"It Is Humble but Honorable Work": A Needs Assessment of Critical Care Education in the Pediatric Residency Programs of Honduras.

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.