Trauma-Informed Virtual Reality Simulation for Pediatric De-Escalation: An Early Evaluation

To address a critical gap in trauma-informed de-escalation training for interprofessional pediatric staff and trainees, a virtual reality (VR) simulation program was developed and implemented at a Canadian tertiary care hospital. This early-stage evaluation assessed the feasibility, acceptability, and usability of immersive VR as a psychologically safe and engaging learning modality as part of a formally approved quality improvement initiative. Developed through multidisciplinary collaboration, the simulation integrated trauma-informed pedagogy within a realistic, emotionally complex scenario in which staff practiced responding to escalating patient distress. The mixed-method evaluation included posttraining surveys, facilitated debriefs, and learner-generated summaries guided by the New World Kirkpatrick Model. Participants from diverse patient-facing roles reported high engagement, psychological safety, and commitment to applying learned skills. Findings suggest trauma-informed VR simulation can support early indicators of capacity building across cognitive (decision-making), affective (emotional awareness and confidence), and interpersonal (communication and collaboration) learning domains. Immersive VR simulation shows promise as an effective learning strategy for preparing pediatric health care teams for complex behavioral escalation scenarios.