1234 Reflecting on attitudes and experiences of clinicians. The qualitative interview journey when building immersive education

<h3>Background</h3> Good communication to facilitate advance care planning can support care that meets person and family needs at the end-of-life (EoL). Discussions about advance care planning are not always delivered in a timely manner and may be ineffective or of poor quality. There is increasing recognition for the need of person-centred, EoL care communication for patients and their families with life limiting illnesses. We explored the experiences and needs of medical, nursing, and allied health staff to inform the development of a multi-component intervention to improve communication and shared decision making for persons at end-of-life. The content will be based on the research findings. The intervention will include an online learning package with training videos showing novice and skilled responses and simulation lab training using AI-driven conversational agents, and virtual reality to practice and refine communication strategies. <h3>Method</h3> 20 qualitative interviews were conducted with medical, nursing, and allied health in a large, urban hospital in New South Wales, Australia. The semi structured interviews allowed for discussions which reflected on professional and personal experiences of the participants and how these shape interactions for the future. Interviewees varied in years of experience, specialty, and gender. <h3>Findings</h3> The findings showed senior clinicians feel burden for fear of making errors. Therefore, often focus on treatment and length of life rather than quality of life, timing and prognostication. This over-medicalisation can lead to poor advance care planning and unwarranted costs associated with over diagnosis. This medical model is supported by a hierarchical bureaucracy which discourages junior clinicians from engaging in EoL care matters and reduces their agency and confidence. Junior clinicians frequently learn on the job and perpetuate these processes and behaviours. Clinicians identified a need for early and frequent EoL conversations with clinicians, patients and families. All interviewees described a demand for formal, supportive and ongoing education initiatives in EoL care. <h3>Unique Contribution/Implication!</h3> Interview findings provide valuable insights that will help ensure the intervention is tailored to specific context, addressing the complex and sensitive nature of EoL communication. By focusing on key areas such as goals of care, resuscitation plans, organ donation, and voluntary assisted dying, clinicians will have the opportunity to repeatedly practice these challenging conversations. This approach not only enhances their confidence but also reduces peer vulnerability, ultimately empowering them to engage in these important discussions with skill and compassion, leading to better outcomes for both patients and healthcare providers.