, describes one approach used to manage a simulation for 375 1st year nursing students and to report on the quality of the experience from the student's perspective. To ensure quality was maintained within the large cohort, aspects of the simulation were assessed against the following indicators: alignment with curriculum pedagogy and goals; preparation of students and staff; fidelity; and debriefing. Data obtained from a student focus group were analysed in the context of the quality indicators. The following themes emerged from the data: knowing what to expect; assuming roles for the simulation; authenticity and thinking on your feet; feeling the RN role; and, preparation for clinical practice. This paper demonstrates it is possible to provide students in large cohorts with active participatory roles in simulations whilst maintaining quality indicators.

Duffield, C.M., Conlon, L.S., Kelly, M.A., Catling-Paull, C. & Stasa, H. 2010, 'The Emergency Department Nursing Workforce: Local Solutions for Local Issues', International Emergency Nursing, vol. 18, no. 4, pp. 181-187.
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Demand for health services especially emergency services has increased substantially in recent years. As a consequence, Emergency Departments and hospitals have focused greater attention on the way they provide care using the workforce differently to meet efficiency targets. A strategy frequently implemented is either the initiation or restructuring of Emergency Nurse Practitioner roles. The future role of the emergency nurse is likely to be different from that of today, as health services adapt and evolve to meet demand. However, the authors caution against the notion of implementing new positions or restructuring existing positions without first analysing patient throughput, case-mix, staff competency levels, cross-professional boundaries and relevant local issues.

Kelly, M.A. & McKinley, S.M. 2010, 'Patients' recovery after critical illness at early follow-up', Journal Of Clinical Nursing, vol. 19, no. 5-6, pp. 691-700.
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Aim. To determine the quality of life, particularly physical function, of intensive care survivors during the early recovery process. Background. Survivors of critical illness face ongoing challenges after discharge from the intensive care unit and on returning home. Knowledge about health issues during early phases of recovery after hospital discharge is emerging, yet still limited. Design. Descriptive study where the former critically ill patients completed instruments on general health and quality of life (SF-36) in the first six months of recovery. Methods. Participants responded to the SF-36 questionnaire and questions about problems, one to six months after intensive care, either face-to-face or by telephone. Results. Thirty-nine participants had a mean age of 60 years; of them, 59% were men and had been in intensive care for 1+69 days (median = 5). Most participants (69%) rated their health as good or fair, but 54% rated general health as worse than a year ago. Mean quality of life scores for all scales ranged from 25+65ã5%, with particularly low scores for Role-Physical (25) and Pain (45ã1). Half the participants reported difficulty with mobility, sleep and concentration, and 72% that their responsibilities at home had changed. No relationships were found between SF-36 scores and admission diagnosis, gender, age or length of intensive care stay. Conclusions. These survivors of critical illness and hospitalisation in an intensive care unit perceive their general health to be good despite experiencing significant physical limitations and disturbed sleep during recovery. Relevance to clinical practice. Knowledge of issues in these early phases of recovery and discussion and resolution of patient problems could normalise the experience for the patient and help to facilitate better quality of life.

Kelly, M.A. & Flanagan, B. 2010, 'Trends and developments in the use of health care simulation', Collegian, vol. 17, no. 3.
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A national strategy for simulation will set the scene for a new future in terms of both establishing the work-readiness, and ensuring the skills maintenance of our future healthcare workforce, and aid the movement form a time-based to a competency-based approach to training. We are on the verge of a new frontier with more effective, and efficient learning of clinical skills, in which the first time a clinician does a procedure on a patient doesn't have to be the clinician's "first" time. The prospect of greater consistency in training, greater objectivity in feedback and assessment, and more transparent, and credible credentialing of individual practitioners all sit well with the recent move to national registration of healthcare practitioners. New opportunities will also become available in terms of the way to learn teamwork behaviours. Much work needs to be done to ensure that simulation training is indeed consistent and that standards are developed and maintained. The simulation community will need to provide leadership and work with government and other stakeholders to develop transparent criteria regarding accreditation of simulation programs and facilities ("centres"). Likewise, certification standards will be required for simulation staff.

Horvancsek, M.T., Jeffries, P., Escudero, E., Foulds, B., Husebo, S., Iwamoto, Y., Kelly, M.A., Petrini, M. & Wang, A. 2009, 'Simulation Faculty Development Project-International Contributions Creating Simulation Communities of Practice: An International Perspective', Nursing education perspectives, vol. 30, no. 2, pp. 121-125.

Kelly, M.A. 2009, 'International collaboration to advance simulation in nursing', Clinical Simulation in Nursing, vol. 5, no. 6.
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A 3-year project led by Pamela Jeffries, DNS, on behalf of the National League for Nursing (NLN) and Laerdal Medical is completing work this year. Many of you may have already accessed the Simulation Innovation Resource Center (SIRC) at http://sirc.nln.org. An important aspect of this work is the input given by a group of international nursing simulation experts, part of the project team together with nine U.S. authors, the technical team, and staff representing this NLNeLaerdal Medical alliance activity. Every day we are witnessing exponential global growth in the integration and use of simulation within health care environments. The SIRC project has enabled nurse simulation experts from Australia, Canada, Chile, China, Japan, and Norway to come together annually, through the support of Laerdal Medical, and provide international social, cultural, and development perspectives to the project (http://sirc.nln.org/mod/resource/view.php?id-+347).

Marshall, A.P., Fisher, M., Brammer, J., Eustace, P., Grech, C., Jones, B. & Kelly, M.A. 2007, 'Assessing psychometric properties of scales: a case study', Journal Of Advanced Nursing, vol. 57, no. 4, pp. 398-406.
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Assessing psychometric properties of scales: a case study Aim. This paper is a report of a study to examine the construct validity of The Nursing Students' Attitudes and Awareness of Research and Development within Nursing Scale. Background. The validity of instruments is critical in ensuring that data collected are sound and that the data measures what it purports to measure. When a new instrument is used in a different population or when it has been modified, it is useful to re-examine the construct validity of the instrument.

Clay-Williams, R., Kelly, M.A., Everett, B., Perry, L. & McDonnell, G. 2012, 'Modelling clinical judgement improved health care delivery:using "how nurses think" to manage the deteriorating patient', SimHealth 2011, Sydney, Australia, September 2011 in Selected Abstracts of Free Papers Presented at the SimHealth: Innovation, Education and Research in Healthcare Conference, ed Watterson, L; Brooks, P., Wolters Kluwer: Lippincott Williams & Wilkins, Simulation in Health care, pp. 66-66.
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This study aims to construct a model for learning reasoning in the workplace, using computer based system dynamic processes, to support clinical decision-making in relation to detection and management of the deteriorating patient. Assessment and timely management of a deteriorating patient is a priority area for improvement highlighted by several Government, independent and health agency reports. Computer modelling of judgement processes can identify areas of difficulty in decision-making and assist nurses and other health care professionals to recognise and seek timely assistance for patients who deteriorate. Seminal work by Benner and Tanner on "how expert nurses think" led to the publication of Tanner's theoretical model of clinical judgement. This model maps the primary processes involved in clinical reasoning, and forms the basis of curricula in nursing courses internationally and within Australia. By explicitly modelling the time nurses take to progress through the processes of decision-making when planning and providing patient care, we can identify points where potential error and harm could occur, and thereby potentially improve patient outcomes.

Gray, J., Kelly, M.A., Raymond, J. & Hogan, R. 2012, '"Spaced out or tuned in?": Do clinical simulation spaces enable learning?', Society in Europe for Simulation Applied to Medicine (SESAM), Stavanger, Norway, June 2012.
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Discussion: The clinical practice laboratory setting is an ideal environment to enable active, participatory learning to take place, simulating decision-making and problem solving in clinical practice. It was clear from this research that students sometimes have difficulty engaging in their learning. These difficulties arose when students were not given sufficient time to engage in the activity, where they were unable to view what was happening, where the skill was taught without a context, and where the environment lacked realism. Ô+¿Conclusion: Space can have a significant impact on teaching and learning. The influence of Ô++built pedagogyÔ+ , or the ability of space to define how students are taught, is very powerful (Oblinger, 2006). The ways in which a space is designed therefore shapes the learning that happens in that space. It is clear then that the design of learning environments for clinical simulation must enable students to actively engage in learning.

Huseb+©, S.E., Kelly, M.A., van Gele, P. & Aldridge, M. 2012, 'Integrating simulation into curricula; Designing and developing scenarios;', Nurse Educator pre-conference course in simulation, Stavanger, Norway, June 2012.
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Full day session - mix of didactic sessions, demonstrations, group work and facilitated debriefing sessions. One of 4 international nursing simulation experts invited to deliver the workshop. Participants from across Europe and USA

Kelly, M.A. 2012, 'Modelling the way - preparing novices for simulation with a DVD preview of expert behaviours', Sigma Theta Tau 23rd International Nursing Research Congress, Brisbane, Australia, July 2012.
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An innovative strategy to align preparation for simulation and modelling of professional practice will be discussed. The strategy has multiple benefits for staff and students. For staff, rehearsing the simulation provides opportunity to validate learning objectives, confirm timings, roles and anticipated responses; and gain insight into the studentÔ++s likely experience. Filming the rehearsal allows staff to review their performances and to create a DVD of expected responses during the simulation encounter. Benefits for students include: gaining insight into what is expected during the simulation; choosing a particular role they could manage within the scenario; and gathering a repertoire of phrases or responses. Excerpts from developed DVDs will be featured in the presentation.

Kelly, M.A. 2012, 'Simulation down under: Australian approaches in nursing simulation', Annual WISER Nursing Simulation Symposium, Pittsburgh, USA, May 2012.
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International keynote presentation to over 300 delegates

Orr, F.R., Kelly, M.A., Stein-Parbury, M.J., White, H.L. & McGarry, D. 2012, '"It was real": Use of actors in simulation to learn therapeutic communication', Society in Europe for Simulation Applied to Medicine (SESAM), Stavanger, Norway, June 2012.
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The students' evaluations of role plays with actors were rated as slightly higher than those with fellow students. Analysis of self-efficacy scores showed mixed results; some students reported increased confidence with therapeutic communication, while others reported a decrease. When aggregated, the results demonstrated that students' confidence increased, related to 'uncovering strong feelings' and 'ending a conversation by summarizing'. Nursing focus group results revealed that role plays with actors created emotional arousal that 'felt real' and 'put me under pressure', whilst role plays with students were limited by 'knowing each other' and 'not taking the emotion too far'.

Clay-Williams, R., Kelly, M.A., Everett, B., Perry, L. & McDonnell, G. 2011, 'Modelling clinical judgement improved health care delivery: using 'how nurses think' to manage the deteriorating patient', SimHealth, Sydney, September 2011.
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This papaer presents a dynamic model of reasoning, using computer based system dynamic processes based on a model of 'how nurses think' to support clinical decision-making in relation to detection and management of the deteriorating patient.

Kardong-Edgren, S., Durham, C., Leighton, K., Howard, V., Kelly, M.A., Jeffries, P., Chatillon, H. & Lopez, C. 2011, 'Meet the Sim Pros - Simulation-Based Education: A Nursing Model', 11th International Meeting on Simulation in Health Care, New Orleans, January 2011.
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The goal of this discussion is to provide an environment that will allow for in-depth discussion of topics for nurses working in simulation. Discussions will be tailored to fit the needs of the audience. Simulation experts in hospital transition to practice, research, and education will lead each topic group. Topics for discussion include: 1) transition to practice: orientation program for new grads and new hires; 2) competency testing in school and clinical organizations; 3) best practices for skill learning and retention in schools and hospitals; and 4) best practices in teaching and learning with simulation, ie, debriefing, multiple scenario runs etc,

Matiuk, S., Jenkins, M.K. & Kelly, M.A. 2011, 'Simulation on a grand scale: not losing sight of the patient', SimHealth, Sydney, September 2011.
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Workshop - enabling participants to respond to a challenge of providing a participatory simulation experience for large numbers of students. Presenters then provided tips and strategies for how this was managed at UTS.

McDonnell, G., Kelly, M.A. & Clay-Williams, R. 2011, 'Clinical decision-making for improved health care delivery: how can a computer-based model help?', SimHealth, Sydney, September 2011.
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The aim of the presentation is to explore practical uses of the clinical decision-making model, and to establish priorities for future development and investigation.

Kelly, M.A. 2010, 'Empowering the RNs of tomorrow: An immersive simulation scenario for recognising and managing the deteriorating patient', The Deteriorating Patient Seminar (Change Champions), Sydney, Australia, March 2010.
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An important aspect of preparing students for practice is offering experiential learning opportunities within the context of contemporary patient care issues. Team simulation scenarios provide opportunity for students to practice assessment skills, interpret findings and initiate nursing management strategies. Students can learn from errors in a safe environment without harm to the "patient" and reflect on their practice. All students in the final semester of the Bachelor of Nursing participated in a "deteriorating patient" simulation scenario. This initiative continues across other faculty courses.

Kelly, M.A., Forber, J., Conlon, L.S., Stasa, H. & Roche, M.A. 2010, 'Empowering the RNs of tomorrow: pre and post simulation analysis of clinical skill parameters related to deteriorating patients', SimTecT Health, Melbourne, August 2010.
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Final year Bachelor of Nursing students in an adult medical surgical subject engaged in a deteriorating patient simulation encounter. Local Ethics Review Committee approval was obtained for the study. Sixty two students agreed to participate in the study and completed consent and confidentiality forms. A pre-simulation survey consisting of ten questions, with a 4 point Likert scale response was completed immediately prior to the activity. Students participated either actively in predetermined roles or as observers with structured questions to address and discuss during the debriefing. A post-simulation survey, of identical questions, was completed immediately after the simulation encounter.

Kelly, M.A. 2010, 'Enabling authentic simulation learning experiences for tomorrow's practitioners: experiences from 5 years of planning, refurbishing, collaborating, integrating and managing large numbers', Clinical Training and Workforce Summit, Melbourne, August 2010.
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Deliberate rehearsal of clinical practice experiences can be facilitated through patient care simulations Enabling participants to learn from errors in a safe environment, contributes to competent and safe clinical practices Integrating simulation learning experiences into higher education courses requires sustained managerial support, deliberate planning, a project leader and persistence A range of experiences within and beyond the university setting is possible, particularly to promote interdisciplinary learning for tomorrows practitioners

Kelly, M.A. 2010, 'Transformation in simulation reflecting current practice and practice environments', 8th International Conference for Emergency Nurses, Canberra, October 2010.
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There is increasing use of simulation learning strategies in health care across hospital and university settings worldwide. Typically, low-volume, high-risk scenarios i.e. acute patient collapse requiring ALS, has been a common focus of continuing professional development and assessment for many years. Based on data from critical incident reviews and root cause analyses, the worldwide mandate to reduce medical errors and improve patient safety 1-3 has influenced contemporary simulation strategies. A wide range of clinical practice scenarios can be enacted through a team based simulation encounter, providing opportunity for deliberate rehearsal of such scenarios and review of both technical and non-technical skills. If appropriately briefed and engaged, participants and observers can experience powerful learning, facilitated by debriefing and reflection. Advances in technologies have added a higher level of fidelity and authenticity in simulation encounters. However, equally memorable learning experiences can be gained through using low fidelity equipment within a high fidelity environment through 'less critical' but equally important clinical scenarios. Examples of the types of simulation encounters being used locally and internationally will be discussed during this session.

Kelly, M.A. 2010, 'Using simulations to enhance clinical judgement and patient safety', ACCCN's 11th Annual Critical Care Nursing Continuing Education Meeting (ICE), Sydney, NSW, May 2010.
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There is increasing use of simulation learning strategies in health care across hospital and university settings worldwide. Recently, attention has been raised on how simulation encounters can provide opportunity to enhance clinical judgement for both practicing clinicians and health care students. Examples of simulations developed based on Tanner's Model of Clinical Judgement will illustrate how these immersive learning activities can enhance both clinical judgement and patient safety issues. Current Australian Governments' initiatives around Simulated Learning Environments (SLEs) will also be raised.

Kelly, M.A. 2009, 'A new strategy for Master of Nursing students: Advancing clinical practice through simulating critical patient care events', 8th Annual International Nursing Simulation/Learning Resource Centers Conference, St Louis, United States, June 2009 in Clinical Simulation in Nursing, ed Meccariello, M, Elsevier, St Louis, United States, pp. S8-S9.
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A Master of Nursing subject (Advanced Clinical Practice) was transformed in 2008 to incorporate simulation strategies within subject content and assessment work. Students were introduced to simulation as a vehicle for addressing clinical practice issues particularly around patient safety and quality care. Students undertook a brief literature review regarding simulation and patient safety, then within groups developed a simulation scenario using a Faculty designed template. Students peer reviewed others scenarios then academics from the Faculty and Learning Institute together with an external simulation expert viewed the recorded scenarios and offered input into focus and design.