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Press release

New virtual patient simulation to improve cultural representation in Australian nursing education

Australia | August 30, 2023

A new Digital Clinical Experience is set to improve cultural representation in healthcare education and will encourage empathetic and inclusive care by student nurses in Australia and New Zealand 

Aboriginal and Torres Strait Islander and Māori populations in Australia and New Zealand will be represented in the launch of Shadow Health, a new simulation teaching tool by Elsevier. 

Australian nursing students can now practice and apply clinical reasoning skills and therapeutic communication through realistic interactions with a range of virtual patients of different cultures, nationalities and ethnicities. The impact of Shadow Health for Australia and New Zealand means that the next generation of healthcare providers are more equipped to promote and deliver culturally safe care across the region.  

Elsevier worked closely with a team of clinical, cultural, and educational experts to build Shadow Health for Australia and New Zealand, aligning to relevant curricula and the Australian Nursing & Midwifery Accreditation Council and the Nursing Council of New Zealand’s standards. To ensure the product was culturally appropriate, the Elsevier development team partnered with four independent cultural consultants and DE&I consulting firm Watson Nelson Consulting to create accurate virtual First Nations and Māori patient scenarios. Nursing students will treat and develop a rapport with two Indigenous patients: Allyra Watts, a 25-year-old of Aboriginal, First Nations Wiradjuri descent, who presents to the hospital suffering from abdominal pain and in need of an assessment; and Nikau Kahoro, a 44-year-old of Māori descent, who presents to the outpatient clinic for a cardiovascular risk assessment. 

Michael Tully, Country Director – ANZ at Elsevier, said: “We are so excited to bring Shadow Health to Australia and New Zealand to help better prepare nurses to care for patients. We want nurse educators and students to feel more confident about treating Aboriginal and Torres Strait Islander patients in Australia and Māori patients in New Zealand after using Shadow Health. Ultimately, our goal is to use our next-generation technology to arm future healthcare providers with the tools needed to provide quality, culturally sensitive care and create better patient outcomes for all people.” 

As the importance of culturally appropriate care for Aboriginal and Torres Strait Islander and Māori communities in Australia and New Zealand continues to gain recognition, simulation learning tools provide a modern and unique opportunity to upskill healthcare professionals in a culturally safe environment. 

Kayla Cartledge, Gurindji, founder of Our Songlines, and Cultural Consultant, said, “It is so important that Aboriginal and Torres Strait Islander people feel included and understood when receiving care, especially in closing the health equity gap from those of their non-Indigenous peers. Shadow Health was designed to do this by creating a deeper understanding of the complexities and values of Aboriginal people in Australia through a teaching tool. And, when healthcare providers are better informed, they can provide better care. By creating a place of understanding, Aboriginal and Torres Strait Islander people will feel more accepted in the healthcare system and feel more comfortable accepting care.” 

In Australia, a long history of racism and discrimination exists for Aboriginal and Torres Strait Islanders, which has resulted in poorer patient healthcare outcomes. The burden of disease for Aboriginal and Torres Strait Islander people is 2.3 timesopens in new tab/window that of non-Indigenous Australians, and access to health services for Indigenous Australians is reduced due to cost and lack of accessible or culturally appropriate health services. 

Elsevier is dedicated to addressing prevalent bias in the healthcare field and providing resources to create culturally competent nurses and healthcare professionals globally. This is one step towards creating a more empathetic and inclusive nursing workforce in Australia and New Zealand, and in turn, creating positive outcomes for patients in need.  


About Shadow Health 

Shadow Health is a web-based teaching and learning platform that allows students to practise essential nursing skills in a realistic, safe and standardised virtual environment. Its cutting-edge simulations, powered by Shadow Health's Conversation Engine, help students develop therapeutic and empathetic communication skills through meaningful interactions with a diverse cast of Australian and New Zealand patients. Students perform interviews and physical assessments of increasing complexity, practise documentation and demonstrate their clinical reasoning skills while caring for patients with diverse medical and personal histories.  

To learn more about Shadow Health and its value for students and educators, please visit our Shadow Health page.  

About Elsevier

As a global leader in scientific information and analytics, Elsevier helps researchers and healthcare professionals advance science and improve health outcomes for the benefit of society. We do this by facilitating insights and critical decision-making with innovative solutions based on trusted, evidence-based content and advanced AI-enabled digital technologies.

We have supported the work of our research and healthcare communities for more than 140 years. Our 9,500 employees around the world, including 2,500 technologists, are dedicated to supporting researchers, librarians, academic leaders, funders, governments, R&D-intensive companies, doctors, nurses, future healthcare professionals and educators in their critical work. Our 2,900 scientific journals and iconic reference books include the foremost titles in their fields, including Cell Press, The Lancet and Gray’s Anatomy.

Together with the Elsevier Foundationopens in new tab/window, we work in partnership with the communities we serve to advance inclusion and diversity in science, research and healthcare in developing countries and around the world.

Elsevier is part of RELXopens in new tab/window, a global provider of information-based analytics and decision tools for professional and business customers. For more information on our work, digital solutions and content, visit

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Shane Cartlidge

E-mail Shane Cartlidge