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Simulation versus live tissue training randomised trial for ECMO proficiency: is one better than the other?
  1. Thornton Mu1,
  2. Tricia Garcia-Choudary2,
  3. Amanda Staudt2,
  4. Melissa Tyree3,
  5. Krystal Valdez-Delgado2,
  6. Nicole Caldwell2,
  7. Nicholas Carr1,
  8. Matthew Borgman1,
  9. Heather Delaney4
  1. 1 Pediatrics, Brooke Army Medical Center, JBSA Ft Sam Houston, Texas, USA
  2. 2 Clinical Research Support, US Army Institute of Surgical Research, JBSA Ft. Sam Houston, Texas, USA
  3. 3 Pediatrics, Center for Neonatal Care, Advent Health for Children, Orlando, Florida, USA
  4. 4 Pediatrix Medical Group, San Antonio, Texas, USA
  1. Correspondence to Thornton Mu, Dept of Pediatrics, Brooke Army Medical Center, 3551 Roger Brooke Dr., JBSA Ft. Sam Houston, TX 78234, USA;thornton.mu2.mil{at}mail.mil

Abstract

Introduction Extracorporeal membrane oxygenation (ECMO) is a classic low-volume high-risk procedure that requires just in time and/or refresher training through animal or simulation modalities. This manuscript evaluated the performance of ECMO personnel trained with both modalities to determine which is better suited for ECMO skills training.

Methods Participants (physicians, nurses and respiratory/medical technicians) completed a series of ECMO scenarios with synthetic tissue cannulation task trainer as well as a live tissue model. Objective performance quality was based on task completion using a validated ECMO skills assessment tool.

Results Thirty-eight individuals completed this study. Participants completed individual scenario tasks 3 min faster using the simulator (26 min vs 29 min; p=0.03). No differences were seen in percentage of individual tasks completed. In the group scenarios, participants completed a higher percentage of critical tasks using the simulator (97%) versus the animal model (91%; p=0.05), but no differences were seen in task completion times. Additionally, no differences were seen in either lab-based or participants’ prelab cognitive scores.

Conclusions Regardless of their self-assessment or experience, participants’ objective performances were similar among both animal and simulation labs. Task completion times were quicker with simulation model. The distinction between simulation versus animal model may be less important as both demonstrate benefit in development of and/or maintaining skill competency. In the era of questioning the need for and costs of live tissue training, expanding the role of simulation may achieve similar training goals.

  • High fidelity simulation
  • interprofessional education
  • procedural skills training
  • procedure based assessments
  • infant, newborn
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Footnotes

  • Contributors TM, TG-C, NCarr, MB and HD contributed to the conception of the work as well as data acquisition and analysis, the drafting/revisions of the manuscript for intellectual content as well as final approval of the published version, and agree to be accountable for all aspects of the work. MT, KV-D and NCald contributed to the conception of the work, data analysis, revising the manuscript for intellectual content as well as final approval of the published version, and agree to be accountable for all aspects of the work. AS contributed to the data analysis/interpretation, revising the manuscript for intellectual content as well as final approval of the published version, and agrees to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Disclaimer The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, U.S. Army Institute of Surgical Research, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, or the Department of Defense or the U.S. Government.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplemental information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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