Simulation Addressing Verbal Escalation (SAVE): An Interprofessional Simulation for Pediatric Health Care Professionals

Authors

• Abigail Nolan, Pediatric Critical Care Medicine Fellow, Children's National Hospital.
• Mallory Cordes, Simulation Education Specialist, Simulation Program, Children's National Hospital.
• Ananya Datta, Simulation Education Specialist, Simulation Program, Children's National Hospital.
• Kellee Humphries, Simulation Operations Specialist, Simulation Program, Children's National Hospital.
• Ayushi Jain, Medical Student, The George Washington University School of Medicine and Health Sciences.
• Simmy King, Director, Nursing Education and Professional Development, Children's National Hospital; Assistant Professor of Pediatrics, The George Washington University School of Medicine and Health Sciences.
• Rosalyn Manuel, Simulation Education Specialist, Simulation Program, Children's National Hospital.
• Laura Nicholson, Simulation Education Specialist, Simulation Program, Children's National Hospital.
• Jennifer Owens, Executive Director, Clinical Learning and Simulation Skills (CLASS) Center, The George Washington University School of Medicine and Health Sciences.
• Haroon Shaukat, Director of Emergency Department Simulation, Simulation Program, Children's National Hospital; Assistant Professor of Pediatrics & Emergency Medicine, The George Washington University School of Medicine and Health Sciences.
• Gregory Yurasek, Medical Unit Director, Pediatric Cardiac Critical Care Unit; Director of ECMO, Johns Hopkins Children's Center; Associate Professor of Anesthesia and Critical Care Medicine, Johns Hopkins University.
• Pavan Zaveri, Medical Director, Simulation Program, Children's National Hospital; Associate Division Chief for Education, Division of Emergency Medicine, Children's National Hospital; Professor of Pediatrics & Emergency Medicine, The George Washington University School of Medicine and Health Sciences.
• Simranjeet S. Sran, Director of Education, Simulation Program, Children's National Hospital; Director of Education, Division of Neonatology, Children's National Hospital; Assistant Professor of Pediatrics, The George Washington University School of Medicine and Health Sciences.
• Heather Walsh, Simulation Program Manager, Children's National Hospital; Assistant Professor of Pediatrics, The George Washington University School of Medicine and Health Sciences.

Document Type

Journal Article

Publication Date

1-1-2026

Journal

MedEdPORTAL : the journal of teaching and learning resources

Volume

22

DOI

10.15766/mep_2374-8265.11593

Keywords

Communication Skills; Interprofessional Education; Pediatrics; Provider-Patient Relationship; Simulation; Standardized Participant; Verbal Escalation

Abstract

INTRODUCTION: Clinicians frequently encounter workplace verbal violence from patients and caregivers. We created Simulation Addressing Verbal Escalation (SAVE) training for hospital-based staff to practice managing verbal escalation in a safe learning environment while reinforcing available hospital resources. METHODS: This curriculum included a 1-hour session with 2 scenarios, each involving interprofessional ad hoc teams simultaneously managing a pediatric patient (manikin) experiencing sepsis with decreased responsiveness, and a verbally escalating caregiver (standardized patient). A debriefing reinforced the BEAR (Bond, Engage, Assess, Reinforce) communication framework, sepsis management, and hospital resources for caregiver support. Training was evaluated using a checklist documenting team actions, and a learner feedback survey (4-point scale; 1 = nothing/not at all, 4 = quite a bit). RESULTS: From October 2024 to April 2025, 860 clinicians participated in SAVE training. There were significant increases from scenario 1 to scenario 2 in team implementation of the full BEAR communication tool (35% to 77%, p < .0001), the Bond (67% to 94%, p < .0001) and Reinforce (56% to 83%, p < .0001) components, and SWIFT (Social Work Intervention for Families and Teams) utilization (1% to 6%, p = .014). Among survey respondents (n = 610), mean ratings were 3.55/4, 3.73/4, and 3.88/4 for learning, engagement, and facilitator effectiveness, respectively. Relevant takeaways included supporting families, considering patient care team dynamics, applying communication strategies, and accessing hospital resources. DISCUSSION: SAVE training provided a meaningful experience for practice and discussion about emotional clinical situations. Hospital-wide training empowers staff to leverage resources to support patients' caregivers.

APA Citation

Nolan, Abigail; Cordes, Mallory; Datta, Ananya; Humphries, Kellee; Jain, Ayushi; King, Simmy; Manuel, Rosalyn; Nicholson, Laura; Owens, Jennifer; Shaukat, Haroon; Yurasek, Gregory; Zaveri, Pavan; Sran, Simranjeet S.; and Walsh, Heather, "Simulation Addressing Verbal Escalation (SAVE): An Interprofessional Simulation for Pediatric Health Care Professionals" (2026). GW Authored Works. Paper 9054.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/9054

Department

Pediatrics