The Case Reflection Emergency Master Class

Melissa Hanson1, Kerralyn Buckman2, Judy Townsend3

1 Dubbo Base Hospital, Myall Street, Dubbo, N.S.W., 2830,
2 Dubbo Base Hospital, Myall Street, Dubbo, N.S.W., 2830,
3 Dubbo Base Hospital, Myall Street, Dubbo, N.S.W., 2830,

Reflection is an important facet of nursing, because it helps us as nursing professionals to analyse and evaluate our practice. It helps us to recognise those elements of excellent service provision, as well as areas for improvement. It provides for a wider scope of learning from these experiences. It is through this reflection that we as Emergency Nurses aim to continually improve the professional standards of nursing in our Australian Emergency Departments (ED).

The Case Reflection Emergency Master Class was developed for the Dubbo Base Hospital ED nursing employees in response to the need for reflection and education opportunities. It was designed to provide additional education and service improvement prospects within the Dubbo rural area, and further aims to expand these prospects to Dubbo’s outlying rural and remote peripheral services – the Western New South Wales Local Health District (WNSWLHD) – in view of its continuing success. The Case Reflection Emergency Master Class is an innovative model of education designed to maintain and enhance nursing knowledge and skills.

As nursing employees within the WNSWLHD, we know it can be difficult to access and participate in education and simulation-based learning opportunities due to a myriad of multi-faceted issues. Distance and isolation are all too real; resources are limited; and being able to get time off in order to attend education is often difficult due to a lack of staff in the first place. Most of the education and travelling involved are undertaken in nurses’ own time, and at their own expense.

That is where the Case Reflection Emergency Master Class steps in. Dubbed “Master Class” for short, it is Dubbo Base Hospital ED’s analysis session focussed on education and reflection. It involves the discussion of important cases that we see in our department – we talk about what we did well; what we can learn from; the background and patho-physiology of the case, and more. Think along the lines of a Morbidity and Mortality Meeting, only less formal, less confronting for nursing staff, and more targeted to nursing knowledge and performance.

The main aims of the Master Class are to:

  • Identify areas of strength, as well as areas of need;
  • Enable additional ED skill acquisition;
  • Improve clinical competency and confidence amongst ED nursing staff, and therefore as a result;
  • Improve health-based outcomes for all our patients.

The added benefit of this form of education is that we can review and learn about presentations that are classified as infrequent in nature. These types of presentations, for example, a major trauma or a paediatric cardiac arrest, require advanced skills and knowledge that may not be fully utilised regularly by nursing staff in rural and remote areas. The Master Class gives ED nurses the opportunity to learn and develop these skills, and practice them in a simulation-based environment without having to travel great distances, pay a great deal of money, and take significant time off work.


Melissa Hanson is an Advanced Clinical Nurse and the acting Clinical Nurse Educator in the Emergency Department of Dubbo Base Hospital. She has 5 years of experience in Emergency Departments within metropolitan and rural New South Wales. When she is not living and breathing emergency nursing, you’ll find her being a mum to her 3 babies aged 4 and under, baby-wearing one of her babies, or out on the family farm trying her hand at country life!