High fidelity simulation – a novel approach to end of life teaching

Abstract

Background The hospice model of care is the model of excellence for delivering high quality care to dying patients. However, only a small number of patients in the UK actually die in a hospice with the majority of patients dying in hospital. The major challenge faced by specialist palliative care services has been the transfer of best practice from the hospice setting to other care settings. At the Hollier Simulation Centre an end of life course has been developed for band five and six nurses within the acute trust, using the novel teaching modality of high fidelity simulation. High risk industries such as aviation and the armed forces have been using this type of simulation as an integral education tool for years and using this form of teaching to train healthcare professionals is becoming increasingly common. Aims The study aimed to look at what impact high fidelity simulation teaching had on the participants' confidences and their perception of their knowledge and skills in end of life care. Method The study used a mixed method approach with a combination of pre and post course focus groups and pre and post course questionnaires. Two separate cohorts were used for this study. Results Using thematic analysis, the focus groups' transcripts were analysed. Free text from the questionnaires was used to support the focus group analysis. Conclusion Using high fidelity simulation to teach end of life care did have an impact on the participants' confidence, knowledge and skills. Participating in the scenarios was felt to be more beneficial then didactic teaching. This course allowed the study groups to both participate and observe their peers in the scenarios. The facilitated debrief sessions were found to be beneficial and the participants felt they learnt a number of new skills within these sessions from their peers.

Does simulation have a role in palliative medicine specialty training?

“…These reflect a trend towards using high-fidelity simulation to teach generalist nurses how to manage patients at the end of life including symptoms and communication, showing this can improve confidence and knowledge25 26 and the value of a facilitated debriefing to allow reflection and peer teaching 27 28. Similar models have been used to teach end of life care to first year nursing students, and found that compared to traditional teaching, high-fidelity simulation meant students were better prepared emotionally and in terms of ‘hands on’ skills for their first placement 29…”