Background/context Neonatal Intensive care is a high-risk clinical area, involving critical events requiring time critical decision making. In 2012, 2.8/1000 neonatal deaths occurred.1 Individual exposure to these events is infrequent. Research suggests senior trainees feel unprepared when faced with the decision to discontinue resuscitation or focus on the palliative care needs of their patients.2 However, clinical simulation in cancer and palliative care indicates improved confidence, awareness and communication.3
We investigatedwhether exposing a group of senior paediatric trainees (ST6–8) to a simulation scenario involving cessation of resuscitation and breaking bad news as a single experience changed attitudes or behaviour.
Methodology This immersive hybrid simulation consists of resuscitation, as per Resuscitation Council guidelines4 and breaking bad news, followed by debriefing of both components. Candidates do not know the infant will die. This is important in simulating stress and emotional aspects. Candidates were asked to complete a questionnaire one month following the simulation to evaluate the impact of this experience on their practice.
Results/outcomes We will share the candidate evaluation of this experience and whether it has altered their behaviour in practice, and will report on their perceptions of the simulation experience with the focus on maintaining a safe environment.
Potential impact Many senior trainees lack experience and confidence in relation to handling death2. The loss of a child is devastating for parents. How practitioners communicate at this time is of paramount importance. Simulation allows trainees to use prospective reflection to explore the situation before they encounter it within clinical practice. This simulation exposes practitioners to these infrequent time critical events, aiming to reduce anxiety and improve performance, enabling practitioners to plan how they are going to deal with it, to ensure the highest quality care for parents in real situations.
Office for National Statistics (2012). Child Mortality Statistics: Childhood, Infant and Perinatal. Available at < http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=tcm%3A77-332784 > [accessed 18 May 2014]
Michelson KN, Ryan AD, Jovanovic B, Frader J. Pediatric residents’ and fellows’ perspectives on palliative care education. J Palliat Med 2009;12(5):451–457
Pease N (2007). High Fidelity Clinical Simulation in Cancer and Palliative Care Education. In: L Foyle, J Hostad, ed. Innovations in Cancer and Palliative Care Education. Oxon: Radcliffe Publishing. Ch 1
Resuscitation Council (2010) Neonatal Life Support Guidelines. UK Resuscitation Council
- Category: Course or curriculum evaluation/innovation/integration
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