LAUSR

Background There is increasing engagement with real people within simulation based education (SBE), as simulated patients (SPs), including child SPs (cSPs). An ethical framework of engaging with cSPs has developed organically by educators and clinicians, with some input, latterly, from children (Hamilton 2017). There is a paucity of information from young adults about the personal repercussions of their involvement, as children, in SBE, hence broad judgements have been made regarding ‘maleficence and beneficence’ with limited consultation with the SPs themselves. The ASPiH standards specifically state that ‘the patient perspective is considered and demonstrated within educational planning’ - consulting with the SPs is vital. Project description We undertook a qualitative study exploring young adults’ views on involvement in SBE as cSPs. Inclusion criteria was for the participants to be 16 or over and to have been involved as a SP as a child (aged 15 and younger). Twelve people were now young adults, two cited lack of time, ten took part. Two focus groups were conducted which then directed the content of four skype interviews. The principles of autonomy, non-maleficence, beneficence and justice provided the context for the overall domains and the areas of discussion were informed by lived experience. Summary of results Participants ranged from 16–24 years and had worked as cSPs from 8–15 years. The breadth of roles: trauma, mental health, (bullying, anxiety, depression, self-harm, anger management), sexual health (early pregnancy, STD), domestic violence, child carer, HPV vaccine and Gillick competence. The range of organisations equated to 3 HEIs, 5 Trusts, 2 fire and rescue facilities and a Royal College. The domains, with semi-structured prompts enabled detailed information about personal and group perceptions and opinions, to be collected. Initial analysis identifies an overwhelming positivity and weight towards beneficence. 7/10 have chosen to enter health professions (nursing, medicine, psychology). Confidence (with adults and peers), knowledge of health professions, ability to support others experiencing illness, a knowledge of safety and safe practices, were consistently cited, as too was being a voice for children. Conclusions and recommendations A unique feature of this study has been focussing on the young adults who have been cSPs. The ethics of working with cSPs has been questioned (Gamble 2016). Undue anxiety by faculty and educators, and the perceived potential of ‘maleficence’, can override the reality and the ‘beneficence’ from the perspective of the SP involved; a well governed programme is an essential element. References Gamble A, Bearman M, Nestel D. A systematic review: Children & adolescents as simulated patients in health professional education. Advances in Simulation 2016;1(1):1. Hamilton C, Clarkson G, Perry J. O54 Child simulated patients: being ethically responsible BMJ Simulation and Technology Enhanced Learning 2017;3:A36-A37