An immersive simulation and virtual reality-enhanced course for the recognition of pediatric Non-Accidental Trauma (NAT) and abuse: A proof-of-concept study.

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.