Oral Themed Presentation
Sudden Unexpected Death in Infancy and Childhood – simulation training to improve management of the SUDIC process
Tuesday, May 15
11:00 - 12:30
Location: Neptune 1&2
Context: : Paediatricians play a vital role in managing the multi-agency investigative process following a sudden unexpected death in infancy or childhood (SUDIC). Inadequate SUDIC investigation has devastating consequences for families and professionals.
The low incidence of SUDIC and shortened training time result in reduced exposure. The Kennedy Report highlighted the need for improvement of training. Despite these recommendations a lack of experience and awareness of the multi-professional roles exists amongst senior trainees. In a recent survey no senior trainees had observed the whole SUDIC process, and several had not been exposed to any cases so far.
Simulation-based education has been used effectively to bridge the gap between knowledge and clinical experience. We developed a one day course for senior paediatric trainees and consultants using high fidelity simulation and experiential learning.
Description: : Key events of a SUDIC case and investigation were simulated including:
• Breaking bad news
• Post-mortem examination and investigations
• Death scene examination
• Rapid response meeting
• Report writing
• Parent experiences
Content and scenarios were mapped to the Postgraduate RCPCH Curriculum for General Paediatrics and Community Child Health, and delivered by SUDIC specialists within paediatrics and police.
Outcomes assessed included qualitative pre- and post-course confidence and self-reported skills performing key aspects of SUDIC management.
Observation/Evaluation: : Seven SUDIC simulation courses have been delivered to date (2015-2017), with 8-15 candidates in each. Significant improvement was seen between pre- and post-course Likert scores for confidence and skills in all key aspects; including confidence explaining the process to parents (increased from 14.3% to 90.9%) and practical skills e.g. performing skin biopsy (from 17.9% to 87.9%). Free text feedback comments were overwhelmingly positive – referencing much improved understanding of the investigative process.
Discussion: : Simulation training improved confidence and perceived ability to manage key aspects of SUDIC – an area where self-reported confidence and skills are low due to little clinical exposure. This may ultimately improve the quality of SUDIC investigations and experiences for families.
This course is funded for all trainees within our deanery. It has the potential to be delivered nationally and could be adopted for multi-professional SUDIC training for health, social care and police.