1. Dr Clare Kendall Dr Rachel Royston

2. Simulation Training: The Context

3. Palliative Care and Oncology: The Context Growing body of evidence about need for better training: NCEPOD Report, 2008 National Cancer Advisory Group, 2009 “One Chance to Get it Right”, 2014

4. Our Aims and Objectives

5. The Background CONVENTIONAL SIMULATION TRAININGCOMMUNICATION SKILLS TRAINING CASE BASED DISCUSIONS

6. The Background CONVENTIONAL SIMULATION TRAININGCOMMUNICATION SKILLS TRAINING CASE BASED DISCUSIONS SIMULATION BASED TEACHING  Low tech  Faculty  Actors and SIM models

7. The Pilots: Methods Piloted 2 afternoon teaching sessions at North Bristol NHS Trust in June 2013 28 FY2 doctors Faculty: Mix of oncology and palliative care consultants and SpRs 4 scenarios based on 6 common palliative care and oncology problems

8. The Pilots: Feedback Universally excellent: 100% participants evaluated 5/5 for meeting objectives & quality of teaching. Very positive comments: “Best teaching of the year” Invited to deliver a Regional F2 Training Day - Severn 5 Excellent 4321 Poor Were the session objectives met? 280000 Quality of teaching 280000

9. Regional Training Day: Methods 28 FY2 doctors 5 scenarios based on 8 commonly encountered palliative care and oncology clinical problems: Pain Neutropenic Sepsis Malignant Spinal Cord Compression Hypercalcaemia Deteriorating patient & Treatment Escalation Decisions Brain metastases with seizures and agitation Advance Care Planning

10. COMMON TO ALL: Low tech F2s rotate lead 1 hour/scenario Supporting documentation STATION 1: ACUTE ONCOLOGY Spinal Cord Compression Neutropenic sepsis Faculty as patient STATION 3: SEIZURES & AGITATION Brain metastases Faculty as patient STATION 4: ADVANCE CARE PLANNING End Stage renal failure Actor as patient STATION 5: PAIN & HYPERCALCAEMIA Lung cancer Faculty as patient STATION 2: DETERIORATING PATIENT COPD SIM man and actor

11. Regional Training Day: The Results Evaluation of:Rating out of 4 (n =28) Preparation3.82 Content3.75 Method3.71 Opportunity to ask questions 3.75 Relevance to F23.79 Overall impression 3.82

12. The Results Practically applicable and well run Should be compulsory for F2 teaching Very informative, good interaction & very engaging Excellent day very useful Excellent & relevant teaching for my stage of training

13. We can’t please everyone….! “Lunch not as good as the other trusts… and a mixture of simulation and more didactic teaching might have been less tiring…”

14. Discussion AdvantagesDisadvantages Low techLarge faculty required Engaging and stimulatingSmall numbers of trainees per session “Real life”Time consuming – prep &delivery Suitable for training all grades/disciplines Resource heavy: faculty/actors/space Highly adaptableFaculty training

15. The Future Severn Regional F2 training day – April 2015 Formalise a faculty training programme for sustainability Potential for other specialities to use low tech simulation Scope for introducing simulation as a tool for multidisciplinary End of Life training Potential for research opportunities

16. THANK YOU