Is virtual advance care planning simulation as effective as face-to-face learning?

Poster ID
1286
Authors' names
A Barnard1; H Petra2; L Owen3; K Goffe4; C Bergbaum5; H Wickham6; O Fox7; J Pleming5; A Steel5.
Author's provenances
1.Dept of Respiratory; East Surrey Hospital; 2.Dept of Acute Medicine; Barnet Hospital; 3.Dept of Geriatric Medicine; Barnet Hospital; 4.Dept of Neurology; Barnet Hospital; 5.Dept of Geriatric Medicine; Barnet Hospital; 6.Dept of Geriatric Medicine; Royal

Abstract

Introduction

Advance care planning (ACP) is about what matters to patients, enabling their wishes to be respected, even when they become unable to engage in decision-making. Evidence shows ACP improves end of life care for patients and reduces relatives' bereavement reactions (Detering KM et al. BMJ. 2010; 340:1345). A simulation course for multidisciplinary healthcare professionals, using actors, was developed to improve understanding of ACP, and confidence in having these conversations. In response to the COVID-19 pandemic, the course was adapted to an online format.

Method

Participants were asked about their ACP confidence and understanding pre- and post-course, using a Likert scale (1-Not at all to 5-Very confident). Data between 2018-2022 was analysed to compare face-to-face and online course responses. Free-text responses to 'How do you feel about attending the course online?' were analysed qualitatively. Ethics approval was not required.

Results

Five face-to-face and five virtual sessions trained 128 and 133 attendees respectively. Confidence in having ACP discussions improved significantly following the course in both cohorts; from a mean Likert rating of 2.77 (95% CI 2.60-2.94, n=132) to 4.11 following face-to-face training (95% CI 3.97-4.25, n=128), and from 2.79 (95% CI 2.66-2.91, n=149) to 4.11 following the online course (95% CI 4.01-4.21, n=133). Additionally, 97% (n=132) of face-to-face attendees and 99.2% (n=133) of virtual attendees said their practice would change because of the course. Following the training, 100% of participants across both cohorts reported that they 'fully understood' what was meant by ACP, from a baseline of 77.3% (n=132) in the face-to-face cohort and 81.9% (n=149) of virtual participants. Free-text analysis highlighted the convenience of attending online (n=22,21%), and only a minority reported technical difficulties (n=8,8%).

Conclusion

This course was successfully adapted to a virtual format, improving participants' ACP confidence and understanding as effectively as in-person training, whilst being more accessible.

Presentation

Comments

Thank you, excellent and important work. What was the spread & subtypes of different healthcare professionals attending?

Submitted by Dr Marc Bertagne on

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The multidisciplinary team members attended consisted mainly of doctors and nurses but we also had good attendance from therapists, physiotherapists and SLT and physician associates

Submitted by Dr Anna Barnard on

In reply to by Dr Marc Bertagne

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