39 Development of a simulation based teaching day to support palliative medicine higher specialty trainees with the DOPS (direct observation of procedural skill)

<h3>Background</h3> In August 2022 the Palliative Medicine curriculum underwent changes in line with Shape of Training. Specialty Trainees in Palliative Medicine are expected to manage patients with spinal lines, a tracheostomy, indwelling pleural and peritoneal catheters and non-invasive ventilation within a specialised palliative or community setting, but not initiate these procedures themselves. It is acknowledged that exposure to these procedures and their problems are limited within palliative medicine training (and indeed as a consultant) therefore it is appropriate to use clinical skills labs to ensure exposure and competence in the above. <h3>Method</h3> This is a hybrid training day utilising the advantages of high fidelity simulation for a formative learning process in the morning and then a summative opportunity to assess the DOPs (direct observation of procedural skill) in the afternoon. The formative simulation process has the chance for group reflection, learning and exploration of human factors around these often complex clinical scenarios. The course is run at Montagu Simulation centre, an experienced centre of excellence to deliver simulation training with healthcare professionals. The course has been developed in conjunction with simulation experts, subject matter experts and specialty trainees and will undergo continuous development in response to feedback. <h3>Results</h3> Trainees rated their confidence levels from 1 ‘extremely’ to 5 ‘not at all’ confident for each procedure both before and after the simulation course. The average pre-course confidence score of 4.14 has improved to 1.77 in the post-course feedback demonstrating a significant improvement in how able candidates feel to manage these procedures and their complications. <h3>Conclusions</h3> Simulation has proved to be an effective way to expose trainees to important procedures that are otherwise infrequently come across and improve their confidence in managing these situations. The future includes opening this up to other medical professional working across specialist palliative care in non-training posts.