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Development and implementation of a modified IMEGH Paediatric Advanced Life Support course in a low-resource setting.

Nita Avrith1, Sussana Oad1, Ann Pearson1

  • 1Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

African Journal of Emergency Medicine : Revue Africaine De La Medecine D'Urgence
|March 19, 2026
PubMed
Summary

The Initiative for Medical Equity and Global Health (IMEGH) Paediatric Advanced Life Support (PALS) course significantly improved healthcare providers' knowledge and self-confidence in paediatric resuscitation in low-resource settings. Simulation performance did not show significant improvement in this study.

Keywords:
Low-fidelity simulationPediatric advanced life supportPediatric resuscitation

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Area of Science:

  • Emergency Medicine
  • Global Health
  • Medical Education

Background:

  • The American Heart Association (AHA) Paediatric Advanced Life Support (PALS) course is often inaccessible in low-resource settings due to cost and logistical challenges.
  • The Initiative for Medical Equity and Global Health (IMEGH) developed a modified PALS course tailored for these environments.

Purpose of the Study:

  • To implement and evaluate the impact of the modified IMEGH PALS course.
  • To assess changes in participants' paediatric resuscitation knowledge, self-confidence, and simulation performance.

Main Methods:

  • A mixed-methods study was conducted with medical professionals at the 2024 African Conference of Emergency Medicine in Gaborone, Botswana.
  • Participants completed pre- and post-course assessments including a knowledge test, self-confidence survey, and simulation checklist.
  • Data were analyzed using descriptive statistics, paired t-tests, Wilcoxon signed rank test, and thematic analysis of feedback.

Main Results:

  • Mean knowledge scores significantly improved from 75.29% to 90% post-course (p<0.05).
  • Median self-confidence scores showed statistically significant improvement across all 24 assessed domains (p<0.05).
  • No significant difference was observed in pre- versus post-course simulation performance scores.

Conclusions:

  • The modified IMEGH PALS training effectively enhanced provider knowledge and self-confidence in paediatric resuscitation.
  • Grouped simulation assessments limited the evaluation of individual competency; future studies should use individualized scoring.
  • Recommendations include larger sample sizes, diverse participants, and long-term retention assessments.