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Palliative care simulation for internal medicine trainees: development and pilot study
  1. Felicity Dewhurst1,2,
  2. Kate Howorth3,
  3. Hannah Billett3,
  4. Jolene Brown2,
  5. Maxwell Charles3,
  6. Elizabeth Fleming3,
  7. Craig Gouldthorpe3,
  8. Amy Huggin3,
  9. Emily Kavanagh3,
  10. Rachel Kiltie3,
  11. Lucy Robinson1,4,
  12. Grace Rowley3,
  13. Lauri Simkiss3,
  14. Donna Wakefield5,
  15. Elizabeth Woods3,
  16. Deepta Churm4,
  17. Rowan Warmsley4 and
  18. Kerry Waterfield6
  1. 1Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
  2. 2Palliative Care, St Oswald's Hospice, Newcastle, UK
  3. 3Palliative Medicine, Health Education England North East and North Cumbria, Newcastle upon Tyne, UK
  4. 4Palliative Care, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
  5. 5Palliative Care, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK
  6. 6Palliative Care, Gateshead Health NHS Foundation Trust, Gateshead, UK
  1. Correspondence to Dr Felicity Dewhurst, Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK; drfelicitywerrett{at}


Objectives Shape of training has recognised that ‘Managing End-of-Life and Applying Palliative Care Skills’ is a key competency for internal medicine trainees. It provides the opportunity and challenge to improve palliative care training for generalist physicians. Simulation has been recognised internationally as a holistic teaching and assessment method. This study aimed to produce a palliative medicine simulation training package for internal medicine trainees for delivery by palliative medicine trainees providing the former opportunity to practice assessment and management of patients with life-limiting illness and the latter teaching and management opportunities.

Methods A regional group of palliative medicine trainees were trained in simulation and debrief. Nominal and focus group techniques designed a simulation training package. Learning outcomes were mapped to the internal medicine curriculum descriptors.

Results Palliative simulation for internal medicine trainees (PALL-SIM-IMT) is a training package meeting internal medicine trainees’ curriculum requirements. Regional pilots have demonstrated feasibility for delivery by palliative medicine trainees and improvement in recipients’ confidence in all curriculum descriptors.

Conclusions PALL-SIM-IMT can aid competency achievement for the provision of generalist palliative care by internal medicine trainees. It allows reciprocal development of palliative medicine trainees’ leadership and teaching skills. National adoption and evaluation is ongoing.

  • education and training
  • terminal care
  • supportive care
  • clinical decisions
  • clinical assessment
  • communication

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  • Contributors All authors were responsible for study conception and design. All assisted with the creation, delivery and evaluation of the educational package. FD, KH and KW were responsible for data analysis. All authors were responsible for data interpretation, manuscript writing and final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.