Aims Simulation is increasingly used in medical education though not traditionally in safeguarding training. We conducted a national survey of 50 paediatric and emergency medicine doctors, all with safeguarding responsibilities, which revealed a gap in training and lack of confidence in managing adolescent safeguarding and unexpected child death. Few had experienced safeguarding training via simulation but when asked their training preferences the majority said their preference would be via simulated scenarios. We designed an innovative course simulating common safeguarding scenarios and reviewed candidates’ perception of change in knowledge and self-confidence in dealing with these difficult situations.

Methods Three safeguarding scenarios were simulated using manikins and actors: a physically abused neglected child, the unexpected death of an infant in a difficult social context and the possible sexual exploitation of a young teenager. Candidates took turns to communicate sensitive safeguarding issues with the actors. A multi-disciplinary team including Detective Inspectors from Project Indigo, Youth Workers from Red Thread, Paediatric Bereavement Team and named doctors for Safeguarding and Child Death participated in each scenario modelling communication skills and leading discussion about legal processes and safeguarding resources. Each scenario was followed by a group debrief aiding reflection and consolidating learning.

Results Pre and post-course questionnaires revealed a significant improvement in confidence in managing these safeguarding scenarios. Candidates’ perception of simulation as an educational tool in safeguarding, thought pre-course to be “effective”, was rated as “very effective” post-course. The course was extremely well received with feedback including “this course was amazing”; “by far the most useful safeguarding course I’ve ever been on”; and “an excellent programme with unique practical application of theory”.

Conclusion Simulation is a validated tool in medical education, allowing trainees to practice skills in a safe, supportive environment without the risk of patient harm.¹ By actively experiencing an event, simulation stimulates ‘emotional insight’,² with debrief aiding reflection to identify strategies to improve future practice.³ Simulation in safeguarding improves confidence in managing difficult scenarios and trainees clearly want it to become a much larger part of their safeguarding training. We urge other centres to follow our lead and incorporate simulation into their safeguarding training programmes.

References

1. Kneebone et al, 2004

2. Moon, 1999

3. Fanning and Gaba, 2007