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Objective. Preparing and responding to the needs of children during public health emergencies continues to be challenging. The purpose of this study was to assess the usefulness of a tabletop exercise in initiating pediatric preparedness strategies and assessing the impact of the exercise on participants’ understanding of and confidence in their roles during pediatric public health emergencies.

Methods. A tabletop exercise was developed to simulate a public health emergency scenario involving smallpox in a child, with subsequent spread to multiple states. During the exercise, participants discussed and developed communication, collaboration, and medical countermeasure strategies to enhance pediatric public health preparedness. Exercise evaluation was designed to assess participants’ knowledge gained and level of confidence surrounding pediatric public health emergencies.

Results. In total, 22 participants identified over 100 communication and collaboration strategies to promote pediatric public health preparedness during the exercise and found that the most beneficial aspect during the exercise was the partnership between pediatricians and public health officials. Participants’ knowledge and level of confidence surrounding a pediatric public health emergency increased after the exercise.

Conclusion. The tabletop exercise was effective in identifying strategies to improve pediatric public health preparedness as well as enhancing participants’ knowledge and confidence surrounding a potential pediatric public health emergency.