Simulation and getting the right person, with the right skills for the

right job in critical careMarion Mitchell

Associate Professor SONM, HPI, Griffith University & Intensive Care Unit

Princess Alexandra Hospital, Brisbane, Australia. 11th Congress of the Turkish Society of Medical & Surgical Intensive Care Medicine & 10th international Congress of World Federation of Critical Care Nursing, 12-15th November, 2014.

Project Aims

Team membersPetra Strube, Amanda Vaux, Nicky West, Anthony Auditore

Previous Practice

Behaviour Based RecruitmentBehaviour Based Recruitment

Based on principle that past behaviours will predict a

candidates' future behaviour and performance

Background

Objective Structure Clinical Examination (OSCE)

◦Under/post graduate ◦Medical students ◦Senior Medical Exams◦New Graduate Recruitment (but use skill stations)

• Assessing in role

Recruitment Obligations

Australian Public Service Act Concept of Merit (2008)

Panel should interpret ‘merit’ broadly:-

• Use tool not bias to local expertise

• Use selection technique relevant to role

• Interpret the potential of applicant with

relevant training

•Able to defend decision

• Consider other personal qualities(Queensland Government, 2011)

Clinical Nurse Position in Australia

Demonstrates:

1.Expert clinical care;

2.Supports application of best practice;

3.Leadership & education.

Panel preparation

OSCE Best Practice Guidelines • Developed for nursing students;• Provides theoretical foundation for scenario

development & assessment matrix;• Able to clearly identify desired skills & attributes.

Best Practice Guidelines

1. Focus on delivery of safe patient care;

2. Aspects most relevant to clinical practice;

3. Use of holistic marking guide;

4. Integrated rather than piecemeal;

5. Delivered in a manner clinically aligned;

6. Appropriately timed to skill levels;

7. Allow of ongoing integration of clinical skill.

(Nulty,et al., 2013)

1.Patient mannequin

2.Patient’s nurse

3.Doctor

4.2nd Nurse

5.Candidate

Assessment Criteria

Preparation for Applicants

Results

Total applications 27Total shortlisted for clinical scenario

11

Total successful 3

Applicants’ Experience

All applicants from first process invited to attend a feedback session

7 of 11 attended:-◦Acknowledge very different process;

◦Felt stressed at the time but felt was a fair and equitable way to assess;

◦Knew they had to be able to demonstrate abilities.

Recognised Barrier/ Concerns

1. Resources required: 1. Time,

2. Space,

3. Access to simulation equipment and trained staff,

2. Equity for external applicants.

Conclusion

• Simulation provided an innovative, valid and reliable way to identify competent performance in senior nurses in an ICU environment.

• The Simulation provided a relevant and appropriate simulated real-life situation where candidates displayed their ability to provide the crucial elements of a senior clinical nurse’s role.

References

• Queensland Government (2011). Recruitment and selection guidelines. Retrieved from www.health.qld.gov.au

• Mitchell, M., Henderson, A., Groves, M., Dalton, M., & Nulty, D. (2009). The objective structured clinical examination (OSCE); optimising its value in the undergraduate nursing curriculum. Nurse Education Today, 29, 398-404).

• Nulty, D., Mitchell, M., Jeffery, C., Henderson, A., & Groves M. (2011). Best Practice Guidelines for use of OSCEs: maximising value for student learning. Nurse Education Today, 31, 145-151.

• Walsh, W., Hill, P., & Koren, I. (2009). Objective structured clinical evaluation of clinical competence: an integrative review. Journal of Advanced Nursing, 65(8), 1584-1595.

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