Dynamic Branching Virtual Simulation for Management of Medication-Induced Anaphylaxis by Pediatric Nurses: A Pilot Educational Evaluation

Background: Pediatric inpatient anaphylaxis requires rapid recognition and prompt intramuscular administration of epinephrine. A dynamic branching, engine-driven virtual simulation was developed that delivers guided training and exports time-stamped performance logs. Method: In a unit-based educational evaluation, 12 pediatric nurses completed baseline assessment, one guided training run, and a posttraining variant assessment. System Usability Scale scores and log-derived performance metrics were summarized. Results: All participants completed all phases and generated analyzable log report files; mean performance scores increased from 9.7 to 15.5 (range, 0–20), and epinephrine completion rates increased from 33% to 100%. Mean System Usability Scale score was 62.5. Conclusion: Engine-driven virtual simulation was feasible within routine unit workflow and showed signals of improved time-critical actions, supporting further refinement and broader evaluation