Abstract

Background: Inter-facility transport of critically ill children in the Western Cape, in South Africa, poses significant risks, often contributing to preventable morbidity.¹ While specialised teams exist, many transfers are undertaken by non-specialist personnel. South African literature confirms this gap, noting that paediatric critical care retrieval is often absent as a formal, stand-alone course in tertiary curricula and that transfers are handled by personnel with variable baseline training.² This lack of standardised, continuous professional development creates a gap between theoretical knowledge and clinical application.

Methods: We developed the Paediatric Transport Reflective Improvement and Simulation-based Education (PaeTRISE) framework, informed by literature on simulation, reflective practice, and transport medicine. PaeTRISE is founded on two pillars: Reflective Improvement (structured debriefing to critically analyse clinical experiences) and Simulation-based Education (safe practice of high-acuity, low-occurrence events.³ The framework integrates these pillars into a continuous cycle of learning, reflection, and adaptation, tailored to the geo-historical and socio-cultural realities of the Western Cape healthcare system.

Results: PaeTRISE has the potential to cultivate emergent excellence. By coupling simulation with reflective practice, it transcends procedural training to enhance adaptive decision-making, teamwork, and resilience. From a critical realist perspective, PaeTRISE functions as a causal mechanism to activate practitioners’ latent capacity. Crucially, it directly addresses the documented absence of a formalised, standardised learning structure for this high-risk activity, proposing a scalable, contextually relevant model for continuous professional development. The explicit integration of reflection and simulation represents a novel contribution to standardising paediatric transport education in South Africa.

Conclusion: PaeTRISE offers a theoretically grounded, practical framework to strengthen the quality and safety of paediatric transport. Adoption of this model may empower healthcare providers, improve patient outcomes, and foster a culture of reflective excellence

Author contributions
All authors contributed equally and validated the final version of
record.
Declarations
Conflicts Of Interests
The Authors declare that there is no conflict of interest.
Funding
This research received no specific grant from any funding agency in
the public, commercial, or not-for-profit sectors.
Registration
No registration applicable.
Data availability statement
The data that support the findings of this study are available from
the corresponding author upon reasonable request.
Ethical approval
Ethical approval for this study was not required.

References

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2.      Williams W, Theron E, Khan W, Stassen W. Developing a South African curriculum for education in neonatal critical care retrieval: An initial exploration. PLoS One. 2023 Aug 31;18(8):e0290972. https://doi.org/10.1371/journal.pone.0290972

3.      Alinier G, Al Shaikh L, Campbell C, Fawzy I, Meyer J. Board# 200-Program Innovation Development of a Multi-disciplinary Simulation-based Training Course for the Safe High Acuity Adult Retrieval Programme (SHAARP) (Submission# 9978). Simulation in Healthcare. 2014 Dec 1;9(6):439. https://doi.org/10.1097/01.SIH.0000459339.11544.33