Caregiver Codesigned Simulation Training for Paediatric Intellectual Disability Emergency Care

Children and young people with intellectual and developmental disabilities (IDD) often face significant challenges in emergency departments (ED), where a high-acuity environment can exacerbate distress, leading to behaviours of concern (BOC). Identifying and managing BOC requires specialised skills, yet many healthcare professionals report a lack of confidence and structured training. Traditional educational models may lack real-world applicability by failing to incorporate the lived experiences of patients and families.

The Motivated for Change programme was codeveloped with caregivers to enhance healthcare professionals' ability to identify, mitigate, and de-escalate BOC in children with IDD using simulation-based education (SBE). The programme integrated prelearning modules, interactive lectures, and novel immersive simulations. SBE was codesigned with parents, clinicians and educators to reflect real-world ED challenges and guided child and family-centred approaches. Participants engaged in simulation exercises to practice communication strategies and implement reasonable adjustments in a structured, supportive learning environment.

Eighty-two ED healthcare professionals participated in 11 simulation sessions. Postsession surveys revealed SBE was effective in consolidating skills in communication and engagement (100%), identifying BOC (99%), preventing escalation (99%) and de-escalation strategies (96%). Ninety-seven percent felt more confident applying reasonable adjustments in clinical practice. Reflexive thematic analysis identified key learnings, including parent partnership, effective communication, early recognition and intervention and environmental modifications.