Implementing the Safer Anaesthesia From Education Paediatrics Course in Japan: Contextual Adaptation and Early National Dissemination.

Abstract

Background: In Japan, declining birth rates and concentration of pediatric cases in fewer high-volume children's hospitals have reduced anesthesiologists' opportunities, particularly during training, to gain experience in pediatric anesthesia. There is no standardized national curriculum, and training relies largely on workplace-based learning. The Safer Anaesthesia From Education (SAFE) Paediatrics Course is a structured program originally developed for low- and middle-income countries; whether it can be contextually adapted and disseminated in a high-income country facing different training challenges has not been established.

Aims: To describe the translation, contextual adaptation, early implementation, and initial national dissemination of the SAFE Paediatrics Course in Japan, including preliminary educational outcomes from a single-center resident training program.

Methods: We conducted a two-phase descriptive educational project. Phase 1 comprised course translation, contextual adaptation, pilot testing of a multiple-choice question (MCQ) examination, and pilot delivery. Phase 2 comprised single-center implementation and evaluation at Saitama Children's Medical Center among anesthesia residents (October 2021-March 2023). Participants completed pre- and post-course MCQ tests and confidence ratings; a post-course survey assessed satisfaction. National dissemination was described using aggregated course-level data.

Results: Thirty residents participated in the single-center evaluation. MCQ scores increased from 37.87 to 41.67 out of 50 (mean increase 3.80; 95% CI: 2.64-4.96; p < 0.001), and self-rated confidence increased. Satisfaction was high (17/20 respondents rated the course 4 or 5). Between October 2021 and January 2026, 28 courses were delivered across four geographical areas and national meeting-affiliated sessions, accounting for 359 participant attendances; many used condensed one-day or half-day formats.

Conclusions: The SAFE Paediatrics Course was translated, contextually adapted, and implemented in Japan, with early dissemination across multiple geographical areas and flexible delivery formats. Preliminary single-center outcomes support its suitability as a structured pediatric anesthesia educational program in this setting. Further multicenter and longitudinal evaluation is warranted.