Pediatric Cardiology

, Volume 34, Issue 3, pp 543–552 | Cite as

Prospective Assessment of Novice Learners in a Simulation-Based Extracorporeal Membrane Oxygenation (ECMO) Education Program

  • Soi-Yu Chan
  • Mayte Figueroa
  • Thomas Spentzas
  • Ashley Powell
  • Ricky Holloway
  • Samir ShahEmail author
Original Article


This study aimed to assess the impact of integrating a simulation-based education module into an extracorporeal membrane oxygenation (ECMO) curriculum on novice learners and to test the duration of time that skills obtained during this training exercise were retained. The authors hypothesized that multidisciplinary, simulation-based ECMO training would improve comfort and confidence levels among participants. An ECMO training curriculum was developed that incorporated in situ simulation modules to train multidisciplinary health care professionals involved in the management of patients receiving ECMO in the pediatric cardiac intensive care unit (PCICU). During the simulation, a team was assembled similar to the one that would staff the PCICU during a routine workday. Pre- and postparticipation questionnaires were used to determine the effects on the knowledge, ability, and confidence level of the participants. The participants were required to repeat the simulation test within 6–8 months. The study enrolled 26 providers (10 fellow physicians, 12 nurses and nurse practitioners, 4 respiratory therapists). All except one had no previous training in the management of ECMO. Of the 26 participants, 24 passed the initial written and practical tests. One participant failed the written test, whereas another failed the practical test. All the responding participants scored the didactic and scenarios education as useful, at 4 or higher (5 = very useful), in improving their perception of their overall knowledge and their ability to perform the required critical performance criteria on simulated ECMO. The 20 participants who appeared for the 6 month follow-up visit to assess maintenance of competency skills demonstrated success with simulated ECMO emergencies. All four questionnaires were completed by 18 participants. Simulation-based training is an effective method of improving knowledge, ability, and confidence levels among novice ECMO specialists and physician trainees. Further research is needed to assess real-time demonstration of skills retention during ECMO emergencies.


ECMO Education Simulation Novice learner 


  1. 1.
    Allan CK, Thiagarajan RR, Beke D et al (2010) Simulation-based training delivered directly to the pediatric cardiac intensive care unit engenders preparedness, comfort, and decreased anxiety among multidisciplinary resuscitation teams. J Thorac Cardiovasc Surg 140:646–652PubMedCrossRefGoogle Scholar
  2. 2.
    Anderson JM, Boyle KB, Murphy AA, Yaeger KA, LeFlore J, Halamek LP (2006) Simulating extracorporeal membrane oxygenation emergencies to improve human performance: Part I. Methodologic and technologic innovations. Simul Healthc 1:220–227PubMedCrossRefGoogle Scholar
  3. 3.
    Anderson JM, Murphy AA, Boyle KB, Yaeger KA, Halamek LP (2006) Simulating extracorporeal membrane oxygenation emergencies to improve human performance: Part II. Assessment of technical and behavioral skills. Simul Healthc 1:228–232PubMedCrossRefGoogle Scholar
  4. 4.
    Bloom BS (1956) Taxonomy of educational objectives: the classification of educational goals, 1st edn. Longmans, Green, New YorkGoogle Scholar
  5. 5.
    Chamberlain D, Smith A, Woollard M et al (2002) Trials of teaching methods in basic life support (3): comparison of simulated CPR performance after first training and at 6 months, with a note on the value of retraining. Resuscitation 53:179–187PubMedCrossRefGoogle Scholar
  6. 6.
    Donoghue AJ, Durbin DR, Nadel FM, Stryjewski GR, Kost SI, Nadkarni VM (2009) Effect of high-fidelity simulation on pediatric advanced life support training in pediatric house staff: a randomized trial. Pediatr Emerg Care 25:139–144PubMedCrossRefGoogle Scholar
  7. 7.
    Habashi NM, Borg UR, Reynolds HN (1994) An in vitro physiologic model for cardiopulmonary simulation: a system for ECMO training. Int J Artif Organs 17:399–407PubMedGoogle Scholar
  8. 8.
    Halamek LP, Kaegi DM, Gaba DM et al (2000) Time for a new paradigm in pediatric medical education: teaching neonatal resuscitation in a simulated delivery room environment. Pediatrics 106:E45PubMedCrossRefGoogle Scholar
  9. 9.
    Hammond J (2004) Simulation in critical care and trauma education and training. Curr Opin Crit Care 10:325–329PubMedCrossRefGoogle Scholar
  10. 10.
    Herzer KR, Rodriguez-Paz JM, Doyle PA et al (2009) A practical framework for patient care teams to prospectively identify and mitigate clinical hazards. Jt Comm J Qual Patient Saf 35:72–81PubMedGoogle Scholar
  11. 11.
    Howard SK, Gaba DM, Fish KJ, Yang G, Sarnquist FH (1992) Anesthesia crisis resource management training: teaching anesthesiologists to handle critical incidents. Aviat Space Environ Med 63:763–770PubMedGoogle Scholar
  12. 12.
    Knowles MS, Holton EF, Swanson R (1998) The adult learner. The definitive classic in adult education and human resource development, 5th edn. Gulf Publishing Company, Houston, TXGoogle Scholar
  13. 13.
    Patel RM, Crombleholme WR (1998) Using simulation to train residents in managing critical events. Acad Med 73:593PubMedCrossRefGoogle Scholar
  14. 14.
    Rodriguez-Paz JM, Mark LJ, Herzer KR et al (2009) A novel process for introducing a new intraoperative program: a multidisciplinary paradigm for mitigating hazards and improving patient safety. Anesth Analg 108:202–210PubMedCrossRefGoogle Scholar
  15. 15.
    Weinstock PH, Kappus LJ, Kleinman ME, Grenier B, Hickey P, Burns JP (2005) Toward a new paradigm in hospital-based pediatric education: the development of an onsite simulator program. Pediatr Crit Care Med 6:635–641PubMedCrossRefGoogle Scholar
  16. 16.
    Weinstock PH, Kappus LJ, Garden A, Burns JP (2009) Simulation at the point of care: reduced-cost, in situ training via a mobile cart. Pediatr Crit Care Med 10:176–181PubMedCrossRefGoogle Scholar
  17. 17.
    Young V (1987) Why planes crash. NOVA: WGBHGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Soi-Yu Chan
    • 1
  • Mayte Figueroa
    • 1
  • Thomas Spentzas
    • 2
    • 3
  • Ashley Powell
    • 2
  • Ricky Holloway
    • 2
  • Samir Shah
    • 2
    Email author
  1. 1.Division of Pediatric CardiologyLe Bonheur Children’s Hospital, University of Tennessee Health Science CenterMemphisUSA
  2. 2.Division of Pediatric Critical Care Medicine, Pediatric Extra Corporeal Life Support ProgramLe Bonheur Children’s Hospital, University of Tennessee Health Science CenterMemphisUSA
  3. 3.Division of Epidemiology and BiostatisticsLe Bonheur Children’s Hospital, University of Tennessee Health Science CenterMemphisUSA

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