Debating death in simulation

6th Annual National Neonatal Simulation Conference  26 Sept 2017 

Workshop: Simulating and Debriefing Neonatal Death

Hannah Shore and Maria Tsakmakis

 

“Take home messages”

 

• Simulated deaths can be a powerful learning tool

- particularly if the objective of the scenario is to teach about the management of neonatal death and end of life care

• Do not use simulated death punitively

• Ensure psychological safety of candidates, actors, faculty

• Good debriefing essential if the death is unexpected by the learner to ensure psychological safety and encourage positive learning.

• It is important that the simulated patient behaves as it would in real life i.e. the patient should deteriorate / not improve if the management initiated is not correct (provision of a realistic environment) to ensure learning.

• The learning objective of a scenario is often not met in neonatal death unexpected by both facilitator and learner and psychological safety is often lost (particularly with junior staff). Consider other methods of managing the scenario and debriefing to ensure learning objective met.

References:

Corvetto, Marcia A. MD; Taekman, Jeffrey M. MD. To Die or Not To Die? A Review of Simulated Death. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: February 2013 - Volume 8 - Issue 1 - p 8–12

Mileder LP, Vajda C, Wegscheider T. Patient death in simulation-based medical education. International Journal of Medical Education. 2015;6:109-110. 

Aggarwal R, Mytton OT, Derbrew M, et al.  Training and simulation for patient safety.  BMJ Quality & Safety 2010;19:i34-i43.

Bruppacher, H. R., Chen, R. P. and Lachapelle, K. (2011), First, do no harm: using simulated patient death to enhance learning?. Medical Education, 45: 317–318. 

Yardley, S. (2011), Death is not the only harm: psychological fidelity in simulation. Medical Education, 45: 1062. 

Rogers, G., Jones de Rooy, N. and Bowe, P. (2011), Simulated death can be an appropriate training tool for medical students. Medical Education, 45: 1061. 

Leighton K (2009) Death of a simulator, Clinical simulation in nursing Vol 5 Issue 2 e59-e62

Weiss A 2017 Does the unexpected death of the manikin in a simulatin maintain the particpants perceived self efficacy? BMC Medical Education  17: 109