Palliative care simulation for internal medicine trainees: development and pilot study

Felicity Dewhurst, Kate Howorth, Hannah Billett, Jolene Brown, Maxwell Charles, Elizabeth Fleming, Craig Gouldthorpe, Amy Huggin, Emily Kavanagh, Rachel Kiltie, Lucy Robinson, Grace Rowley, Lauri Simkiss, Donna Wakefield, Elizabeth Woods, Deepta Churm, Rowan Warmsley, Kerry Waterfield

BMJ SUPPORTIVE & PALLIATIVE CARE(2021)

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Abstract
Objectives Shape of training has recognised that 'Managing End-of-Life and Applying Palliative Care Skills' is a key competency for internal medicine trainees. It provides the opportunity and challenge to improve palliative care training for generalist physicians. Simulation has been recognised internationally as a holistic teaching and assessment method. This study aimed to produce a palliative medicine simulation training package for internal medicine trainees for delivery by palliative medicine trainees providing the former opportunity to practice assessment and management of patients with life-limiting illness and the latter teaching and management opportunities. Methods A regional group of palliative medicine trainees were trained in simulation and debrief. Nominal and focus group techniques designed a simulation training package. Learning outcomes were mapped to the internal medicine curriculum descriptors. Results Palliative simulation for internal medicine trainees (PALL-SIM-IMT) is a training package meeting internal medicine trainees' curriculum requirements. Regional pilots have demonstrated feasibility for delivery by palliative medicine trainees and improvement in recipients' confidence in all curriculum descriptors. Conclusions PALL-SIM-IMT can aid competency achievement for the provision of generalist palliative care by internal medicine trainees. It allows reciprocal development of palliative medicine trainees' leadership and teaching skills. National adoption and evaluation is ongoing.
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Key words
education and training,terminal care,supportive care,clinical decisions,clinical assessment,communication
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