Perceptions of challenges in clinical pediatric research: a survey of Italian pediatricians

BACKGROUND: Clinical research is essential for advancing pediatric care, yet pediatricians often face unique structural, organizational, and methodological barriers that may hinder their participation in scientific activities. Understanding these obstacles is crucial to designing effective strategies that strengthen pediatric research capacity in Italy, a country with a leading role in European pediatric output. This study aimed to investigate Italian pediatricians' perceptions of barriers, facilitators, and needs related to conducting research, applying evidence in clinical practice, and publishing scientific work. METHODS: We conducted a cross-sectional online survey of Italian pediatricians using an 18-item questionnaire administered between April and May 2025. Data were analyzed descriptively, and multilevel logistic regression assessed associations between perceived barriers and respondents' characteristics. RESULTS: A total of 717 pediatricians involved in clinical and/or research activities were included. Among those engaged in research (n = 385), the most frequently reported personal barriers were difficulties balancing clinical and research duties (79.3%) and limited access to funding (67.9%). Operational issues such as delayed Ethics Committee approvals (80.8%) and challenges in multicenter data sharing (55.9%) were also prominent. Many respondents expressed dissatisfaction with current research evaluation systems: 78.2% believed that metrics should reflect long-term patient impact, and 73.1% reported that existing criteria penalize pediatric researchers in low-resource settings. Regarding scientific publishing, major obstacles included limited time (75%), complexity of data analysis (58.7%), and publication costs (55%). Interest in support initiatives was high, particularly for monthly evidence summaries (88.5%) and training in artificial intelligence tools (74.3%). Multivariate analysis revealed significant differences by age, gender, and professional role, especially concerning perceived research training adequacy and data analysis difficulties. CONCLUSIONS: Italian pediatricians face substantial structural, organizational, and methodological barriers to conducting research. Despite this, they show strong motivation to engage in scientific activities and express clear needs for training, infrastructural support, and improved evaluation systems. Strengthening funding opportunities, enhancing institutional support, and streamlining ethical and administrative procedures are essential to advancing pediatric research capacity and improving future child health outcomes.