(796) Pediatric Cardiac Surgery and Inclusive Psychologically Safe Pedagogy as Drivers of PCCM Capacity

Introduction: Historically, humanitarian pediatric surgical missions often do not build sustainable Pediatric Critical Care Medicine (PCCM) capacity. They are usually short term, and almost completely comprised of external staff. While arguably necessitated by both the time frame and complexity of care involved, this approach does not promote inclusive PCCM growth. We have previously reported on the success of High Yield Pedagogy in building PCCM capacity over the past decade in Guyana, Haiti, and Nepal. Here we discuss a globally unique variant wherein reoccurring pediatric cardiac surgical missions, strategically combined with High Yield Pedagogy PCCM Training, has resulted in the establishment of self-sufficient multidisciplinary PCCM teams in The Democratic Republic of the Congo (DRC) and Iraq.

Methods: Reoccurring surgical missions address both the time and staffing limitations that preclude development with one-off missions by providing continuity of mentoring through both didactic and clinical milieus. High Yield Pedagogy further addresses these limitations by focusing on developing local staff as Clinician-Educators. In High Yield Pedagogy, PCCM Concepts are taught in a step-wise synergistic modular model over multiple missions via culturally sensitive, inclusive and student driven Scenario Based Training in an environment emphasizing Psychological Safety, 360 Degree Feedback, High Performance Teamwork, Dynamic Process Improvement, and Training the Trainer.

Results: Over 6 months, in conjunction with multiple pediatric open heart surgical missions, training in Pediatric Critical Care Medicine was provided to over 100 multidisciplinary health care providers in DRC and Iraq. Individuals were evaluated via multiple tools pre, peri, and post didactic and clinical missions as Individuals, Team Leaders, and Instructors. Improved didactic and clinical outcomes were consistently observed throughout all cadres. Moreover, our long term goal of building PCCM capacity was realized in the formation of multi-disciplinary PCCM teams in both DRC and Iraq.

Conclusions: Reoccurring pediatric cardiac surgery missions in combination with High Yield Pedagogy is a novel valid and reproducible strategy for promoting global health equity and developing sustainable PCCM Capacity in Low Middle Income Countries.