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O-11 Managing dying: multimedia end of life care simulation training for medical undergraduates
  1. Robert Brodrick,
  2. Deirdre Cijffers,
  3. Anna Spathis,
  4. Annabel Price and
  5. Stephen Barclay
  1. The University of Cambridge School of Clinical Medicine, Cambridge University Press and Assessment


Background and Introduction UK medical students consistently report feeling unprepared to look after patients in their last days of life.1 Junior doctors trained in the UK also frequently lack confidence in this key area of practice, in part due to a scarcity of undergraduate exposure to dying patients and associated decision-making.2 The COVID-19 pandemic has further reduced medical student opportunities to be involved in the care of dying patients and their families.

Method We created a novel multimedia simulation, with participants playing the role of a F1 doctor managing a patient with advanced pancreatic cancer. We filmed actors in a replica ward environment to play the parts of the patient, their partner, a registered nurse, and a medical registrar. The final resource contained 48 video clips, 64 audio files, more than 200 pages of text, plus bespoke media items such as photographs, blood tests, and imaging results. The scenario was designed to unfold differently for each of the participants, depending on their individual decisions. This allowed them to make clinically significant mistakes in a safe way. In addition, real-time feedback was built in to optimise learning from patient assessment choices, medication rationalisation, anticipatory prescribing, and charged clinically assisted hydration discussions.

Results 164 final year medical students at the University of Cambridge completed Managing Dying in November 2020. Feedback was strongly positive, with several students reporting it was one of the most valuable learning experiences of their entire six-year course. Following completion, 92% of students reported feeling more confident about managing dying patients in the future.

Conclusion Multimedia simulation can be an effective means of delivering undergraduate palliative care training. The format is particularly suited to providing students with experiences that are challenging to access otherwise, such as making patient-specific end of life care management decisions.


  1. Wells G, Youssef E, Winter R, et al. Medical student confidence in care of the dying and their family: a systematic review. BMJ Supportive & Palliative Care 2021;11:233–241.

  2. General Medical Council. Working in partnership to improve doctors’ preparedness for end of life care. Education and Training Advisory Board. 24 May 2016. Available at:

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