Simulation-Based Assessment of ECMO Clinical Specialists.
OBJECTIVE
The aims of the study were (1) to create multiple scenarios that simulate a range of urgent and emergent extracorporeal membrane oxygenation (ECMO) events and (2) to determine whether these scenarios can provide reliable and valid measures of a specialist's advanced skill in managing ECMO emergencies.


METHODS
Multiscenario simulation-based performance assessment was performed.


METHODS
The study was conducted in the Saigh Pediatric Simulation Center at St. Louis Children's Hospital.


METHODS
ECMO clinical specialists participated in the study.


RESULTS
Twenty-five ECMO specialists completed 8 scenarios presenting acute events in simulated ECMO patients. Participants were evaluated by 2 separate reviewers for completion of key actions and for global performance. The scores were highest for the hemodilution scenario, whereas the air entrainment scenario had the lowest scores. Psychometric analysis demonstrated that ECMO specialists with more than 1 year of experience outperformed the specialists with less than 1 year of experience. Participants endorsed these sessions as important and representative of events that might be encountered in practice.


CONCLUSIONS
The scenarios could serve as a component of an ECMO education curriculum and be used to assess clinical specialists' readiness to manage ECMO emergencies.
From the Departments of Anesthesiology & Pediatrics, Washington University School of Medicine (J.J.F.); St. Louis Children's Hospital (M.S., M.M.), St. Louis, MO; Department of Pediatrics, Northwestern University School of Medicine (M.E.M.), Chicago, IL; Department of Anesthesiology (K.R.), Washington University School of Medicine, St. Louis, MO; Department of Anesthesiology, Washington University School of Medicine (D.J.M.), St. Louis, MO; and Foundation for Advancement of International Medical Education and Research (J.R.B.), Philadelphia, PA.
James J
JJ
Fehr
Mark
M
Shepard
Mary E
ME
McBride
Mary
M
Mehegan
Kavya
K
Reddy
David J
DJ
Murray
John R
JR
Boulet
D000328:Adult; D002983:Clinical Competence; D003422:Critical Care; D003479:Curriculum; D004509:Education, Nursing, Continuing / Q000379:methods*; D004521:Educational Measurement; D015199:Extracorporeal Membrane Oxygenation / Q000193:education*; D005246:Feedback; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D008348:Manikins; D010372:Pediatrics / Q000193:education*; D000066908:Simulation Training