16 Do you think they are dying doctor? – The role of palliative medicine based simulation sessions in preparing newly qualified doctors for foundation training

<h3>Background</h3> Undergraduate education in palliative medicine is essential in preparing medical students for foundation training.¹ Questionnaires completed by FY0 students in the Northern Trust, due to commence foundation year1 (FY1) in August, highlighted a number of gaps in confidence and knowledge in their role in caring for the dying patient. Only 35.5% of students felt they understood their role in the care of the dying patient and only 16.1% felt they were confident in speaking to family members. Simulation teaching is known to offer students the opportunity to practice challenging skills in real life clinical environments.² Learning objectives included improving confidence and knowledge in prescribing, holistic assessment of a dying patient, judging appropriateness of interventions, communication with families and colleagues, and an awareness into personal limitations. <h3>Methods</h3> This project was piloted in the Northern Trust over 6 weeks, beginning with a lecture delivered to the 31 FY0s during their induction. Following this, each student attended 1 simulation session in groups of 4–7, in which we ran scenarios including opiate toxicity, agitation at end of life, handover to colleagues, and updating family. Each session finished with a prescribing workshop. <h3>Results</h3> Qualitative data highlighted the comfortable and supportive learning environment. Post teaching questionnaires highlighted that 93.3% felt they understood their role in the care of these patients and 80% felt confident in speaking to family members. The results emphasise the role for palliative medicine simulation in the preparation for FY1. Future focus for this project will involve a repeat questionnaire 3–4months into the beginning of FY1, to ascertain if learning has had a lasting impact on clinical practice, in line with Kirkpatrick model of training level-3,² and to identify potential areas of challenge not anticipated by the researchers that could be included in future simulation sessions. <h3>References</h3> Linklater GT, Bowden J, Pope L, McFatter F, Hutchison SM, Carragher PJ, Walley J, Fallon M, Murray SA, Scottish Palliative Medicine Curriculum Development Group. Developing learning outcomes for medical students and foundation doctors in palliative care: a national consensus-seeking initiative in Scotland. <i>Medical Teacher</i> 2014;<b>36</b>(5):441–446. Kozhevnikov D, Morrison LJ, Ellman MS. Simulation training in palliative care: state of the art and future directions. <i>Advances In Medical Education And Practice</i> 2018:915–924.