Aims Paediatric trainees attending a course to support transition to ST4/registrar role reported high anxiety around fulfilling their Safeguarding responsibilities due to lack of experience. They described a widespread practise whereby safeguarding concerns are escalated immediately to seniors, reducing juniors’ clinical exposure.

Simulation offers a safe environment to rehearse communication skills essential in Safeguarding, including inter-professional information sharing. We therefore developed a short scenario, “Phone a friend”, for this course with the aims to:

1. Provide a learning environment to practise the leadership and communication skills needed to initiate management of a child where there is a safeguarding concern.

2. Help trainees apply safeguarding knowledge, thereby reinforcing learning and building confidence.

Method Collaboratively, we constructed a challenging yet realistic scenario that highlighted key safeguarding themes. In small groups, trainees first observed their colleague take a history from a mother (actor) whose child had presented to A&E with a non-accidental injury. Realistic supporting information was given (A&E triage and clerking notes). Another trainee swopped into the “hot seat” and spoke to the ‘on-call paediatric consultant’ (faculty consultant) for advice and a third trainee spoke to the ‘duty social worker’ (facilitator) to escalate their concerns. The calls were made on speakerphone and the trainee in role could call ‘time out’ to ask for advice from the group. This was followed by a structured debrief with individual teams presenting key learning points to the larger group.

Results Course feedback showed that trainees valued highly the chance to “run through what you would actually do or say”. They reported that as a result of the simulation, they felt their approach to safeguarding had changed and they now felt “more confident to ask the difficult questions”, “protect the children they were seeing” and “set a good example to their junior colleagues”.

Conclusion We successfully ran a Safeguarding simulation to help prepare junior trainees for their role in the initial management of a child with safeguarding concerns. It is a scalable learning exercise, which is low tech and easily reproducible in local safeguarding courses. We would recommend the use of simulation for this purpose.