Background High Fidelity Simulation Training originates in the aviation industry and has been shown to improve safety. Within healthcare, it is increasingly utilised to reproduce clinical situations and train multi-disciplinary professionals in technical skills and human factors. A fundamental role for clinicians of all disciplines, is the provision of end of life care. However limited work has been undertaken within the UK to develop the high fidelity simulation training model within Palliative and End of Life Care. Collaborative work between the Heart of England Hospital Palliative Care Team and the Hollier Simulation Centre has begun to explore the role of simulation training in end of life care.

Methods During 2010, a pilot of six 1-day courses were undertaken for hospital nurses. A simulated ward provided an accurate clinical environment within which participants could monitor, investigate and treat a sophisticated patient mannequin in real time. In addition role-play of trainers enabled realistic interaction with other healthcare professionals and relatives. Appropriate signs and symptoms were replicated including pain, breathlessness, vomiting, distress, respiratory secretions, agitation and bleeding. Participants were facilitated to develop skills in symptom control, advanced care planning, hand-overs and communication. Evaluation was undertaken via participant questionnaires completed before and after the course. Visual analogue scales enabled nurses to rate their confidence in performing aspects of end of life care.

Results The confidence of nurses increased in all areas of end of life care, demonstrated by increased mean visual analogue scores after the course. Free text responses indicated that nurses were apprehensive about undertaking simulation training but felt it was extremely effective.

Discussion Following the success of the pilot, end of life care simulation courses are continuing within the Heart of England Trust and work is in progress to extend the model of simulation training to hospice staff and primary care clinicians.