1366: POSTRESUSCITATION DEBRIEFING PRACTICES AMONG PEDIATRIC CRITICAL CARE FELLOWS IN PAKISTAN

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Introduction: Postresuscitation debriefing (PRD) is associated with improved team performance, clinical learning, and provider well-being. However, there is a lack of data on PRD practices in low- and middle-income countries (LMICs). This study aimed to examine the current practices, training, and perceived utility of PRD among pediatric critical care medicine (PCCM) fellows in Pakistan. Methods: This abstract presents findings from Phase 1 of a two-phase, mixed-methods study on PRD in Pakistan. A structured online survey was distributed to second year PCCM fellows and recent graduates from accredited fellowship programs. Eligible participants had sufficient resuscitation exposure during training. The survey assessed PRD frequency, structure, leadership, training, knowledge, and barriers. Descriptive statistics were used. Phase 2 will include in-depth interviews to explore contextual and experiential aspects of PRD. Results: Sixteen fellows responded, representing 6 of 9 national PCCM training institutions. The current national trainee cohort includes approximately 24 fellows. All had participated in resuscitation teams; 81% reported involvement in >20 events. PRD followed 26–51% of resuscitations for 5 fellows, 1–25% for 6, and 50–75% for 5. Eighty-eight percent reported no formal PRD protocol in their PICUs. Debriefings were most commonly led by attendings (88%) and fellows (69%), typically held immediately post-event (44%) or within 6 hours (25%). Thirteen fellows had led ≥1 debriefing. Seventy-five percent had received formal training; commonly taught models included PEARLS and Debriefing with Good Judgment. The mean knowledge score was 12.8 ± 2.9 out of 16. All fellows endorsed PRD’s value in improving team performance, clinical reflection, emotional well-being, critical thinking, and collaboration, and expressed strong interest in further training and broader PRD implementation. Reported barriers included limited time (69%), training (63%), team attendance (25%), and leadership support (19%). Eighty-one percent reported institutional support. Conclusions: Despite high exposure to resuscitations, PRD is inconsistently practiced among PCCM fellows in Pakistan. Structured training and institutional strategies are needed to embed PRD into fellowship programs across the country.

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