Patient death in simulation-based medical education

‘Deficit omne quod nascitur’, the Roman rhetorician Marcus Fabius Quintilianus wrote in his opus magnus “Institutio oratoria”. As death is an immanent part of human life, death and the medical profession are inseparably connected. The process of dying and death is complex, spanning the continuum of palliative care, diagnosis and certification of death, performance of last offices, and support of relatives.1 Literature shows that a patient’s death may have a strong emotional impact on healthcare professionals irrespective of their level of expertise.2 However, evidence suggests formal undergraduate education and practical training in caring for dying patients and dealing with patient death to be highly variable and underrepresented.3 According to DeMaria and colleagues4, psychological fidelity in simulation-based medical education (SBME) is frequently neglected in favour of equipment fidelity. Yet, adding emotional stressors to SBME has been shown to result in superior practical competency during standardized assessments,4 representing another reason to include patient death as specific learning goal in SBME. In our opinion the topic of patient death in SBME is of importance to medical educationalists. Therefore, the aim of this article is (i) to offer our experience with delivering simulation-based training in emergency medicine and acute care for undergraduate medical students and (ii) to briefly review and discuss relevant literature.