DOI: 10.1192/j.eurpsy.2026.11335 ISSN: 0924-9338

Simulation as a Learning Tool in Cases of Aggression Against Healthcare Professionals

P. Fernández De Romarategui Urresti, M. Sánchez López, C. B. Jose Manuel

Introduction

Healthcare personnel are affected by various types of aggression during their professional activity.

In our center, incidents of violence have risen by 43% in the past year (6.7% involving physical assaults).

Protocols, legal support, and assistance from organizations and security staff must be complemented by training that equips personnel with the skills to manage and de-escalate conflict.

Objectives

Our objective is to adapt conventional aggression training to a practical, experiential format that enables professionals to apply their knowledge and skills in managing external violence.

This aims to:

Develop coping skills through realistic scenarios

Identify and correct behavioral or attitudinal errors

Enhance well-being through learning

Create practical action sheets

The methodology involves role-playing aggression cases followed by debriefing for reflection and analysis, complemented by pre- and post-training questionnaires to evaluate outcomes.

Methods

The methodology consists of simulating, through role-playing, cases of aggression and then conducting a debriefing session for reflection and analysis. In addition, questionnaires were administered at the beginning and end of the training to assess the degree to which objectives were achieved.

Results

After analyzing the initial and final questionnaires, we observed a clear improvement in students’ knowledge of how to act in cases of aggression.

The graph shows the percentage of students who answered affirmatively before (PRE) and after (POST) the training.

Main results:

Knowledge of the first action to take in an aggression situation: 100% after training vs. 41% initially.

Familiarity with de-escalation techniques: 97% vs. 31%.

Ability to respond to verbal assault: 100% vs. 48%.

Feeling prepared to manage an aggression situation in hospital settings: 88% vs. 12%.

Confidence in applying calming techniques with aggressive patients or relatives: 79.4% vs. 34%.

Overall, the course significantly improved participants’ preparedness, confidence, and ability to handle aggressive situations effectively.

Conclusions

Experiential training has made it possible to increase the perceived sense of safety among staff who face these situations, as well as to achieve improvement and greater knowledge regarding:

Actions to take in the event of verbal or physical aggression

De-escalation (calming) techniques

The influence of staff behavior when facing aggression

Internal reporting procedures

Disclosure of Interest

None Declared

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