Aims To explore medical students’ experiences of communicating with patients and relatives about death and dying and their responses to communication skills training using high-fidelity simulation.
Methods This qualitative study was carried out at a hospital in the south of England with seven final year medical students. Tutorials were developed using high-fidelity simulation to teach communication skills in discussing cardiopulmonary resuscitation. Scenarios involved a simulated ward environment, a high fidelity mannequin and an actor as the patient’s relative. The scenarios were observed through a video link by other students and a facilitator. Data was collected through joint interviews which were audio recorded and transcribed verbatim, then analysed using framework analysis.
Results Students reported few opportunities to observe consultations regarding end of life issues or to interact with dying patients and their relatives. Barriers reported included healthcare professionals’ and patients’ attitudes to students observing consultations about death and dying. This led to a lack of confidence and preparedness to have these conversations as junior doctors. Students reported that the high-fidelity simulation scenarios were more realistic than low-fidelity (role-play) scenarios and improved their preparedness to have conversations about death and dying with patients and families.
Conclusions This study has suggested that students lack confidence and are underprepared to communicate with patients and relatives about death and dying as junior doctors. High fidelity simulation may be a useful tool for communication skills training, but further studies are needed to explore the feasibility and cost-effectiveness of this teaching method.