P-55 High fidelity simulation training in end of life care; one chance to get it right

Abstract

Background High fidelity simulation uses technologically-advanced manikins to simulate complex clinical situations to train professionals in technical skills and human factors in a multidisciplinary group. We have expanded the use of simulation training (SIM) to educate about end of life care (EOLC). Aims To evaluate the impact SIM training at Epsom and St Helier University Hospitals NHS Trust (ESTH) has on participant confidence, understanding and skills in EOLC and their perception of their role in end of life care. Methods A 1 day end of life care course was initially designed by The Simulation and Interactive Learning Centre at Guy’s and St Thomas’ Hospital and subsequently delivered twice at ESTH. The ESTH Team adapted the scenarios and held a further 6 courses from January 2015 to June 2016. Five scenarios covered subjects including the 5 priorities for care of the dying person, individualised care planning, cultural beliefs, the Mental Capacity Act, compassion and communication. The courses took place in the Simulation Centre, allowing a realistic ward or home setting, utilising a professional actor to enhance the scenarios. Participants were given pre and post course questionnaires with free text sections. Information from these was used to identify themes. Results 63 nurses and doctors of varying seniority attended the courses. Over half of the participants had worked in the NHS for at least a decade. Analysis of the data revealed that high fidelity simulation had a significant impact on the participants’ confidence, understanding and skills in EOLC and their perception of their role in EOLC. Additionally, the free text sections identified learning in patient centred care, communications skills, honesty and the importance of cultural factors. Conclusion Use of high fidelity simulation to teach EOLC had a positive impact on the participants. We are now looking to expand the course into community settings.