{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:27:59Z","timestamp":1786116479771,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Agency for International Cooperation","award":["81294565"],"award-info":[{"award-number":["81294565"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr. Rep.","Pediatric Reports"],"abstract":"<jats:p>Background\/Objectives: Road traffic accidents represent the leading cause of death in children and adolescents in Brazil. In the state of Piau\u00ed, 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 \u00b1 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.<\/jats:p>","DOI":"10.3390\/pediatric18040109","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T09:46:38Z","timestamp":1786009598000},"page":"109","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Designing and Implementing a Simulation-Based Pediatric Trauma Training Program in a Resource-Limited Setting: The PRACTICE Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Jakob","family":"Olbrich","sequence":"first","affiliation":[{"name":"Center for Emergency Training (ZfN), BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"},{"name":"Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-0639","authenticated-orcid":false,"given":"Alexander","family":"H\u00f6nning","sequence":"additional","affiliation":[{"name":"Center for Clinical Research (ZkF), BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Icaro Luan","family":"Tavares Latado","sequence":"additional","affiliation":[{"name":"Center for Emergency Training (ZfN), BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"},{"name":"Clinic for Anesthesiology, Critical Care Medicine, and Pain Management, BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5658-2298","authenticated-orcid":false,"given":"Andrea","family":"Laufer","sequence":"additional","affiliation":[{"name":"Clinic for General Orthopedics and Tumor Orthopedics, Muenster University Hospital, 48149 Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janna","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Hand Surgery, and Sports Medicine, Vivantes-Humboldt Klinikum, 13509 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Haucke","sequence":"additional","affiliation":[{"name":"Center for Emergency Training (ZfN), BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"J\u00fcnemann","sequence":"additional","affiliation":[{"name":"Center for Emergency Training (ZfN), BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Weibrecht","sequence":"additional","affiliation":[{"name":"Associa\u00e7\u00e3o ProBrasil Nordeste, Coronel Jos\u00e9 Dias 64793-000, PI, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 de Ribamar","family":"Bandeira Filho","sequence":"additional","affiliation":[{"name":"Luc\u00eddio Portella Children\u2019s Hospital, Teresina 64001-450, PI, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Zappel","sequence":"additional","affiliation":[{"name":"Robert Koch Institute, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2448-2150","authenticated-orcid":false,"given":"Sinan","family":"Bakir","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany"},{"name":"Center for Orthopedics and Trauma Surgery, Helios Hospital Berlin-Buch, 13125 Berlin, Germany"},{"name":"Medical School Berlin (MSB), University of Health and Medicine, 14197 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref_1","unstructured":"World Report on Child Injury Prevention, Peden, M., Oyegbite, K., Ozanne-Smith, J., Hyder, A.A., Branche, C., Rahman, A.F., Rivara, F., and Bartolomeos, K. 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