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Conclusions We hypothesize that this study is feasible to be conducted as a cluster RCT and that simulation-based training will be acceptable for acute care pediatric nurses. We anticipate that the intervention ward will have increased confidence in managing clinical aggression in children with ASD immediately and up to 3 months posttraining. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000139976; http//www.ANZCTR.org.au/ACTRN12620000139976.aspx. International registered report identifier (irrid