Designing and Implementing a Simulation-Based Pediatric Trauma Training Program in a Resource-Limited Setting: The PRACTICE Study

Background/Objectives: Road traffic accidents represent the leading cause of death in children and adolescents in Brazil. In the state of Piauí, non-specialized facilities frequently manage critically injured pediatric patients. Targeted training programs are considered a key strategy for improving outcomes. This study assessed the feasibility of adapting a pediatric trauma course developed in a high-income setting for medical first responders in both pre-hospital and in-hospital settings in a resource-limited environment in northeastern Brazil. Methods: This prospective non-randomized mixed-methods feasibility-oriented implementation and educational evaluation study involved the design of a simulation-based course based on a literature review by a German interprofessional and interdisciplinary team. Local adaptation was achieved through a needs assessment, field visits, and stakeholder collaboration. Implementation included the training of Brazilian instructor candidates, who subsequently delivered the course under supervision. Data were collected using study-specific, non-validated questionnaires at two timepoints and analyzed descriptively and exploratively. Results: A total of 98 healthcare professionals participated in the needs assessment (mean experience 9.7 ± 6.3 years; 62.2% nursing staff); 66 completed the pediatric trauma management section. Although familiarity with the ABCDE approach was high (86%), confidence in pediatric trauma management was significantly lower than management in adults (47% vs. 68%, p = 0.0018), particularly for invasive procedures. During implementation, 38 participants completed the course, with a 100% recommendation rate; approximately 80% felt prepared to teach independently. However, participants and instructors highlighted the need for more practical training, longer course duration, and follow-up instructor training. Conclusions: A context-adapted, simulation-based pediatric trauma training program was feasibly implemented and well accepted in a resource-limited region of Brazil. The train-the-trainer approach shows promise for strengthening local pediatric trauma capacity, but sustained implementation requires continued instructor development, supervised teaching, and long-term evaluation of educational and clinical outcomes.