A qualitative assessment of learner experiences with a novel Paediatric Emergency Medicine curriculum in Kenya
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Christine E Maloney1, Amelie von Saint Andre-von Arnim2, Bhupinder Reel3
1Department of Pediatrics, Division of Emergency Medicine, University of Washington, Seattle Children's Hospital, Seattle, WA, USA.
Introduction:
Paediatric emergency and critical care (PECC) services are essential in reducing childhood mortality from treatable conditions, particularly in sub-Saharan Africa where the burden remains high. Despite this need, access to subspecialty training in PECC has been limited in the region. Launched in 2019 at the University of Nairobi, the PECC-Kenya fellowship is a novel subspecialty training program for regional paediatricians in both paediatric emergency medicine (PEM) and critical care. Curricular elements for PEM within the fellowship were adapted from international guidelines for local context. The objective of this study was to explore the perspectives of current fellows and recent graduates on the content of the PEM portion of their curriculum to inform improvements and future development for the program and the region.
Methods:
Semi-structured interviews were conducted with current and former PECC-Kenya fellows. Program faculty developed an interview guide which included questions about perceptions on PEM, anticipated future practice, and strengths and opportunities within the curriculum. Interviews were conducted and recorded via Zoom by a non-faculty interviewer. Anonymized transcriptions were uploaded into Dedoose. After establishing inter-rater reliability, three reviewers coded the data, and key themes were identified.
Results:
Ten interviews were conducted in 2022 and 2023, revealing several themes. Fellows anticipated providing continuous care from the emergency department to the intensive care unit as the sole PECC specialist in their institution or region. They highlighted program strengths including high-quality live online lectures, in-person PEM intensive training, diverse clinical exposure, and establishment of a peer network. Fellows expressed a desire for more hands-on training and recognized the importance of point-of-care ultrasound in facilitating rapid diagnosis and assisting in procedures, with need for additional training.
Discussion:
Given the innovative nature of this training program and its distinctive demands, these themes and findings could serve as valuable guidance for similar initiatives emerging in the region.
