Peer-reviewed article
"It Is Humble but Honorable Work": A Needs Assessment of Critical Care Education in the Pediatric Residency Programs of Honduras.
Napky Raudales PJ, Jimenez-Zambrano A, Velasquez SY, Anariba DC, Rodriguez SL et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study assessed the educational needs of pediatric residents and doctors in Honduras who care for critically ill children, often outside intensive care units due to limited resources. Researchers surveyed residents, graduates, and faculty at the two pediatric residency programs and conducted interviews from 2023 to 2025. The findings show that only about 70% of graduating residents and attending physicians felt confident caring for critically ill children, despite all considering critical care training essential. The research recommends that future training should focus on adaptive expertise and self-directed learning skills suited to resource-limited settings.
Key points
- Only 69% of graduating residents and 69% of attending physicians felt moderately to extremely confident assessing critically ill children in Honduras
- Confidence in managing critically ill children depended on knowledge, skills, available resources, and ability to adapt to constraints
- All surveyed groups considered preidentified critical care diagnoses extremely important for education, but frequency of treatment and training varied
- Experiential and self-directed learning were identified as key educational strategies needed for pediatric trainees
- Most critically ill children in Honduras are cared for by general pediatricians outside pediatric intensive care units due to lack of human, physical, and infrastructural resources
Limitations
This is a needs assessment rather than an evaluation of an intervention, so it identifies problems and gaps but does not test solutions. The study was still ongoing at the time of publication (2023-2025), and only 47% of residents and 52% of pediatricians completed surveys, which may limit generalisability.
Abstract
Background Due to lack of human, physical, and infrastructural resources, most critically ill children in Honduras are cared for by general pediatricians outside of pediatric intensive care units, stressing the need to address the education of this critical group. Objective To understand the educational needs of pediatric trainees in Honduras related to the care of critically ill children, and the impact of the local context to inform future curriculum development. Methods We conducted a needs assessment with a sequential explanatory mixed methods design from 2023 to 2025. Participants included pediatric residents, graduates, and faculty of the 2 pediatric residency programs. Data on essential critical care knowledge and skills, educational needs, and educational strategies was collected through electronic surveys and semistructured virtual interviews. Quantitative data were analyzed using descriptive statistics, and qualitative data, with rapid matrix analysis. Results Forty-five of 96 (47%) residents and 47 of 91 (52%) pediatricians completed the survey; 5 graduates participated in subsequent interviews. Only 69% of graduating residents (11 of 16) and attendings (33 of 48) felt moderately to extremely confident assessing critically ill children. Both surveyed groups considered all preidentified critical care diagnoses extremely important in their education, yet frequency of treatment, confidence with management, and degree of training were variable. Perceived confidence was dependent on knowledge, skills, available resources, and ability to adapt to constraints. Experiential and self-directed learning are key strategies in their education. Conclusions Our findings revealed that teaching that builds adaptive expertise and self-directed learning skills is essential for pediatric trainees in Honduras.