Teaching Palliative Care to Emergency Medicine Residents Using Gamified Deliberate Practice-Based Simulation:...

Area of Science:

• Medical Education
• Palliative Care
• Serious Games

Background:

• Emergency departments (EDs) frequently encounter patients nearing end-of-life with advanced serious illnesses.
• Effective interpersonal skills are crucial for managing end-of-life care in the ED setting.

Purpose of the Study:

• To evaluate the perceived effectiveness of a gaming simulation using the LIVE. DIE. REPEAT (LDR) format for teaching end-of-life communication and palliative care management skills to physicians.
• To assess resident physicians' confidence and preparedness in managing end-of-life scenarios.

Main Methods:

• A gaming simulation was developed, replicating the experience of caring for a dying patient with advanced serious illness in the ED.
• The simulation utilized the LDR serious game scheme, allowing repeated attempts at critical actions within defined stages.
• The Simulation Effectiveness Tool-Modified survey was employed to gauge perceived learning outcomes.

Main Results:

• Nearly all participants (20/20) agreed the simulation improved end-of-life skills and confidence in areas like responding to condition changes, assessment, and clinical decision-making.
• 88% (14/16) felt more empowered to make clinical decisions and confident in communicating with patients.
• All residents found the debriefing valuable for learning and self-reflection.

Conclusions:

• The palliative gaming simulation, employing the LDR format, was perceived by resident physicians to enhance their confidence in end-of-life communication.
• The simulation effectively improved palliative care management skills among participants.