9 Creating a palliative care emergency simulation session for a large oncology department

Background The role of simulation to develop skills around managing complex palliative care emergencies has already been established in training post-graduate doctors. Following several palliative care emergencies on a busy oncology ward, a simulation afternoon was formulated with a focus on consultant-led simulation. The session utilised a trust wide training afternoon which released departments from clinical commitments. Methods Three simulations were developed, the topics inspired by PALL-SIM-IMT by NEPRA. Scenarios were re-written to formalise a role for an oncology consultant. The topics included: status epilepticus; opiate toxicity that required careful naloxone administration; and a catastrophic bleed from a head and neck tumour. Focus was on identification of the situation, clinical judgement, application of knowledge and clinical leadership. The half-day session was hosted at the local hospice's simulation suite. It was attended by 40 people, predominantly oncology consultants with a smaller number of oncology registrars and ward nurses. Only a small proportion of attendees participated in the simulations themselves. The simulations were livestreamed to larger conference room. A member of the faculty remained with the audience and provided a running commentary to stimulate learning and discussion. Each simulation was followed by a debrief and short presentation. Results Formal feedback was collected. Attendees were asked to score each scenario with an average score of 9.32/10 for overall experience of the session and 9.21/10 that simulation was a helpful and efficient way of sharing experiences and learning new points. Following on from the session there has been continued positive feedback particularly when the scenarios have clinically occurred. Conclusion The session was able to demonstrate that palliative care simulations can be applied to other specialties and that simulation itself is well received by consultants, including when not all participants undertake the simulation itself.