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An immersive simulation and virtual reality-enhanced course for the recognition of pediatric Non-Accidental Trauma
Hadas Yechiam1, Ayelet Shles1, Dvora Fridler2
1Pediatric Emergency Department, Meir Medical Center, Kfar Saba, Israel; Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Background:
Non-accidental trauma (NAT) remains a leading cause of child morbidity and mortality, yet recognition of NAT in pediatric emergency departments is frequently delayed. Traditional NAT education emphasizes factual knowledge and inadequately addresses emotional, cognitive, and interpersonal challenges influencing real-world decision-making.
Objective:
This study aimed to evaluate feasibility and short-term educational impact of an immersive multimodal simulation curriculum designed to improve pediatric emergency clinicians' recognition, management, and reporting of suspected NAT.
Methods:
We conducted a proof-of-concept evaluation of a national immersive simulation course integrating virtual reality, high-fidelity simulation, and experiential learning across 13 NAT competency domains. Feasibility and self-reported confidence were assessed using retrospective pre/post surveys at one-month follow-up.
Results:
Fourteen of 16 registered clinicians attended and 13 completed follow-up surveys. All feasibility benchmarks were met. Participants demonstrated significant improvements across all 13 competency domains (all p < 0.05), with largest gains in documentation (+3.15 points), focused examination (+3.00), diagnostic workup selection (+2.85), and acting under uncertainty (+2.54). Composite NAT readiness scores increased from 5.59 ± 1.33 to 7.92 ± 1.08 (p = 0.00024, Cohen's dz. = 1.73). Overall course satisfaction was high (median 9/10). Despite improved confidence, participants identified persistent systemic obstacles including diagnostic uncertainty, legal complexity, and time pressure.
Conclusions:
An immersive multimodal simulation curriculum was feasible and significantly improved pediatric emergency clinicians' self-reported readiness to manage suspected NAT, particularly in complex domains such as documentation, communication, and decision-making under uncertainty.
