ABSTRACT 636

Abstract

Background and aims: Capacity building in Pediatric Critical Care remains a challenge in underdeveloped countries. A Modified Delphi Assessment (MDA) was successfully conducted in Tanzania as part of the ADAPT program which resulted in the development of an educational curriculum focused on local needs. Aims: Conduct a MDA in Ecuador as part of the ADAPT program and compare results with Tanzania. Methods: We conducted a MDA, using a learning objectives survey generated by an expert panel of local and international physicians based on local CCM guidelines. Guided feedback ensured priorities were consistent with local needs and resources. Numeric equivalents were assigned to each priority and objectives prioritized using aggregate mean scores. A consultation group facilitated survey completion. This assessment/development was deemed within the voluntary routine educational activities of the participants and therefore not IRB review applicable. Informed consent, however, was obtained from all participants. Results: The MDA effectively cultivated local input and interest. Ecuador´s leaders embraced their role as expert panel and consultation group members. The majority of respondents (n=14) were clinicians (57%), followed by nurses and respiratory therapists (43%). Response rate was 100%. Simulation education and code card priorities (pediatric advanced life support, stabilization of the critical child, postoperative cardiac surgery, shock, acute respiratory distress) received mean scores above 3.6. Conclusions: Priorities differed between sites, shock being the only consistent topic, suggesting that local MDA based formal individualized training is imperative. Beyond our MDA, we experience mentored leadership, continued quality improvement, guideline revision, and supportive pre/post qualitative mortality studies.