Background There is little published work regarding simulation training in end of life care for registered nurses. Simulation training offers the opportunity to learn in a safe environment, without compromising patient safety.

Methods Each simulation day covered five scenarios, written by Specialist Palliative Care Clinical Nurse Specialists (SPC CNS), based on real cases that ward nurses had reported difficulty in managing. Scenarios included seizures, pain, breathlessness, care planning in last days of life, breaking bad news on the telephone, and dealing with distressed relatives.

In each scenario there was an HCA in the room and a doctor available for telephone advice. The patient and relative were either played by the actor or the ‘SimMan’. The candidates participated in pairs and the remaining candidates observed via video-link.

The subsequent debrief utilising ‘The Diamond’ model was led by a Palliative Medicine Consultant and SPC CNS. This model encourages description, analysis and application of learning in a non-judgemental way.

Results Pre and post-simulation day feedback was collected via a 1 - 5 scale and revealed:

• confidence to manage physical symptoms increased (3.15 vs 4.25)

• confidence in communication increased (3.3 vs 4.24)

• candidates learnt something new from the day (free text)

• scenarios were rated as useful/very useful

• confidence with simulation training was unchanged (3 vs 3)

Conclusion High fidelity simulation training for registered nurses in an acute hospital is an effective way to teach palliative/end of life care skills. Registered nurses are keen for simulation training to be integrated into end of life care education.