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Background Non-pharmacological anxiolytic distraction methods are extensively supported for their role in reducing anxiety; stress in hospitalized children However, there is limited scientic evidence identifying the most suitable distraction strategy, especially in an Indian set-up. Objective To perform a comparative evaluation of the impact of two different distraction strategies as a non-pharmacological anxiolytic among hospitalized children. Methodology In this prospective study, 120 hospitalized children of either sex, satisfying the inclusion criteria were included. Three different treatment groups created: animated cartoon video group (ACV/ n = 40), distraction card therapy (DCT/ n= 40) and control group (n= 40). ACVand DCTwas administered for 20 minutes in their respective groups during the vital signs' procedure, and anxiety was assessed before, during and after the 5 min of procedure by using modied child faces anxiety scale (Wong-Baker FACES). The routine procedure was done on control group without giving them the intervention. P0.05 was considered signicant. Results Most patients were in the age group of 3-6 years, with a male predominance (53.75%) (Male: Female=0.67:0.57). Signicant difference was noted in the post-test anxiety scale test score between ACV and control group, DCT and control group (p < 0.001), with high post-test score noted in the control group. Slightly high mean test score noted in the DCT group (6.8) than ACV group (5.5), but non-signicant. The majority of children in the age group of 3-6 years had moderate anxiety levels in the ACVgroup (p = 0.01408) and DCTgroup (p = 0.0316) indicting their signicant association with age group. ConclusionACV is a more effective non-pharmacological intervention than DCT, for decreasing the anxiety levels in paediatric inpatients

Medical educators tasked with curriculum reform may nd it difcult 1 to implement fresh pedagogical strategies . Although it may be attractive to accept new improvements to the curriculum, these attempts are frequently based on insufcient evidence. Despite the extensive use of innovative educational modalities, there are little direct comparative data and no explicit curriculum prescriptions. Although active learning methodologies are believed to be better to traditional lecture formats, the strategic deployment of specic active 2 learning components has been less precisely dened . Consequently, curriculum leaders are frequently uncertain about how to blend small groups, e-learning, and traditional lecturing to create the optimal 3,4 learning environment . Unfortunately, emerging modes of 5 information transmission can exacerbate uncertainty .

Hospitalization can cause signicant stress and anxiety in a large portion of the paediatric population, making it an important public 1 health issue . Medical procedures, particularly those involving a needle, are one of the most common causes of anxiety, stress, and pain 2 in children . Children's distress resulting from a brief hospitalisation could compromise the success of their desired medical procedure. On the other hand, stress associated with long-term hospitalisation of children may result in aggression and regression in behaviour, non3,4 cooperation, and delayed recovery from the procedure . The response of children to anxiety and stress may vary depending on their age, sex, level of development, temperament, reason for hospitalisation, 5,6 sociocultural factors, and prior pain experiences . There are both pharmacological and non-pharmacological approaches to pain management. Non-pharmaceutical approaches include singing, reading, and playing games as distractions. Parent, child, and/or observer reports of decreased pain, distress, and anxiety are among the benets of nonpharmacological methods. There are both pharmacological and nonpharmacological approaches to pain management. Non-pharmacological methods include singing, reading, and playing a game as methods of distraction. Parent, child, and/or observer reports of decreased pain, distress, and anxiety are among the benets of nonpharmacological methods. Anxiety and stress related to hospitalisation may be treated with pharmacological 7 and non-pharmacological methods . The pharmacological approach entails the use of medications to alleviate stress, anxiety, and pain. However, pharmacological approaches have disadvantages that limit their long-term use, such as the potential for hyperalgesia and tolerance, the possibility of central nervous system (CNS) and gastrointestinal side effects in young children, and the high cost, 8 among others . Non-pharmacological approaches consist of a variety of distraction activities for the children, and are thus cost-effective and secure. They aid in reducing the child's distress, pain, and anxiety 9 during hospitalisation . The most common non-pharmaceutical method for stress and pain relief in hospitalised children is distraction. It is an effort that focuses on diverting children's attention to other 10 stimulants in order to reduce and manage their stress . It operates on the principle that the brain has a limited capacity to focus its attention on stimulation. Diverse techniques, including party blowers, watching cartoons, audio-visual games, distraction cards, and listening to short 11 stories, are used to implement the distraction method. .