TOP 64 - Gun Shy: Using Simulation to Improve Pediatric Resident Comfort in Discussing Safer Firearm Storage

Publication Number: 1823.TOP 64

Alexandra C. Clement, Connecticut Children's Medical Center, Plantsville, CT, United States; Almaas Z. Ghafoor, University of Connecticut, Monroe, CT, United States; Sharon Smith, University of Connecticut School of Medicine, Hartford, CT, United States; Jennifer Haile, CCMC, HARTFORD, CT, United States; Mariann Kelley, Connecticut Children's Medical Center, Hart, CT, United States

Background: Firearms are the leading cause of death for children and adolescents in the United States. The American Academy of Pediatrics (AAP) recognizes the important role pediatricians play in reducing firearm death and injury and encourages pediatricians to counsel patients and families on safer firearm storage. Despite this, many pediatricians report that they do not routinely ask all patients and families about firearm access and storage.

Objective: To determine if the use of simulation improves the comfort of pediatric residents in incorporating safer firearm storage counseling into their practice.

Design/Methods: This is a cross-sectional study of pediatric residents at an urban tertiary-care children’s hospital. Residents participated in three different simulated cases in which they were tasked with counseling a patient actor, playing the role of a parent, on safer firearm storage. Residents were asked to take a voluntary survey before and after participating in the simulation to assess experience with firearms, prior education on safer firearm storage, knowledge of safer firearm storage, and comfort with discussing safer firearm storage with patients and families. Pediatric residents will receive a follow-up survey 3 months after participating in the simulation activity to assess their knowledge retention of safer firearm storage practices and comfort with counseling patients and families. The comfort of the pediatric residents will be analyzed using a Wilcoxon signed-rank test. Descriptive analysis will be used to characterize residents’ experience with firearms, prior education on safer firearm storage, and perceived value of the simulation exercise. Electronic health records from well visits for children ages 13 years and older performed by pediatric residents at the hospital-affiliated academic pediatric outpatient practice from September 1, 2024 through August 31, 2025 were assessed for baseline data, and will be audited post-intervention. 1,045 well visits were audited for pre-intervention and a similar number of visits are expected for post-intervention. Descriptive analysis will be used to describe patient demographics as well as documentation of patient firearm access and storage as a baseline for the clinic population. Data analysis will be completed by January 31, 2026. The study was deemed exempt by the Connecticut Children’s IRB.