# Training Healthcare Assistants for School-Based Care of Children Receiving Paediatric Palliative Care: A Post-Training Evaluation

## TL;DR

A short simulation-based training program significantly boosted school care assistants' confidence in managing routine and emergency tasks for children in palliative care.

## Contribution

The study introduces a modular training approach combining core emergency procedures with child-specific and family-partnership modules to improve school inclusion safety.

## Key findings

- 85% of participants reported high confidence in routine tasks, and 60% in emergency tasks after training.
- 60.5% of severe incidents were resolved autonomously by participants, indicating improved preparedness.
- Participants emphasized the need for regular refreshers and practical skills checks to maintain readiness.

## Abstract

What are the main findings?
Short, simulation-based training was associated with high self-reported perceived confidence in routine and emergency tasks in school settings immediately after the session.Training that includes child-specific scenarios and family-partnership elements was perceived as helpful for supporting safer school inclusion for children with complex needs.

Short, simulation-based training was associated with high self-reported perceived confidence in routine and emergency tasks in school settings immediately after the session.

Training that includes child-specific scenarios and family-partnership elements was perceived as helpful for supporting safer school inclusion for children with complex needs.

What are the implications of the main findings?
Modular programs that combine a common core with individualized modules may help address the heterogeneous experiences and needs of staff.Regular practical refreshers and objective skills checks are recommended to sustain readiness for low-frequency/high-impact events and to strengthen trust with families.

Modular programs that combine a common core with individualized modules may help address the heterogeneous experiences and needs of staff.

Regular practical refreshers and objective skills checks are recommended to sustain readiness for low-frequency/high-impact events and to strengthen trust with families.

Background/Objectives: Children in paediatric palliative care often face school attendance barriers due to complex health needs. This study describes post-training perceptions of a training program by a pediatric hospice team to prepare school care assistants to safely include children with complex conditions, focusing on procedural skills, knowledge of the child, and family partnership. Methods: Care assistants who completed a structured course at the Paediatric Palliative Care Centre, University Hospital of Padua (2023–2024), were surveyed immediately after training. The program combined classroom instruction with hands-on simulation using high-fidelity mannequins and standard devices, including suction, pulse oximetry, ventilation, enteral feeding, and tracheostomy care. It also covered modules on urgent and emergency management, as well as family communication. An anonymous online questionnaire gathered socio-demographic data, prior training, clinical tasks performed, self-efficacy levels, and open-ended feedback. Quantitative results were analyzed descriptively, while qualitative comments were subjected to thematic analysis. Results: Of 130 invited assistants, 105 participated (81%). Participants reported strong perceived confidence: 85% selected the upper end of the 5-point scale (“very” or “extremely”) for routine-management ability, and 60% selected these same response options for emergency-management ability. In the most severe events recalled, 60.5% of incidents were resolved autonomously, 7.6% involved contacting emergency services, and 3.8% involved community or hospice nurses. Seventy-five percent judged the course comprehensive; thematic analysis of 102 comments identified satisfaction, requests for regular refreshers, stronger practical components, and requests for targeted topics. Conclusions: Immediately after the session, participants tended to select the upper end of the self-assurance item for both routine and emergency tasks. Combining core emergency procedures with personalized, child-specific modules and family-partnership training may support safety, trust, and inclusion. Regular refreshers and skills checks are advised.