Simulation Addressing Verbal Escalation (SAVE): An Interprofessional Simulation for Pediatric Health Care...

Clinicians frequently encounter workplace verbal violence from patients and caregivers. We created Simulation Addressing Verbal Escalation (SAVE) training for hospital-based staff to practice managing verbal escalation in a safe learning environment while reinforcing available hospital resources.

This curriculum included a 1-hour session with 2 scenarios, each involving interprofessional ad hoc teams simultaneously managing a pediatric patient (manikin) experiencing sepsis with decreased responsiveness, and a verbally escalating caregiver (standardized patient). A debriefing reinforced the BEAR (Bond, Engage, Assess, Reinforce) communication framework, sepsis management, and hospital resources for caregiver support. Training was evaluated using a checklist documenting team actions, and a learner feedback survey (4-point scale; 1 = nothing/not at all, 4 = quite a bit).

From October 2024 to April 2025, 860 clinicians participated in SAVE training. There were significant increases from scenario 1 to scenario 2 in team implementation of the full BEAR communication tool (35% to 77%, p < .0001), the Bond (67% to 94%, p < .0001) and Reinforce (56% to 83%, p < .0001) components, and SWIFT (Social Work Intervention for Families and Teams) utilization (1% to 6%, p = .014). Among survey respondents (n = 610), mean ratings were 3.55/4, 3.73/4, and 3.88/4 for learning, engagement, and facilitator effectiveness, respectively. Relevant takeaways included supporting families, considering patient care team dynamics, applying communication strategies, and accessing hospital resources.

SAVE training provided a meaningful experience for practice and discussion about emotional clinical situations. Hospital-wide training empowers staff to leverage resources to support patients' caregivers.