Effective pain management requires knowledge, critical thinking and training. An identified problem at Children's Hospital Colorado is the translation and application of knowledge to clinical situations. Like other hospitals, we also operate under the constraints of time, finances, and adult learning styles. To address these issues, the Pain Management Services, Pain Resource Nurses (PRN), Professional Development and Accreditation groups, collaborated to create the “Comfort Wheel”. This is an interactive, case study-based tool targeting integration of pain knowledge and pediatric clinical situations. It is adaptable and able to address changes in pain assessment, interventions, regulations, and documentation needs. Additionally, the “Comfort Wheel” encourages personal reflection and a problem solving approach to pain management. Skills that we reinforce are assessment, actions/interventions, evaluation/reflection, consequences, communication skills, outcomes, rationale, hospital policies, ethical frameworks, resources, attitudes, beliefs, values and scope of practices . Case study categories utilized are regulatory, assessment/reassessment, pain pump issues, barriers, documentation, ethical issues, pharmacological interventions, non-pharmacological interventions, regional anesthesia/blocks and special considerations. Commonly, the new graduates are divided into groups and have buzzers available to utilize when answering the questions related to the case studies. The groups can utilize any available resource. Discussions related to the rationale or evidence occurs when necessary. Questions are encouraged. Moderation of the discussions include 2-3 individuals from the following: advanced practice nurses (APN) (pain management services, education/practice specialists, accreditation, and professional development), and representatives from the PRN group. Case studies were developed by the PRN group and APNs and are visualized via PowerPoint. The atmosphere is adjusted to participants learning styles, personalities and group dynamics. This innovative approach is well received by new graduate nurses.