This paper analyzes the interaction between farmer training in pest management and effects on acute pesticide poisoning and populations of beneficial insects in Nicaragua. Using farm level data from Nicaraguan bean growers, including graduates of Farmer Field Schools (FFS), other integrated pest management (IPM) outreach methods, and farmers without exposure to IPM, we found that small farmers are influenced by pesticide-related acute illness experiences when adopting IPM practices and making decisions about pesticide use. However, exposure to IPM extension programs failed to reduce the use of highly toxic pesticides and increased the number of self-reported acute illness symptoms during the most recent bean crop season. IPM training did result in growth of beneficial insect populations.