48\u2005Supporting internal medicine trainees to meet new curriculum competencies around end of life care: a novel simulation course

Abstract

Introduction The new Internal Medicine Training (IMT) curriculum defines a specific Capability in Practice (CiP) around managing end of life and applying palliative care skills. We have developed a mixed methods program to meet the necessary curriculum competencies, including a simulation course. The aim of this project was to adapt and design a bespoke simulation course and to pilot and evaluate it with IMT trainees Methods The training was adapted from an existing course, CHOICE (Communicating Honestly and Openly to Improve Care at End of life), a high-fidelity simulation course, modelling a patient‘s journey at the end of life. Each trainee participates in a simulated scenario with an actor and receives focused feedback from a multidisciplinary faculty. Two half day courses were piloted with a total of eight trainees. The courses were evaluated using pre and post course questionnaires, assessing confidence in several areas related to end of life care using a 5-point Likert scale. Results In all domains assessed, the IMT trainees reported an improvement in confidence in identifying a patient reaching the end of their life and communicating this with them and their relatives. Feedback demonstrated that trainees found it a safe place to explore and practice conversations around end of life care. 100% of participants reported the course as ‘very much’ likely to have an impact on their approach to end of life care. All participants would recommend the course to a colleague. Conclusion The pilot course was highly valued by IMT trainees to support them to meet their CiP around end of life care. There is a plan to extend to all IMT3 trainees rotating through our hospital trust. Ongoing evaluation is planned with review of resource allocation to assess the long-term sustainability and viability of the course.