Article Text

Download PDFPDF

22 Simulating death: the practical way to identify undergraduates’ palliative care needs
  1. Elizabeth Marsh
  1. South Tees NHS Foundation Trust


Background Foundation doctors are expected to be able to provide interventions and support for patients nearing the end of their life,1 yet many feel underprepared to manage basic palliative care, with minimal first-hand experience of end of life issues.2 The aim of this project was to identify perceived gaps in confidence and knowledge and create a series of practical tutorials and simulation, focusing on areas important to students.

Method A programme was developed with South Tees NHS Hospital Foundation Trust Palliative Care Team focusing on: ‘Prescribing in Palliative Care’, ‘Care Near Death’ and ‘Practical Scenarios in Palliative Care’. Learning outcomes were identified through questionnaires completed by students and mapping to Newcastle University Medical School curriculum. Qualitative data was gathered before and after sessions to assess students’ understanding and perceived confidence. The sessions were delivered in the STRIVE academic centre in James Cook Hospital, Middlesbrough, with assistance from volunteers.

Results 10 students in their 4th or final year of medical school attended the sessions. Prior to the sessions, students were most confident in identifying symptoms near end of life, but all recorded low confidence in key aspects of palliative care, such as rationalising medication and communicating with relatives. All students’ confidence scores improved after the session, by 48% on average. All found the sessions ‘extremely helpful’ and found that being able to practise palliative care in a simulated environment was of notable value, in contrast to other teaching methods, with particular emphasis on the communication elements of the course.

Conclusion The sessions were perceived as valuable and felt from qualitative reflection to fill a gap in the current curriculum. Perception was undoubtedly biassed by the self selecting nature of the timing and voluntary attendance of the teaching. Session length may limit integration into existing curricula in current format. Further feedback is awaited from graduates to determine how the teaching impacted on their practice, which will help to consolidate and adapt the sessions.


  1. General Medical Council. (2019, June 12). Outcomes 2 – Professional skills. GMC.

  2. Bowden J, Dempsey K, Boyd K, Fallon M, Murray SA. Are newly qualified doctors prepared to provide supportive and end-of-life care? A survey of foundation year 1 doctors and consultants. Journal of the Royal College of Physicians of Edinburgh. 2013;43(1):24–8.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.