Back in January, we ran a themed month of Point of Care Simulation Sessions, focused on issues around paediatric end of life care.
This built on the incredible work of the MAPLE group (https://twitter.com/maplepaeds) and their recent Improving Paediatric End of Life Care Course.
We wanted to take some of the learning from the MAPLE course and share it across the children’s hospital in a variety of settings, from high dependency wards to outpatient units.
We created a simulation scenario which could then be adapted depending on the area we were visiting.
A key focus for us when planning this month was acknowledging the fact that these scenarios would be potentially emotive and difficult for both learners and faculty involved. On the other hand, we felt it was really important to cover this area of clinical practice and so we thought of a number of ways to support attendees when developing the sessions.
In Simulation Based Education, you will often hear the phrase ‘Psychological Safety’. The Society for Simulation in Healthcare defines psychological safety as:
” A feeling by participants that they can participate, speak up, share thoughts and ask for help without the risk of retribution or embarrassment“
The Society for Simulation in Healthcare
However, we also felt that we needed to consider a slightly different meaning of ‘psychological safety’ when planning to cover a topic that was potentially distressing and emotive. We wanted to ensure we were appropriately prepared to help navigate any emotional reactions from learners and as such, we integrated the following elements into each session:
- All sessions were attended by Sarah Box (Improving Paediatric End of Life Care Simulation Fellow), who had co-led on the design and delivery of the MAPLE course. With her wealth of experience and insight into delivering sim focused on paediatric end of life care, she was invaluable in contributing to the delivery and debrief of the sessions.
- We involved our paediatric palliative care colleagues and clinical psychology teams when considering how to navigate discussions around these topics.
- Learners were told what the session would cover before they attended and reminded that there was the option to ‘opt out’ at any point. Often, learners can feel like Sim is designed to try and catch them off-guard or surprise them and so we worked hard to ensure all learners had been pre-briefed with regard to what the scenario would cover.
- The part of the parent in the scenario was played by a member of our Simulation Services team. We used a ‘Standardised Participant Checklist’ to ensure they were prepared and happy to participate in the scenario, acknowleding that it might be upsetting for them too.
- We compiled a selection of resources for learners if they felt like they needed additional support after participating in the sessions. This included an open offer from the clinical psychology team if anyone wanted to talk through things after a session.
- Learners were reminded that they could pause the scenario at any time.
Over the course of the month, 31 learners attended sessions. Feedback was really positive and attendees felt that the sessions helped them feel more prepared to have ‘difficult’ conversations with families as well as signpost families and colleagues to additional sources of psychological support if required. Learners also felt that the sessions were psychologically safe, with their emotional needs appropriately considered.
Have you ever addressed paediatric end of life care via simulation in your hospital? Is this something you’d like to try?
Please feel free to comment below or email faith.hannon@uhbw.nhs.uk if you have any questions / happy to share more of the resources we used during the month!
