25 Developing a unified palliative care simulation course for foundation and internal medicine trainees

<h3>Background</h3> Simulation training (SIM) is integrated into mandatory training for foundation doctors (FDs) and internal medical trainees (IMTs). Traditionally, SIM focuses on acute life-threatening events. Increasingly SIM is used to develop skills in management and anticipation of palliative emergencies. In recent years, palliative SIM has gained recognition as an important curriculum element in the development of IMTs but does not have the same role within other trainees’ curriculums. <h3>Methods</h3> Inspired by PALL-SIM-IMT1, we sought to develop a simulation package that could be applied to both FDs and IMTs. By taking a unified approach, we aimed to be able to simulate more realistic ward-based situations but also provide an opportunity to engage with FDs who in the future would move into other specialties. In designing this package, we’ve consulted FDs, IMTs and local palliative care teams to understand the development needs through the use of an online survey as well as individual discussions with education leads. This helped us design a program which was practically applicable to both FDs and IMTs. We focused on only 2 scenarios (opiate toxicity and agitation) and had the group run the same scenarios multiple times to provide a chance to practice what they had learnt. We ran an internal trial day in the trust’s simulation suite to help devise realistic scenarios. The opiate toxicity scenario was based on recently published trust guidance. <h3>Results</h3> We ran 3 half-day sessions. Data was collected with pre and post surveys. Confidence in managing palliative emergencies increased from 50% to 75%, there was an increase in confidence in accessing guidelines and all participants found the sessions useful. <h3>Conclusions</h3> The project has cemented the role of SIM within palliative care, we will continue to develop and refine the training package and expand its use within our trust.