A new approach to multi-professional end of life care training using a sequential simulation (SqS Simulation™) design: a mixed methods study

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Title: A new approach to multi-professional end of life care training using a sequential simulation (SqS Simulation™) design: a mixed methods study
Authors: Weil, A
Weldon, SM
Kronfli, M
Watkins, B
Kneebone, R
Bello, F
Cox, S
Item Type: Journal Article
Abstract: BACKGROUND: A need for improved education and training for hospital staff caring for patients in the last year of life was identified at an urban UK hospital. Sequential Simulation (SqS Simulation™) is a type of simulation that recreates a patient's journey, considering the longitudinal element of care and how this might impact on the patient's experiences, wishes and needs. OBJECTIVES: The aim of this study was to investigate a new end of life care training intervention for multi-professional hospital staff, and its effect on their confidence in managing patients at the end of their life. SETTING/PARTICIPANTS: Based on the results of a formal Training Needs Analysis, four SqS Simulation™ specialty-based courses were designed for general medical and surgical multidisciplinary teams in an acute UK hospital. METHODS: Over three months, seven SqS Simulation™ sessions were attended by fifty-seven multidisciplinary healthcare professionals. A quasi-experimental mixed-methods study was conducted using open and closed-ended questionnaires, pre and post-intervention. Changes in course attendees' confidence levels were analysed and qualitative data from free-text answers informed potential reasons for any differences identified. RESULTS: Confidence improved for all professional cohorts (p < 0.001). The differences were found to be highly significant for 'doctors' (p < 0.001), significant for 'therapists' (p = 0.02) and not significant for the 'nurses' cohort (p = 0.238). This was explored further using a qualitative explanatory framework. Categories included: Communicating with Families; Teamwork; Goal Planning; Do Not Attempt Cardiopulmonary Resuscitation; Course Usefulness; Prior Training; and Clinical Experience. CONCLUSION: This study has shown an overall improvement in confidence across disciplines after attending a SqS Simulation™ course. The differences in quantitative results between disciplines were explored through the qualitative data and revealed a difference in what the professionals gained from it. Further studies are required to assess its effectiveness in maintaining confidence of end of life care in practice, as well as its benefit to patient outcomes.
Issue Date: 9-Sep-2018
Date of Acceptance: 16-Aug-2018
ISSN: 0260-6917
Publisher: Elsevier
Start Page: 26
End Page: 33
Journal / Book Title: Nurse Education Today
Volume: 71
Copyright Statement: © 2018 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence
Sponsor/Funder: London Deanery
Imperial College Healthcare NHS Trust
Health Education North West London
Imperial College Healthcare Charity
Funder's Grant Number: RDOTH
Funder to provide
Keywords: Confidence
Continuum of care
End of life care
Sequential simulation
SqS Simulation
1110 Nursing
Publication Status: Published
Conference Place: Scotland
Online Publication Date: 2018-09-09
Appears in Collections:Division of Surgery
Faculty of Medicine

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