Development of a Hybrid Simulated Patient Experience to Practice Care of the Dying Older Adult

MedEdPORTAL

Jessica L. Kalender-Rich¹  Julie Mack²  Daniel Swagerty³  Déon Cox Hayley⁴ 

[1] Associate Professor, Division of General and Geriatric Medicine, Department of Internal Medicine, University of Kansas Medical Center;Director, Standardized Patient Program, NEIS Clinical Skills Lab, Office of Medical Education, University of Kansas School of Medicine;Professor, Department of Geriatrics, Wright State University Boonshoft School of Medicine;Professor, Division of General and Geriatric Medicine, Department of Internal Medicine, University of Kansas School of Medicine;

关键词: Palliative Care;    Simulation;    Standardized Patients;    Dying;    Older Adult;    Terminal Care;   

DOI  :  10.15766/mep_2374-8265.10777

来源: DOAJ

【 摘 要 】

Introduction Care of the dying older adult includes critical skills that emerging physicians should master but are not consistently taught. Simulation has been shown to be an excellent tool for teaching these skills in a standardized fashion. Simulation allows direct observation to assess and provide learner feedback. Our goal was to develop a learning activity to practice skills caring for the older adult at the end of life and identify areas in need of improvement. Methods We developed a hybrid simulation in which fourth-year medical students and internal medicine (IM) residents cared for a 70-year-old patient (Laerdal SimMan 3G) who was actively dying in the emergency department. He was accompanied by his wife (standardized patient) and a nurse (standardized role). Over the academic year 2012–2013, we observed and videotaped 83 fourth-year medical students and 22 first-year IM residents in this setting. We assessed the learners' completion of 15 tasks associated with good end-of-life care. Results All learners demonstrated professional activity working with the nurse, and all medical students but one gave opioids appropriately for pain. Only 19% of the medical students appropriately disclosed the patient's status to the wife using the words death and/or dying, and only 50% of the IM residents did so. Discussion We successfully developed a learning activity in which learners can practice their skills caring for the dying older adult. We also determined that there is opportunity for improvement concerning communication, especially with the use of the words death and dying.

【 授权许可】

Unknown