LAUSR

Aim Recent statutory changes to the way unexpected child deaths are handled and investigated has resulted in an increase in the work required following a death. A recent update to the Kennedy report sets out expectations for a range of professionals, including hospital staff. A survey of paediatric trainees in the UK suggested that whilst 91% had been involved in an unexpected death, 67% had never received any training in child death. We aimed to develop an educationally valid simulation-based training course specifically aimed at managing unexpected deaths in children. Methods All members of the multidisciplinary team working in relevant acute environments were invited to attend the course, with speakers including the Police Child Abuse Investigation Team; the Coroner; Paediatric Pathologist and a Paediatrician. We also run a session on debriefing led by a Paediatric Intensive Care Consultant. Half the day consists of communication simulation scenarios, using a professional actor to practice discussing difficult topics, including breaking bad news, discussing post mortem and safeguarding concerns. We have now run two courses, training 10 nursing staff and 14 Medical staff (ranging from junior ST trainees to Consultants). We gathered pre and post-course questionnaires, asking about knowledge and confidence in a range of domains (scale of 1, not at all confident, to 10, very confident). Pre and post-course scores were analysed using paired t-tests. Results Only two attendees had received prior training in managing child death (1 Consultant; 1 Paediatric Matron). Confidence improved across all domains (from 4.63 pre-course to 7.59 post-course, p<0.001), with the greatest improvement relating to completion of documentation (increase in confidence of 4.29). Knowledge also increased significantly (certainty-based MCQ scores, scaled from −8 to +4, increasing from 1.05 to 3.13, p<0.001), with the greatest improvement relating to staff debriefing (increase of 3.82). Conclusions To our knowledge, our course is unique in its use of multiagencies to train the multidisciplinary team, using actor-based simulation. We plan to roll out the programme to a wider audience in the region, with the aim of improving the handling of unexpected child deaths and the confidence of the acute teams dealing with them.