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0104 ‘The day the simulator died’. A pilot
  1. Louise Budd1,2,
  2. Susannah Pawley1,2
  1. 1Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  2. 2Royal Alexandra Children’s Hospital, Brighton, UK


Background/context The unexpected death of a child is an infrequent and sporadic event. Many health professionals feel underprepared for facing this challenging task.1,2 An inter-professional simulation day was designed to help prepare learners for being faced with unexpected child death.

The day comprised introductory lectures, 2 high fidelity simulations of unsuccessful resuscitations including a simulated parent and communication skills sessions addressing breaking bad news.

Methodology Immediate feedback was sought on the day and a follow up questionnaire was sent 4 months later to further explore the educational value.

Results/outcomes The pilot day had 9 participants (medical and nursing staff) – 8 answered the follow up questionnaire.

The group had varied prior experience. 50% had no previous formal training on child death procedures or breaking bad news. A significant proportion (5 of 8) had either no experience or had only been the primary deliverer of bad news on fewer than 5 occasions. Limited exposure to informal training opportunities including observation of such encounters and feedback within the work place were also reported.

Participants rated this training day positively; with an increase in self-reported confidence in their knowledge around the topic and approaching communication of bad news to parents and families.

Simulated parents were rated as being very useful and being immersed in high fidelity simulation prior to these difficult discussions was viewed as helpful; increasing the realism.

Conclusions and recommendations We have highlighted an area of practice where self-reported confidence is low as a result of limited opportunities for training and feedback that stem from unexpected child death being an infrequent event. This pilot simulation day was well received and resulted in an increased confidence amongst participants. Plans are in place to further this training and to widen the multi disciplinary team involvement.


  1. Harrison ME, Walling A. What do we know about giving bad news? A Review. Clin Pediatr 2010;49(7):619–626

  2. Meyer EC, et al. Difficult conversations: Improving communication skills & relational abilities in health care. Pediatr Crit Care Med. 2009;10:352–359

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