Comparison of recidivism rates for a Teenage Trauma Prevention Program after the addition of high fidelity patient simulation

<b>Objectives</b>: We evaluated benefits of adding high-fidelity simulation to a teenage trauma prevention program to decrease recidivism rates and encourage teens to discuss actionable steps towards safe driving. <b>Methods</b>: A simulated pediatric trauma scenario was integrated into an established trauma prevention program. Participants were recruited because they were court-ordered to attend this program after misdemeanor convictions for moving violations. The teenage participants viewed this simulation from the Emergency Medical Services (EMS) handoff to complete trauma care. Participants completed a post-simulation knowledge assessment and care evaluation, which included narrative data about the experience. Qualitative analysis of color-coded responses identified common themes and experiences in participants' answers. Court records were reviewed six years after course completion to determine short and long term recidivism rates, which were then compared to our program's historical rate. <b>Results</b>: 124 students aged 16–20 years participated over a two-year study period. Narrative responses included general reflection, impressions, and thoughts about what they might change as a result of the course. Participants reported they would decrease speed (30%), wear seatbelts (15%), decrease cell phone use (11%), and increase caution (28%). The recidivism rate was 55% within 6 years. At 6 months it was 8.4%, at 1 year it was 20%, and increased approximately 5–8% per year after the first year. Compared with our programs historical 6 month and 2 year recidivism rates, no significant difference was seen with or without simulation. <b>Conclusions</b>: Adding simulation is well-received by participants, leads to positive reflections regarding changes in risk-taking behaviors but resulted in no changes to the high recidivism rates This may be due to the often ineffectiveness of fear appeals.