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44 Palliative simulation for internal medicine trainees (PALL-SIM-IM): a nationally adopted education initiative in response to shape of training
  1. Kate Howorth,
  2. Kerry Waterfield,
  3. Felicity Dewhurst,
  4. Emily Kavanagh,
  5. Jo Brown,
  6. Hannah Billett,
  7. Elizabeth Fleming,
  8. Rachel Kiltie,
  9. Elizabeth Woods,
  10. Grace Rowley,
  11. Max Charles,
  12. Amy Huggin,
  13. Craig Gouldthorpe,
  14. Lucy Robinson,
  15. Charlotte Bryan and
  16. Lauri Simkiss
  1. North East Palliative Registrars Research Alliance (NEPRRA)


Background Shape of Training represents a significant change in postgraduate-medical-education. Internal Medicine trainees (IMT) must prove competency in 8 Clinical Capabilities in Practice (CiPs). CiP 8 Managing End-of-Life and Applying Palliative Care Skills represents an opportunity to improve palliative medicine education for generalists, however, the provision of the required education and training is also a significant challenge requiring consideration and innovation. Simulation has been recognised by the Joint Royal College of Physicians Training Board (JRCPTB) as a holistic teaching and assessment method.

Aim To produce a simulation training package for IMTs covering all components/descriptors of CiP 8 which can be effectively delivered by a combination of Palliative Medicine Trainees (PMTs), consultants, simulation technicians and teaching fellows. To enable IMTs to learn/practice required skills whilst PMTs address teaching and management curriculum competencies.

Methods The North East Palliative Registrars Research Alliance (NEPRRA) (a unique initiative ensuring all North East PMTs are involved in teaching/research projects) received simulation training and designed Palliative Simulation for Internal Medicine Trainees (PALL-SIM-IM) a package comprising scenarios mapped to IMT curriculum descriptors. Modification occurred based on feedback and new scenarios incorporated requirements unique to the COVID-19 pandemic.

Results PALL-SIM-IM has been effectively piloted in 6 sessions throughout the North-East, training 25 IMTs/equivalent. It has received excellent qualitative feedback. Quantitative data demonstrates significant improvement in competence in all curriculum descriptors following training. PALL-SIM-IM has been presented (on request) to IM Specialist Trainee Committees, Health Education England and the JRCPTB. PALL-SIM-IM has been requested by, distributed to and is to be adopted by 7 Health Education England training regions, Scotland and Northern Ireland.

Conclusions This educational initiative has successfully produced a nationally adopted simulation-based training package for IMTs to aid competency development in CiP 8, reducing duplication of work whilst allowing reciprocal development of PMTs’ leadership and teaching skills.

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