Training needs and knowledge gaps in acute respiratory distress syndrome care among intensive care physicians and nurses at a single tertiary hospital in Ningxia, China: a cross-sectional survey

Effective ARDS care requires clinician knowledge, coordinated practice, and organizational support, yet continuing education is seldom aligned with measured deficits. Evidence integrating training exposure, knowledge, and institutional readiness among ICU physicians and nurses after the Global Definition remains limited. This study assessed ARDS-related knowledge, attitudes, self-reported practice, organizational readiness, barriers, training priorities, and exploratory differences by previous training modality. Single-center cross-sectional electronic survey conducted from April through June 2026 among physicians and registered nurses providing adult ICU care at a tertiary hospital in Ningxia, China. Participants formed a voluntary nonprobability sample. A study-specific questionnaire, developed through expert review and pilot testing but not formally validated, was scored on 0–100 scales. We compared professions, examined Spearman correlations, applied Benjamini–Hochberg correction to item-level comparisons, and used multivariable linear regression with heteroscedasticity-robust standard errors and ICU-unit fixed effects. Among 422 participants (142 physicians and 280 nurses), mean 0–100 scores were 64.9 (standard deviation [SD] 19.3) for knowledge, 77.4 (SD 9.9) for attitudes, 68.3 (SD 10.6) for practice, 61.3 (SD 13.5) for perceived organizational readiness, and 60.7 (SD 12.3) for perceived barriers. Attitudes exceeded knowledge by 12.5 points and perceived readiness by 16.1 points. The lowest correct-response proportions concerned the peripheral oxygen saturation/fraction of inspired oxygen ratio (43.4%), higher positive end-expiratory pressure without prolonged recruitment maneuvers (47.9%), and lung ultrasonography (49.1%). The physician–nurse knowledge difference narrowed from 18.2 to 10.8 points when analysis was restricted to competencies shared by both professions. High workload (72.7%), inadequate staffing (66.6%), and insufficient practical refresher training (59.2%) were the most frequently reported major or very major barriers. Each 10-point increase in perceived readiness was associated with a 2.54-point higher practice score (95% confidence interval, 1.63–3.45); knowledge, attitudes, ARDS case exposure, prior training, and physician profession were also associated (adjusted R² 0.320). At this center, favorable attitudes coexisted with lower knowledge, self-reported practice, and perceived readiness scores. These cross-sectional associations identify candidate educational and organizational targets; multicenter validation is required before they inform policy.