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0090 Ethical And Practical Implications Of Engaging With Children As Simulated Patients
  1. Carrie Hamilton,
  2. Gill Clarkson
  1. University Hospital Southampton NHS Foundation Trust, Southampton, UK


Context Everyone working with children should have a common set of skills and knowledge and be able to effectively communicate.1,2,3 It is imperative that children are incorporated into simulation and their unique perspective heard, however most information about the practical and ethical implications of SP usage, is linked to adults. University Hospital Southampton (UHS) started with four children as SPs nine years ago, now having fifty-five children on the books; much has been learnt.

Methodology Due to the paucity of information, all that we do, has been underpinned by being transparent with professional organisations including our own, seeking a broad range of advice and considering best practice internationally. In doing this, we have ensured our infrastructure is robust and all areas of governance have been critically evaluated.

There are ethical implications of working with SPs whatever their age. However, working alongside child SPs poses a heightened focus on ethical issues. We have been guided by Beauchamp and Childress’,4 principles of biomedical ethics:

  • Respect for autonomy

  • Non-maleficence

  • Beneficence

  • Justice

Outcomes There is a synergy between ethics and practicality. We have found that the ethical and practical implications of working with children are inextricably linked. We consider what is ethical and then whether it is practical; we consider what is practical and then whether it is ethical. This becomes a cyclical exercise, which we believe is part of the dynamic process of engaging with children. As a consequence, children are now involved frequently and in a large variety of educational roles.

Conclusion Engaging children as SPs is important, but not without challenges. A robust infrastructure is essential to ensure that the health and safety - in the broadest sense - of all involved, is maintained. UHS has developed guidance and operational documents to assist with ensuring our governance is secure.


  1. United Nations Convention on the Rights of the Child (1989).

  2. Every Child Matters (2003), The National Service Framework for Children, Young People and Maternity Services (2004).

  3. The review of the NHS by Lord Darzi (2008)

  4. Beauchamp TL, Childress JF, 2001, Principles of Biomedical Ethics, 5 th edition, Oxford: Oxford University Press.

  • Category: Course or curriculum evaluation/innovation/integration

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