End of life board game provides an innovative solution to palliative care training at Cardiff and Vale UHB

Bedrace is an educational board game that encourages staff to discuss and explore palliative and end of life care. It was created by Dr. Clea Atkinson, Lead Consultant in Palliative and Supportive Care Cardiff and Vale University Health Board and Dr Dylan Harris, Consultant in Palliative Medicine in South Wales.

Palliative care education is important because many staff and students will care for dying patients. At the start of the pandemic, Clea received a request to develop educational materials around palliative care. She recognised that the 5th year medical students were likely to be called on to the wards earlier than expected, due to the immense pressures being placed on the system at that time.

Clea's Approach

She set about developing a practical and engaging game called Bedrace. Initially, Clea simply drew the game out on paper and used Fymo and mini wooden beds as board pieces. The aim was to best prepare students and give them the key skills and knowledge to enhance confidence and improve ability in caring for dying patients.

Clea’s make-shift version came into reality when she connected with the Shaping Change Innovation Team. The team connected her with AgorIP and Focus Games who granted a total of £60k worth of funding for production. AgorIP brings academics, clinicians and businesses together to pioneer research into cutting-edge technologies and drive commercial success with the support of Swansea University, and the European Regional Development Fund through the Welsh Government. Focus Games create evidence based and engaging games for health care.

The Game

The game was made into flexible training tool for all multi-professional staff and students. It has a central set of questions and you can add in other sets depending on who you’re teaching. Any senior member of staff can facilitate without external support and training can happen in the workplace with minimal preparation. It is a competitive game for between 2-4 individuals or teams. Participants compete to move along a pathway depicting the end-of-life patient journey. Teams move forward by correctly answering and discussing questions about palliative and end of life care.

Bedrace can be used as part of formal education or as an informal workplace activity. An average game takes 45 minutes.

What others think

To establish its effectiveness, Bedrace was evaluated with medical students in Wales and the results were published in BMJ Supportive & Palliative Care in 2021.

169 (67%) of students completed pregame and postgame anonymous quiz questions and free-text feedback. Postgame quiz scores were higher for each topic, and the difference in the paired pregame and postgame questionnaires was statistically significant (p<0.05). Themes from the free-text feedback included: ‘engaging and fun’, ‘peer learning and teamwork’ and, ‘relevant learning’.

Clea said that she experienced many barriers along the way but knew that she had a good idea that was going to benefit patients. ‘You can really let people get you down or be deterred, or you can keep sight on your vision and keep going with the people who believe in you.’

Mark Briggs, Assistant Director of Innovation said: ‘Bedrace is a great example of a pragmatic solution that was conceived and created by some of our most creative and dedicated clinical consultants in response to a real-world problem; the results and feedback from those that have used the game as part of their training speak volumes.  I look forward to seeing the take up and use of Bedrace continuing to grow internationally and that it will help our future doctors and associated clinicians develop the skills and understanding that they need, that is so critical in end of life care, but in a fun and engaging way.’

Future plans

The game is now being adopted by the Association of Palliative Medicine and embedded into their training offering as a key educational tool. The hope is that the game will become a tool used in hospitals nationally and internationally to improve palliative care education.