Introduction Approximately 1 in 3 patients currently in hospital is in their last year of life. Palliative care is a neglected part of medical education (Charlton, 2008)2. A majority of junior doctors do not feel well prepared to deliver palliative care (Bowden et al, 2013)1 and report high levels of psychological distress when doing so (Linane at al, 2019)4. Recommendations have been made for palliative care simulations to influence medical student teaching (Koheznikov et al 2018, Price and Schofield 2015, Wells et al 2019, Wells et al 2022).3,5–7
Method Pall-Em (a palliative emergencies study day) was advertised as free for local junior doctors to Coventry and Warwickshire in May 2022 via social networks. 10 candidate spaces were created and successfully filled with an attendance of 8 on the day. The teaching content focused on simulation scenarios and how the ABCDE approach may differ for a palliative patient. An anonymous pre course knowledge questionnaire and post-course knowledge questionnaire was filled in by each candidate.
Results Results showed an increase in candidates’ confidence and knowledge with all candidates recommending the course. Candidates noted that their knowledge improved in palliative care by 47% and improved their confidence in managing palliative care emergencies/terminal events by 85% with all participants in agreement that they would recommend the course to other practitioners.
Conclusion There is a real need, value, appreciation and benefit for junior doctors to develop skills and a holistic competency in palliative care emergencies. Pall-Em has been proven to create a safe and effective model for healthcare professionals to become competent in recognising a dying patient and providing the best possible care.
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. The Journal of the Royal College of Physicians of Edinburgh. 2013;43(1):24–28. DOI: 10.4997/jrcpe.2013.105. PMID: 23516686.
Charlton R, Currie A. A UK perspective on worldwide inadequacies in palliative care training: a short postgraduate course is proposed. Am J Hosp Palliat Care. 2008;25(1):63–71.
Kozhevnikov D, Morrison LJ, Ellman MS. Simulation training in palliative care: state of the art and future directions. Adv Med Educ Pract. 2018 Dec 7;9:915–924. doi: 10.2147/AMEP.S153630. PMID: 30574008; PMCID: PMC6292390.
Linane, H., Connolly, F., McVicker, L. et al. Disturbing and distressing: a mixed methods study on the psychological impact of end of life care on junior doctors. Ir J Med Sci, 2019;188: 633–639. https://doi.org/10.1007/s11845-018-1885-z
Price, S., Schofield, S. How do junior doctors in the UK learn to provide end of life care: a qualitative evaluation of postgraduate education. BMC Palliat Care, 2015;14: 45. https://doi.org/10.1186/s12904-015-0039-6
Wells G, Llewellyn C, Hiersche A, et al. Care of the dying – medical student confidence and preparedness: mixed-methods simulation study. BMJ Supportive & Palliative Care Published Online First: 18 July 2022. doi: 10.1136/spcare-2022-003698
Wells G, Montgomery J, Hiersche A. Simulation to improve medical student confidence and preparedness to care for the dying: a feasibility study. BMJ Supportive & Palliative Care Published Online First: 28 August 2019. doi: 10.1136/bmjspcare-2019-001853
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