Article Text

Download PDFPDF

19 High fidelity simulation in end of life care as part of a simulated ward round for foundation doctors
  1. Lisa Boulstridge,
  2. Alicia Barnes and
  3. Victoria Knight
  1. Burton Hospitals NHS Foundation Trust


Background and Aims Foundation year doctors must achieve competency in palliative care outcomes. An end of life scenario in a high fidelity simulated ward round was designed and evaluated to gauge confidence levels in palliative care and quantify benefit derived.

Methods As part of trust induction Foundation Year 1 doctors (FY1) at Burton Hospitals NHS Trust undertake a simulated ward round with a palliative care scenario included. Newly qualified doctors assessed a patient with her distressed husband, commenced initial treatment and presented their case on the subsequent consultant post-take ward round. Training and orientation on local palliative care guidelines and resources followed. The benefit of this was assessed by anonymous questionnaire completed once the doctors had been in post for a month. They rated confidence in communication skills, managing symptoms, prescribing, decision making and holistic care approach.

Results 73% graded the exercise as highly beneficial. FY1 doctors confidence in the areas mentioned above ranged from 6.6 to 7.6 on a scale of 0–10. The weakest area was discussing DNAR with patients, while the strongest area was confidence with end of life medications and doses. Other low scoring areas all focused around communicating either with the patient or their family, and making decisions about appropriate care (6.8–6.9). Areas of confidence focused around clinical aspects of care including managing symptoms, medications and assessing patient‘s needs (7.0–7.4).

Conclusion FY1s find communication skills and difficult conversations challenging. There is room for improvement across all areas analysed in order to achieve high confidence levels. We will continue to address these with two further high fidelity simulation sessions which will be assessed for benefit and improvement against the baseline confidence levels. These results will also be presented. Ultimately our aim is to help the new doctors achieve their competencies and provide high quality holistic care.

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.