According to a recent study from Brighton and Sussex Medical School (BSMS) and published in BMJ Supportive & Palliative Care, simulating the care of a dying patient and their family can increase medical students’ confidence and readiness to offer such care.
As soon as the simulations were over, student confidence in speaking with dying patients and their families nearly doubled (98% increase). The confidence in patient management rose by 66.2%, while the confidence in interdisciplinary collaboration rose by 48.4%. When confidence levels were reassessed six months later, the gains were still present.
Qualitative assessments of preparation showed that students wanted more hands-on instruction in the care of dying patients and felt more equipped to do so after participating in the simulation.
The study’s lead author, Dr. Geoff Wells, a ST6 Registrar in Palliative Medicine at University Hospitals Sussex NHS Trust and an Honorary Clinical Lecturer at BSMS, notes that fresh out of medical school Foundation Year 1 trainees “can feel anxious, poorly prepared and unconfident in providing care for dying patients.”
Our research revealed that medical students’ confidence increased noticeably following a series of simulation sessions and persisted six months later.
Eight half-day simulation sessions involving a hi-fidelity mannikin (with pulse, breathing noises, and chest motions) to depict an unconscious, dying patient and an actor to portray a family member were conducted for Year 4 pupils at BSMS. A variety of scenarios were performed, some of which involved the patient’s demise.
Dr. Wells said, “They “It is well established that simulation is a useful teaching tool in many areas of medicine, especially in treating urgent situations. There are similarities between the two circumstances in that you have a limited amount of time to give adequate and competent professional care for a dying patient and only one chance to get it properly.”
The patient would die peacefully and any unmet palliative care needs would have been taken care of, which, in the end, is how we think that incorporating simulation into palliative care teaching will lessen distress among junior doctors.
The success of this study has led to the inclusion of these simulations in the BSMS undergraduate curriculum, allowing all students to benefit from the ability to learn through simulated care of the dying scenarios. Additionally, it will open up a lot of doors for future research with a lot more participants.