# Evaluating teachers’ knowledge and attitude toward food allergy and anaphylaxis: a pilot simulation-based questionnaire study in Rabigh elementary schools

## TL;DR

A simulation-based education program improved teachers' knowledge and readiness to manage food allergies and anaphylaxis in a pilot study in Rabigh elementary schools.

## Contribution

This study introduces a simulation-based approach to enhance teachers' understanding and attitudes toward managing food allergies and anaphylaxis in schools.

## Key findings

- Recognition of key anaphylaxis symptoms improved significantly after the simulation-based education.
- Readiness to use an epinephrine auto-injector increased from 18.8% to 84.5% post-intervention.
- Attitudes toward anaphylaxis management protocols showed significant improvement after the intervention.

## Abstract

Simulation-based learning is an effective tool for educating teachers and school staff about anaphylaxis. This pilot exploratory study aimed to assess knowledge and attitudes toward food allergy and anaphylaxis policies and protocols in schools for the management of severe allergic reactions.

A simulation-based education program was conducted using a standardized case scenario in elementary schools in Rabigh, targeting teachers and staff from randomly selected schools. Knowledge and attitudes were assessed before and after the simulation using structured questionnaires. Paired pre–post responses (n = 97) were analyzed. McNemar’s test was applied for categorical outcomes, and the Wilcoxon signed-rank test was used for ordinal attitude scores. Data were summarized as frequencies and percentages, with a significance level set at p < 0.05.

A total of 101 teachers and staff from six elementary schools participated, with 97 completing both pre- and post-simulation assessments. Recognition of key anaphylaxis symptoms improved significantly post-intervention, particularly for swelling of the lips, tongue, face, and eyes (55.4% vs. 79.4%) and shortness of breath (28.7% vs. 78.4%) (both p < 0.001, McNemar’s test). Attitudes toward anaphylaxis management protocols also improved, with a significant reduction in median attitude scores post-simulation (p = 0.001, Wilcoxon signed-rank test). Readiness to use an epinephrine auto-injector increased markedly from 18.8% before the intervention to 84.5% after the intervention (p < 0.001).

This pilot exploratory study demonstrates that simulation-based education can significantly improve teachers’ knowledge, attitudes, and readiness to manage food allergy and anaphylaxis. While the findings are promising, they should be interpreted with caution due to the modest sample size and single-city setting. Larger, multi-center studies.