On June 24-25, over 170 people gathered at the University of Glamorgan in Wales for a FREE two-day nursing conference designed to enhance the knowledge and understanding of how to integrate simulation into nursing education. METI co-hosted the event along with the University of Glamorgan to provide a networking and learning opportunity for nurses and healthcare providers around the UK.

Check back for more information on the 2010 UK Simulation in Nursing Education Conference.

View the 2009 UK Nursing Conference Wrap Up

UK Nursing Conference Workshops

Workshop Session A: Wednesday 15:10 - 16:10

Using Simulation to Question Real Life Clinical Judgements and Decisions
Valarie Dimmock
Homerton University Hospital NHS Foundation Trust

Maximisation of learning using simulation to allow participants to examine how clinical decisions are reached. Simulation provides learning that is unique in relation to teamwork, communication, leadership, and decision-making.

A group of third year medical students were involved in planned simulation activities. Prior to each session facilitators would select a real patient scenario. The parameters of the patient condition at a set point in time were programmed into the simulator. Nurses were available to discuss the patient condition.

De-briefing took the form of reflecting on the judgements and decisions that were made with discussion centring on the consequences of those decisions. The real life outcomes were then examined and discussed making it very real to the students who could follow-up their experience by visiting the patient.

The drive for improved patient safety has led to the introduction in many areas of simulation based learning. The potential to reduce clinical errors through this method is believed to be a sound pedagogic tool offering opportunities for risk-free learning by trial and error. Third year medical students were deliberately selected to introduce them very early to the reality of clinical practice.

OSCE to Evaluate Simulation Lab Training in an Undergraduate Maternal Health Nursing Course
Savithri Raman
Sultan Oaboos University

This paper report on the use of the OSCE to measure the simulation lab training with regard to skill in conducting normal labour, placental examination, vaginal examination & newborn appraisal. Participants were 39 BSN students which consist of 11 male students and 28 female students. Simulation lab training was designed with 3 stations and faculty prepared a structured teaching programme. The sequence consisted of demonstration by the faculty and return demonstration of students, following which the students were allowed to practice themselves before OSCE was used. OSCE skill checklist was prepared for each of the stations by carefully analyzing the steps for each skill. OSCE was conducted based on simulated scenarios and performance was evaluated using skill checklist. The detailed results of students’performance based on competency checklist will be presented. As per the Miller’s pyramid model the students were also assessed on knowledge about the skills performed in each station by written exam consisting of 20 MCQ covering all the stations in the simulation lab training. Based on the experience the researcher found that simulation lab training is an effective strategy and OSCE is a powerful tool in evaluating the students performance.

Telling Stories: A Source of Clinical Content for Simulation Development
E. Tonkin, R. Morgan, M. Kirk
University of Glamorgan

Stories from the public and health care staff can enhance education by providing real-life examples, which are engaging, motivating and help link theory to clinical practice.

Telling Stories, Understanding Real Life Genetics (www.geneticseducation.nhs.uk/tellingstories) is a free, web-based teaching and learning resource for non-genetic healthcare practice. The website uses real-life stories and experiences from individuals with, at risk of or caring for someone with a genetic condition to promote understanding of the impact genetics has on real-life and its relevance across healthcare practice. The content is not limited to genetics and each story crosses many subject areas.

For educators who may have limited experience of genetic conditions, the site provides an excellent source of material that can be used to develop new, or enrich established simulation scenarios. Learning opportunities in genetics within the practice environment may occur infrequently and the incorporation of genetics within simulation provides students with an opportunity to develop understanding and appropriate skills and attitudes in this area.

The written and video stories are linked to a competence-based genetics education framework for nurses, midwives and health visitors1. Video clips are available for download. Educationally, stories are supplemented with activities, quotes, points for reflection and links to further information.

Assessment of Simulated Learning: Students' Experiences of Peer-Assessed Objective Stuctured Clinical Examination
A.C. Wiseman, J. England, G. Taylor
University of Surrey, University of Nicosia, Queensland Ambulance Service

Professional preparatory programmes are constantly striving to develop effective learning opportunities for students to develop their proficiency in clinical skills, in response to initiatives such as the Essence of Care (DH 2000 ), Essential Skills (Nursing and Midwifery Council 2007) The NHS Plan (DH 2000) and Fitness for Practice (UKCC, 1999). However assessing clinical learning in practice can be problematical (Ross et al, 1988, Chambers et al 1998 and Duffy, 2004) therefore it is imperative that, educators evaluate the effects that simulation and the assessment of learning has on students to ensure an effective framework for clinical assessment (Miller, 1990 & McCallum, 2007) is in place.

Objective Structured Clinical Examinations (OSCE) are recognised as a valid and reliable tool for assessing students’ clinical skills (Rose And Wilkerson, 2001; Prislin, Giglio, Lewis, Ahearn, Radecki, 2000). Alinier et al (2004) recognised the value students place on OSCE for their clinical learning , however they are not without their problems such as resource intensiveness and students potentially requiring a number of attempts to pass due to performance anxiety when used as a summative assessment (Sines, Harris, Firth & Boden, 2006).

The Division of Health & Social Care undertook a small exploratory study using peer assessed OSCE as a forum for developing proficiency in a number of clinical skills. Pre registration, second year adult nursing, students were provided with proforma for assessments that were evidence based and validated by practice colleagues. Students worked in pairs on each station for 10 minutes, one being the assessor and one being the assessed. Following 7 stations students then evaluated their learning through open-ended questionnaires. Feedback indicated the value such learning had for them and they have since reported that the assessment proforma have acted as an aide de memoire in practice. The team have now utilised this strategy for all branches and other disciplines in the division with great success.

Utilising Simulation to Develop Student Nurses Assessment Skills
Lesley-Ann Benson, Yvonne Jarvis
University of Glamorgan

It is essential that nurses are competent in undertaking a comprehensive patient assessment to facilitate the early recognition of actual or potential deterioration in a patients condition (Department of Health 2001). McArthur-Rouse (2001) stressed that work needs to be undertaken to educate nurses in the recognition of the early warning signs of critical illness. The recognition of deteriorating health is often delayed or managed inappropriately resulting in late referrals, avoidable admissions to critical care and many unnecessary patient deaths (National Institute for Health and Clinical Excellence 2007). This workshop will identify the benefits of simulation in consolidating theory and facilitating in the transition from theory to practice. It will incorporate second year Bachelor of Nursing students undertaking a simulated clinical experience using iStan, taken from the UK PNCI to demonstrate a hospital based scenario focusing upon the deteriorating condition of an elderly patient having incurred a stroke. The scenario enables the student to link theoretical principles and develop problem solving and decision making skills with regard to patient safety around the recognition and prompt management of the acutely ill patient. Student experiences and evaluations following engagement in this innovative immersive learning and assessment environment will be presented.

Cultural Implications for Hi-Fidelity Implementation in the Middle East
Colette Foisy-Doll
University of Calgary, Qatar

The introduction of Hi-Fidelity Simulation in the Middle East is increasing and many institutions are planning for the inclusion of simulation technology and related pedagogy to existing curriculum. This presentation will serve to stimulate thinking as to the many ways simulation can be used to further develop culturally appropriate learning scenarios, while promoting an understanding of the full scope of practice of the nurse within the existing societal perceptions and organizational structures.

Integrating Simulation into Education and Clinical Practice
Melissa Pollard, Michael Nickerson
Exeter Hospital

Nursing education has a long history of using simulation.  In the current technological age, a variety of high fidelity simulation devices are now available offering enhanced simulation abilities.  Simulation based education allows the educator to use multiple pedagogical learning strategies.  This technique includes hands on practice, followed by reflection on the experience, and the opportunity to improve performance.  Patient safety goals are promoted by allowing the learners to make mistakes they can learn from, with no risk of harm to patients in the process.  Active reflection is incorporated into the debriefing process which is integral to the simulation education experience.
Simulation is a growing trend in nurse training and staff development.  Incorporation of both the old and new technology, combined with an understanding of adult learning principles are leading educators into new realms.
Objectives: Examine the history of simulation; Apply the concepts of adult learning to simulations, Analyze the educational concepts in using active reflection in the debriefing process; Discuss ways to successful overcome barriers and incorporate simulation into educational programs.

Workshop Session B: Wednesday 16:20 - 17:20

Integrating Simulation Lab Training in Teaching Pediatric Nursing Skills for Undergraduate Pragmatic Approach
Preethy Dsouza, Anice George, Renu G.
Sultan Oboos University, Oman

The exploratory research was undertaken to recognize the benefits of Simulation lab training (SLT) in teaching Pediatric nursing skills for undergraduates. Further it was intended to identify areas for integration of simulation in pediatric nursing. The overall purpose was to develop a proposal for an ideal pediatric simulation set up within the resource available. Participants of the study were pediatric nurse educators, pediatricians, pediatric nurses and graduates of a BSN programme. The study was conducted in a university. Total Sample size was 200 and quota sampling technique was used. Data was collected using questionnaire method. Findings regarding benefits of SLT include patient safety, competency of skills; improving critical thinking and reflection were the major response. Several areas were identified to integrate like basic life support, tube feeding, physical assessment, suctioning etc. Qualitative data was also obtained through focus group discussions. Based on the findings a proposal was developed to set up an ideal pediatric simulation unit. The proposal includes the infrastructure, simulators and manikins required soft ware programmes, facilities required for an ideal pediatric ward and other aspects. The details findings will be presented later.

A Systematic Review of the Use of Simulation in the Continuing Education and Training of Qualified Medical and Nursing Staff
Peter Harper, Sharon Elliott, Karen Murrell, Carol Pellowe
Thames Valley University

This is a presentation the findings of a systematic review being undertaken by Thames Valley University as a collaborative centre within the Joanna Briggs Institute. The subject of the review is the effectiveness of simulation in the continuing education and training of qualified medical and nursing staff.

First Encounters, Patients or Simulation: The Ethical Implications of Using Patients in the Development of Clinical Skills for Student Nurses: An Exploration Study
Peter Harper, Sharon Elliott, Karen Murrell, Carol Pellowe
Thames Valley University

Clinical placements are a feature of all educational programmes in the preparation of entry-level health professionals. Historically, patients have been utilised as an €learning resource for these students. Although it is recognised that all health care students ultimately need exposure to real patients, it is questionable whether patients should continue to be used as a a˜taken for granted “teaching tool when alternative methods exist.

Aim
The aim of this pilot study was to gather professional healthcare educators perceptions of the ethical implications of using patients in clinical settings for the teaching of pre-registration health care students.

Methods and analysis
A purposive sample of professional healthcare educators attended one of two focus groups. Data was subject to thematic analysis and emerging themes were identified and coded.

Findings
Nurse educators had given limited thought to the ethical implications of the continued use of patients as a teaching tool for student nurses. Simulated clinical environments were considered secondary to the training experiences offered by real patients and many of the potential benefits of the simulated clinical environment had been overlooked. This study suggests that there is a need to re-evaluate how and when simulation techniques are utilised to support student nurse learning.

Embedding Human Patient Simulations: In Pursuit of Strategic and Business Planning Competence
Dr. Virendra Mistry
University of Glamorgan

Human Patient Simulations (HPS) represent a major step in the development of health sciences education. Primarily these learning technologies assist faculty leaders to address a a triple challenge”  to enhance the quality of the learning and teaching experience; to improve effectiveness and efficiency; and, possibly, to reduce costs in the medium to long term.

This presentation will discuss elements within a framework developed to assist faculty and departmental leaders understand the kinds of impact HPS will have on faculty/departmental missions, structures and operating practices. The framework assumes that a faculty’s effectiveness in the use of HPS for teaching and learning is a function of six inter-related elements: (1) understanding the external environment; (2) the faculty structures that support the application of HPS; (3) management and curriculum processes that facilitate the initiation, sustainability and success of HPS; (4) the way in which human resources are developed and deployed to support the implementation of HPS; (5) faculty strategy in relation to HPS; and (6) the characteristics of the HPS being applied.

The presentation argues that HPS are more likely to be embedded when all the elements are co-ordinated and are pulling together in the same direction, i.e. “a goodness of life."

Ask How? Ask Why?
Ian Ballard, Amanda Wilford
METI

This is a “drop in” workshop that is available for any new and/or current METI users.  Just drop by to ask any questions or clarify any points or if you just want to talk about how a METI simulator works.

Clinical Argumentation: Using the Virtual Hospital
Helen Gillanders, Teri Boese
International University of Nursing, Basseterre, St. Kitts

Due to the confines and availability of clinical experiences, it’s necessary to give students baseline, standardized clinical experiences. At the International University of Nursing in St. Kitts, we have designed ten simulations that graduate in acuity for the beginning students in foundations to the more advanced students taking care of clients in the hospital setting.

Students come to a virtual hospital experience that is designed to incorporate previously acquired skills and knowledge into the management of the care of a scenario based simulated patient or patients. They are expected to implement their plan of care incorporating assessment, prioritization and organization. Clinical faculty guide and direct students as they care for the simulated patient as they would in the hospital environment. During post conference, students present their patients to the clinical instructor and peers. This gives them the opportunity to review the care that they have  given the patient and receive feedback. The simulation is debriefed as participants reflect on the experience.

The audience will have the opportunity to participate in a scenario based virtual hospital experience in which they will care for simulated patients and take part in a follow up debriefing and reflection session.

The Human Factors De-brief
Neal Jones
The Cheshire & Merseyside Simulation Centre

Human factors training has been utilised by high risk industries for over 60 years, most notably in aviation and nuclear fuels.
Human factors can be identified as the elements of human behaviour that directly contribute to approximately 80% of error irrespective of professional domain.
The principle of the de-brief, is to provide a facilitated reflective learning environment following a simulated scenario, although it is equally valid as a mechanism for deconstructing real life error’s.

De-briefing is not the same as critiquing, it is not a passive process within which substandard elements of the delivery of patient care are identified by an instructor, instead it is an active process within which the student makes sense of the elements of their behaviour that led to error, and is supported through the mechanism of reflection.

Workshops Objectives:
•    To gain an understanding of the underpinning elements of human factors.
•    To identify the value of the human factors de-brief in preventing clinical error.
•    An overview of the art of delivering, a facilitated de-brief.
•    To gain an understanding of the dangers of an ineffective de-briefing process.

 

Improved Recognition of the Critically Ill Patient: an Interprofessional Approach to Simulation Training
Sarah Sibley
Bristol Medical Simulation Centre

Provisionally registered doctors now must demonstrate their competence and meet certain outcomes as part of the Foundation Programme Curriculum before full registration is granted.  At University Hospitals Bristol, F1 doctors attend the HELP course at the Bristol Medical Simulation Centre as part of their Foundation Programme.  The aims of the course relate to some of the outcomes they need to demonstrate in good clinical care and working with colleagues; improved recognition of the critically ill patient, immediate management of the critically ill patient and improved communication between all members of the clinical team to provide the best possible information and treatment.  The course can easily be applied to junior nurses improving their competence in these outcomes and their attendance provides an interprofessional learning opportunity.  This workshop will provide a course overview and demonstration of the simulated clinical experience.

Workshop Session C: Thursday 11:35 - 12:35

Integrating Theory and Practice During the Transition from Student to Qualified Practitioner
Alison Foster-Lill
The University of York

At York University we run a day-long simulated exercise, known as a “Coordinating Care” for third-year adult branch students, as they prepare to make the transition from student to qualified practitioner. This exercise is embedded within a module which aims to integrate the theory and practice of nursing and focuses on topics such as team-working, prioritising, time management and managing challenging situations. The simulated exercise takes place in the middle of the module with preparatory sessions prior to the exercise. During the exercise students spend half the day as a member of a nursing team, where they are required to organise, coordinate and deliver care to a group of patients and relatives, constituting their peers, academic staff and medium and high fidelity patient simulators. The other half of the day they spend as a patient, being cared for by their peers. The Coordinating Care exercise is filmed and this together with the feedback from the staff and students involved forms the basis of an evaluation and debrief.

Evaluation of the exercise suggests that students are able to address the learning outcomes of the exercise and to critically reflect upon their own practice. Findings also indicate that the exercise boosted student confidence.

Maintaining Competence in Clinical Practice
Matthew Moorse
St. George's Healthcare NHS Trust

Maintaining patient safety in a high tech environment noteable for it's high nurse/patient ratio is a challenge! It is difficult to imagine a way in which the competency of personnel can be assured reliably in such an environment.
This paper will present the unique contribution which can be made to maintaining patient safety and supporting the competence of nursing staff utilising medium fidelity human patient simulation.
Evidence will be provided as to the ways in which this model encourages practitioners ownership of their own learning and meets the cost constraints of such a dynamic, high pressure environment.

Simulation Philosophy and Practice on Simulator Patient Death Versus Survival
Melissa Pollard, Michael Nickerson
Exeter Hospital

Simulation is increasingly being used as an educational tool.  Simulation has many advantages in the educational process, including incorporating multiple pedagogical learning methods.  Advantages include the ability to learn skills in a safe and realistic environment utilizing a simulated patient situation.  This allows the learner to improve confidence, practice techniques, and utilize critical thinking skills.  In simulation scenarios, the patient status can change based on interventions made, or not made, by the learners.  There is controversy among simulation instructors on whether it is appropriate in some cases to allow the simulated patient to die at the end of a scenario. 
A descriptive study was done using an online survey.  The responses were from an international convenience snowball sample of 92.  A majority of simulation users did allow the simulated patient to die in some scenarios, but in most cases there were distinct incorporated outcomes objectives.
Simulation death is a controversial philosophical topic among users.  There are no identified prior research studies looking into the philosophies of incorporating death into simulation scenarios.  From this initial data, further suggestions for practice can be made.

Teaching Ethics Using Simulation - One Approach to Preparing Students for Practice
Amanda Wilford
METI

Traditionally mannequin-based simulation has been used for high dependency and critical care areas and this may only allow a minority of student nurses to gain experience using simulation.  A significant number of nurses once qualified practice in general care and/or community settings. A simulated clinical experience used in undergraduate nursing focusing on a patient with a chronic condition will be discussed that can be used to explore ethical dilemmas, communication and decision-making. This will be used to  illustrate how simulation can be incorporated into ethics in  an undergraduate- nursing programme.

Trouble Shooting: The Top Ten Tips for any METI Mannequin
Ian Ballard
METI

This interactive workshop will aid the new and established who uses METI Mannequins. Many practical suggestions will be shared to aid you as the simulation teacher/facilitator to maximise the learning with your students irrespective of level and professional background.

Maintaining Skills Using Simulation: The Pediatric Critical Care (PCC) Network Approach
Linda Daniel
Leeds Teaching Hospitals NHS Trust

The assessment, measurement and monitoring of physiological observations are important basic skills for all healthcare practitioners (1). However evidence suggests that some staff are unfamiliar with the full range of disturbances in physiology resulting in shortcomings in the recognition of the acutely ill child (2). Other factors such as failure to seek advice and poor communication contribute to patients not receiving timely or appropriate interventions (3). In response to this evidence recommendations nationally advocate a track and trigger systems to measure, monitor and record vital signs, alongside competencies for all practitioners to equip them with the knowledge to respond appropriately to abnormal values (4, 5). To meet these recommendations the Yorkshire and Humber PCC Network have implemented a region wide training program using an infant simulator to build upon the existing basic competencies of recognition and stabilization received during undergraduate training. These sessions promote multi-disciplinary working and are open to any practitioner that may be required to assist a team in the stabilization and management of the critically ill child. This workshop revolves around a paediatric scenario and the skills required when recognizing and responding to potentially life threatening situations.

Simulation from Conception and Beyond
Angela Hope, Stephen Prescott
Huddersfield University

Simulation as a teaching and Learning strategy has evolved dramatically over the past decade. Fuelled by the Fitness for Practice document (UKCC 1988) focus upon the acquisition of skills in the pre-registration nursing has been in the forefront of investment of resources within University clinical health environments. This investment has been supported by the accreditation of simulated practice (NMC 2007) promoting the incorporation of innovative and dynamic teaching strategies, supported by sophisticated high fidelity mannequins.
We aim to explore simulated practice from conception until the present day at Huddersfield, focussing upon the role that the meti team and products have played in our ongoing quest to emerge as a leading simulation centre of excellence within the region.
Further aims of the session will be to examine how simulated practice has allowed enhancement of the problem solving and critical thinking skills within the students and led to a restructuring of the examination procedures in order to integrate theory and practice and offer the current stance, and future plans at the University of Huddersfield.

Workshop Session D: Thursday 13:35 - 14:35

Evaluating the Use of Supraglottic Airway Devices by Paramedics Using a Part Trainer and High Fidelity Simulators.
Alan Jones, Colin Torrance
University of Glamorgan

In the past few years a range of supraglottic airway devices (SADs) have been introduced. SADs are used by anaesthetists to overcome some of the disadvantages associated with endotracheal intubation or when there are problems with intubation. Increasingly SADs are also being used by paramedics when endotracheal intubation fails. Currently paramedics in the UK are expected to perform 25 intubations during a hospital placement as part of their criteria for requalification. However, hospital placements may provide only limited opportunities to gain experience with using SADs as rescue devices for non-intubatable patients and for paediatric airway management. The Glamorgan Clinical Simulation Centre in collaboration with the Welsh Ambulance Service’s Pre-Hospital Emergency Research Unit (PERU) is evaluating practical and educational aspects of preparing paramedics to use SAD for problematic intubation in the field. Paramedics will be educated in the use of SADs using the AirSim (Trucorp) part trainer and METI high fidelity manikins. Preliminary results from this study focusing on ease of use, correct insertion and adequacy of ventilation will be presented.

The Use of Clinical Simulation in the Recognition and Management of the Seriously Ill
Michelle McKenzie Smith
Montagu Clinical Simulation Centre

The management of an acutely unwell patient can be incredibly stressful for all members of the multi-disciplinary healthcare team, not the least the patient and their family.
The re-creation of clinical events to simulate crisis situations, gives staff permission to manage that event, identify potential errors, investigate concepts behind effective leadership and teamwork, and provides a safe environment to explore strengths and areas for improvement in our own practice.
RAMSI allows multi-disciplinary candidates to utilise the systematic
A-B-C-D-E approach, to aid thorough patient assessment, enabling early recognition of potentially life threatening conditions.
Simulation is a modern innovation, which excels as an exciting educational tool on which to rehearse these essential skills within the multi-disciplinary team.

Ask How? Ask Why?
Ian Ballard, Amanda Wilford
METI

This is a “drop in” workshop that is available for any new and/or current METI users.  Just drop by to ask any questions or clarify any points or if you just want to talk about how a METI simulator works.

Planning a Simulation Capability
Dr. Matthew Cox
METI

METI currently manufactures 8 patient simulators and a range of peripheral tools. In this presentation the design philosophies of these systems will be discussed. An overview of the major considerations required in the planning of a successful simulation facility will provide the context needed to appreciate how these technologies can relax resource requirements.

Mobile Simulation - The Highest Fidelity Simulation Available
Nicholas Gosling
St. George's Healthcare NHS Trust

The purpose of this session will be to discuss and demonstrate challenges and strategies used in creating successful simulation teaching programmes within the clinical environment. St.George’s Advanced Patient Simulation Centre has experience of running mobile simulation for over seven years for multi-professional teams in their own clinical area using a combination of low, medium and high fidelity simulators. It is intended that during this workshop we will discuss these experiences identifying the key components of designing and setting up mobile simulation training.

Make-up, Moulage and Mannequins: What is the Real Value of Authenticity in Medical and Nursing Simulation
Colin Torrance, Keith Weeks and Jane Riddiford
University of Glamorgan

Terms such as fidelity and authenticity are widely used in the simulation literature and much is made of the importance of striving for “realism” when designing simulation learning. Medical manikins are increasingly being developed with additional features such as tears, cries, coughs, cyanosis etc. but remain somewhat plastic in appearance. Moulage can be used to add realism to trauma simulations and is extensively used in military and disaster simulations. However, there is little research into the benefits and costs of achieving authenticity and how it relates to learning outcomes. This paper will explore some of the theoretical and practical issues related to achieving realism in human patient simulation based education.

Cognitive Apprenticeship and Authentic Assessment: An Education Framework for Facilitating Learning and Assessment within High-Fidelity Simulated Clinical Environments
Keith Weeks, Norman Wooley, Peter Lewis and Colin Torrance
University of Glamorgan

Workshop description to come.

Poster Session: Wednesday 14:40 - 15:00
                            Thursday 11:10 - 11:30 and 13:00 - 13:30

Utilising On-Site Simulation to Reform Registered Nurse Education in Paediatric Intensive Care
Caroline Haines
Bristol Royal Hospital for Children

The widespread emergence of computer simulation in health education focuses primarily on the development of centres for simulation (SIM) (1, 2, 3).
We have established an on-site SIM programme within paediatric intensive care (PIC) for qualified nurses. The programme focuses specifically on nursing-care management within PIC, with the aim of improving competence and confidence. The programme allows nurses to be educated in a controlled and safe environment and offers true realism with nurses expected to utilise the equipment, clinical guidelines and resources available to them in every day practice.
METHODS
A programme of eight scenarios was developed with specific learning outcomes which focus on:
- Recognition of respiratory distress
- Removal of pacing wires and chest drains
- Log rolling a child requiring C-spine immobilisation.
- Arrest situation
- Professionalism
- Managing a complex child, focusing on prioritising care and team dynamics
-To ensure realism a senior nurse, a medical trainee and consultant also participate, with the senior nurse leading the debrief.
RESULTS
Over a one-year period 31 participants undertook the programme. Participant evaluation of the programme was undertaken using a 3-point likert scale together with qualitative analysis.
Although the programme is still in its infancy and requires wider evaluation, it identifies how on-site simulation can assist in developing the competence and confidence of PIC nursing staff. Although resource-rich and time-intense it is proving to be an invaluable approach to nurse education.

Evaluation of a Second Life Simulation with Student Nurses in a 3D World
M. Crossan, M. Honley, K. Connar, S. Diener, D. Bodily, M. Veltman
University of Auckland, Boise State University, Western Wyoming Community College

Virtual World applications are increasingly used to simulate environments that facilitate learning. This poster represents the interim findings of the first use of Second Life (SL) simulation within a School of Nursing. Three third year students participated in a post partum haemorrhage simulation where they assessed, then initiated care. Aim:
Evaluate Second Life as a learning medium that promotes and encourages problem-solving skills.

Design:
A clinical environment was digitally modeled. Students interacted with two lecturers; one the SL patient the second facilitating the simulation. A debrief followed where students reflected on their performance and lecturers provided feedback.

Findings:
- Students and lecturers found the experience positive.
- Some unexpected technological problems occurred.
- Students were proactive in familiarising themselves with SL.
- Communication between patient and students was effective.
- Better teamwork would improve their overall performance.
- The simulation was deemed really realistic Student immersion facilitated good patient assessment and problem solving capabilities to evolve; care initiated was safe and
Conclusion:
Second Life does provide a learning medium that promotes and encourages problem-solving skills. Students found the experience, positive, fun and safe.  The debrief prompted reflection and was deemed a valuable learning tool.

Simulation and the Linking of Cultural Care in Nursing
Dr. Michelle Dorin, Donna Wells
University of Phoenix

Cultural diversity is impacting healthcare and nursing education around the world, as practitioners are providing services to a wider range of patients and as nurse educators are teaching more diverse student bodies. No matter where one provides healthcare or educates nurses, there is a greater chance today that one will be exposed to a wide range of peoples. In order to be effective students, teachers and practitioners; healthcare professionals must understand how different cultures and practices impact their profession, with a specific concentration on the similarities and differences of how patient care is taught and performed. Professionals who understand these matters will not only have a more global perspective on healthcare, they will have a more concrete knowledge base of medical and cultural practices, possibly expanding evidence based practice. Collaboration between colleges of nursing who utilize simulation is one way to embark on this global education, where these institutions can examine identical case scenarios, compare care given, and highlight varying approaches to healthcare. The following poster presentation demonstrates how colleges of nursing from different countries can engage in such patient simulations and then, using advanced telecommunications services can collaborate on their practices and results.

Partnership Working: A Must for Innovative Simulation
Kate Goodhand, Caroline Wood
The Robert Gordon University

The provision of supportive, meaningful and challenging learning environments is central to enabling students to achieve their potential (The Robert Gordon University, 2004). Collaboration and partnership between education and practice are imperative to achieving this goal. The Robert Gordon University works in partnership with NHS Grampian to ensure that clinical skills teaching is relevant, innovative and delivered collaboratively to produce competent practitioners. For clinical skills sessions, practitioners teach with academics to ensure that the scenarios are realistic and relevant, that what we are teaching is current and the feedback is related to practice. We have developed a true partnership approach to simulation as advocated by NMC (2007).

This presentation will share our experience of partnership working to deliver simulation. We will discuss the collaborative approach to module development and the delivery of clinical skills in the timetable and how we ensure that an academic and clinician work in partnership to deliver our clinical skills based modules. We will also present some initial findings from a qualitative study that provides data from students and clinicians about the impact that this approach has upon their simulation experience. 

Directions to the Glamorgan Clinical Simulation Centre at University of Glamorgan, Wales.

View Larger Map