By Mandy Thorpe, lead practice educator at Martin House Children’s Hospice.
At Martin House Children’s Hospice, we are pioneering simulation training in paediatric palliative care, providing education to healthcare and allied professionals across the UK.
While simulation training has been used in medicine for years, we are the first to develop a suite of courses designed to increase knowledge and understanding of children’s palliative care, and currently the only centre in the UK offering care after death and spirituality simulation courses.
Alongside key clinical skills, our simulations focus on the management of people and communication, which are vital to providing high-quality palliative care.
We currently have five simulation courses: paediatric palliative care in the acute setting; care after death; advance care planning and symptom management; perinatal palliative care skills; and spirituality in paediatric palliative care.
One of the areas where our simulation training differs from other courses – and where we are breaking new ground – is that quite often, our mannequins ‘die’ during or prior to the scenario. In standard simulations this is seen as a negative outcome, but in palliative care simulations our aim isn’t necessarily ‘saving’ the patient.
For example, one course has the scenario of a young person admitted to A&E, who is clearly unwell but has an advance care plan (ACP). While the first instinct can be to make the child better, the aim of the simulation is to explore the content of the ACP with the family and discuss treatment options.
We offer a mixture of low and high-fidelity simulations, and work with Bradford Teaching Hospitals NHS Foundation Trust and York and Scarborough Teaching Hospitals NHS Foundation Trust, using their acute setting high-fidelity simulation suites. This is important, because we want to break down preconceived ideas that good palliative care only happens in a hospice – good palliative care is possible anywhere.
Palliative care training isn’t embedded yet within mandatory medical or nursing training, so increasingly professionals seek it out. Subjects like care after death aren’t frequently taught formally, with professionals learning on the job from more experienced colleagues.
Our simulation training is about preparing people, in a safe environment, to have these vital conversations, to feel more confident talking to families about subjects like death and dying, ACPs, preferred place of care, and post-death care, or whether active treatment is the best option.
Another important aspect of our simulation training is to slow down. We know hospital staff are time poor, and decisions often need to be quick, but in a palliative setting it’s often about stopping, listening and finding time to think first.
Simulation training gives time and space to explore this way of working, and how it can be integrated into the high-quality care they already deliver. Active listening is an important part of all of our courses, and an especially strong theme in our spirituality course.
A wide range of health professionals attend our courses, from consultants to allied health workers, along with Martin House care staff as part of their ongoing professional development.
It means there is a real mix of experience, and we place huge value on the debrief – even more than the simulation – there’s really deep, shared MDT learning in those discussions, both from those taking part and those observing the simulation.
We work hard to create a brave space within debriefs, giving professionals the chance to be vulnerable and ask questions they’ve never had time or space to ask before. We hear past – often challenging – clinical experiences discussed, and rich learning and experience being shared that can’t be read from a textbook.
It gives people confidence to deal with real-life situations in future, and reassurance there is always a colleague to phone for support. It is such a pleasure to watch candidates develop and their confidence grow with their evolving skills during the course.
We have been running simulation courses since 2022, in the past 12 months alone training 160 healthcare professionals from across the UK, plus presented our findings at conferences nationally and internationally.
Other healthcare providers have also commissioned us to run simulation course. Most recently, we worked with Yorkshire Ambulance Service to deliver a new innovative course on palliative care and pregnancy loss in the pre-hospital setting.
We are always developing new courses, and from early 2026 will have a bespoke education centre at Martin House, as part of our major rebuild and redevelopment programme. This will provide a dedicated simulation room and seminar space, with state-of-the-art facilities, allowing us to run more courses in-house, in addition to our work with NHS partners.
Ultimately, as health professionals, we only have one chance to ensure a child or young person has good palliative care at the end of their life. Our simulation training is leading the way in helping professionals learn how they can deliver that care in any setting.
You can find out more about the Martin House Education Centre simulation courses and book at www.martinhouse.org.uk/education.
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