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P-242  Junior doctors caring for the dying: a pilot of peer-peer teaching improves confidence in end-of-life care
  1. Simon Haslam1,2,
  2. Alice King1,2,
  3. Caroline Pinckney1,2,
  4. Rameshwor Sunar1,2 and
  5. Becky Baines1,3
  1. 1Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  2. 2Joint first authors
  3. 3Hospiscare, Exeter


Background The National Care of the Dying Audits have described a need for improvements in end-of-life care in hospitals and highlighted the need for further training for doctors of all levels of seniority. Junior doctors (JDs) are often at the front line of end-of-life care and are well placed to address issues.


  • To identify the challenges for JDs when they are providing end of life care in hospitals.

  • To address these through training and quality improvement methodology.


  • Electronic questionnaire to all Foundation Years (FY) JDs working within one medium sized UK teaching hospital.

  • Peer-to-peer teaching on core topics including use of case-based discussions.

  • Simple rating of confidence in managing patients at the end of their lives on 10-point scale, before and after sessions.

  • Mentoring for the peer educators from a palliative care consultant.

Results 21 FY Doctors responded to an electronic questionnaire. Their main needs for education were: help with recognising the dying patient, symptom control, nutrition and hydration issues, and communicating management decisions at the end-of-life.

Two lunchtime sessions were delivered to cover these issues. Attendance was on a voluntary basis. Mixed teaching methods were used: short presentations on key topics and case based discussions. A total of 15 JDs attended one or both sessions.

Mean self-rated scores of confidence in managing patients at the end of life improved:

  • 2.4 points for those attending 2 sessions (n = 5)

  • 3 points for those attending 1 session (n = 9)

Further training in communication skills was highlighted as key by many JDs.

Conclusion Short mixed methods lunch time sessions attracted good voluntary attendance and improved confidence in JDs caring for those at the end of life. Practical tips – both for prescribing and communication were highly valued. Further lunchtime communication skills sessions are planned.

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