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12 Is simulation an effective way to teach palliative medical emergencies to specialist trainees?
  1. Samuel Krauze and
  2. Fiona Wiseman
  1. Northampton General Hospital NHS Trust, Northamptonshire Healthcare NHS Foundation Trust


Background Simulation is increasingly being used to train those in ‘acute’ medical specialties, offering the chance to practice in a safe environment, without compromising patient safety. It lends itself particularly to infrequently occurring situations which are potentially life-threatening. Its use in palliative medicine is mainly limited to advanced communication skills – there is little published work regarding its use for acute clinical skills.

Methods A simulation day was arranged for eleven palliative medicine specialist trainees in the East Midlands. This covered five scenarios (hypoglycaemia, opioid toxicity, acute left ventricular failure, massive haemorrhage and anaphylaxis) from the specialty training curriculum for palliative medicine. In each scenario trainees took part in pairs, the ‘patient’ being an actor, or the ‘SimMan’ manikin. There was a nurse and HCA present in each, and an actor playing a relative was present in three of the scenarios. Each was observed by the consultant present. The trainees not taking part watched events unfold via video-link. Feedback was led by the consultant present, with input from an acute medic. There was group discussion with all trainees present. The consultant completed ‘mini-CEXs’ for each trainee in the scenario.

Results Pre and post-simulation day feedback was collected via a 1–5 scale (1=strongly disagree, 5=strongly agree), and showed:

  • They felt their clinical knowledge increased (3.5 vs 4.0)

  • They felt their confidence increased (3.6 vs 4.1)

  • They felt they would learn/had learnt something new from the day (4.3 vs 4.7)

Free text feedback explained that trainees felt it was a fun and effective way to learn, and that it was especially beneficial to have other members of the multidisciplinary team present, and to receive feedback from acute medics.

Conclusion Simulation seems to be an acceptable, enjoyable, and effective way to teach palliative medical emergencies. Trainees are keen for simulation to be incorporated into their training.

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