Abstract
Background: We developed and tested a clinical simulation program in the principles and conduct of postcardiotomy extracorporeal membrane oxygenation (ECMO) with the aim of improving confidence, proficiency, and crisis management. Methods: Twenty-three thoracic surgery residents from unique residency programs participated in an ECMO course involving didactic lectures and hands-on simulation. A current postcardiotomy ECMO circuit was used in a simulation center to give residents training with basic operations and crisis management. Pretraining and posttraining assessments concerning confidence and knowledge were administered. Before and after the training, residents were asked to identify components of the ECMO circuit and manage crisis scenarios, including venous line collapse, arterial hypertension, and arterial desaturation. Results: In the hands-on portion, residents had difficulty identifying the gas source and flow rate, centrifugal pump head inlet, and oxygenator outflow line. Timely and accurate ECMO component identification improved significantly after training. The arterial desaturation crisis scenario gave the residents difficulty, with only 22% providing the appropriate treatment recommendations in a timely and accurate fashion. At the end of the simulation training, most residents were able to manage the crises correctly in a timely manner. Posttraining confidence-related scores increased significantly. Most of the residents strongly recommended the course to their peers and reported simulation-based training was helpful in their postcardiotomy ECMO education. Conclusions: We developed a simulation-based postcardiotomy ECMO training program that resulted in improved ECMO confidence in thoracic surgery residents. Crisis management in a simulated environment enabled residents to acquire technical and behavioral skills that are important in managing critical ECMO-related problems.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 901-906 |
| Number of pages | 6 |
| Journal | Annals of Thoracic Surgery |
| Volume | 95 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2013 |
Fingerprint
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Pulmonary and Respiratory Medicine
Cite this
Simulation-based postcardiotomy extracorporeal membrane oxygenation crisis training for thoracic surgery residents. / Burkhart, Harold M.; Riley, Jeffrey B.; Lynch, James J.; Suri, Rakesh M.; Greason, Kevin L.; Joyce, Lyle D.; Nuttall, Gregory A.; Stulak, John; Schaff, Hartzell V; Dearani, Joseph A.
In: Annals of Thoracic Surgery, Vol. 95, No. 3, 03.2013, p. 901-906.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Simulation-based postcardiotomy extracorporeal membrane oxygenation crisis training for thoracic surgery residents
AU - Burkhart, Harold M.
AU - Riley, Jeffrey B.
AU - Lynch, James J.
AU - Suri, Rakesh M.
AU - Greason, Kevin L.
AU - Joyce, Lyle D.
AU - Nuttall, Gregory A.
AU - Stulak, John
AU - Schaff, Hartzell V
AU - Dearani, Joseph A.
PY - 2013/3
Y1 - 2013/3
N2 - Background: We developed and tested a clinical simulation program in the principles and conduct of postcardiotomy extracorporeal membrane oxygenation (ECMO) with the aim of improving confidence, proficiency, and crisis management. Methods: Twenty-three thoracic surgery residents from unique residency programs participated in an ECMO course involving didactic lectures and hands-on simulation. A current postcardiotomy ECMO circuit was used in a simulation center to give residents training with basic operations and crisis management. Pretraining and posttraining assessments concerning confidence and knowledge were administered. Before and after the training, residents were asked to identify components of the ECMO circuit and manage crisis scenarios, including venous line collapse, arterial hypertension, and arterial desaturation. Results: In the hands-on portion, residents had difficulty identifying the gas source and flow rate, centrifugal pump head inlet, and oxygenator outflow line. Timely and accurate ECMO component identification improved significantly after training. The arterial desaturation crisis scenario gave the residents difficulty, with only 22% providing the appropriate treatment recommendations in a timely and accurate fashion. At the end of the simulation training, most residents were able to manage the crises correctly in a timely manner. Posttraining confidence-related scores increased significantly. Most of the residents strongly recommended the course to their peers and reported simulation-based training was helpful in their postcardiotomy ECMO education. Conclusions: We developed a simulation-based postcardiotomy ECMO training program that resulted in improved ECMO confidence in thoracic surgery residents. Crisis management in a simulated environment enabled residents to acquire technical and behavioral skills that are important in managing critical ECMO-related problems.
AB - Background: We developed and tested a clinical simulation program in the principles and conduct of postcardiotomy extracorporeal membrane oxygenation (ECMO) with the aim of improving confidence, proficiency, and crisis management. Methods: Twenty-three thoracic surgery residents from unique residency programs participated in an ECMO course involving didactic lectures and hands-on simulation. A current postcardiotomy ECMO circuit was used in a simulation center to give residents training with basic operations and crisis management. Pretraining and posttraining assessments concerning confidence and knowledge were administered. Before and after the training, residents were asked to identify components of the ECMO circuit and manage crisis scenarios, including venous line collapse, arterial hypertension, and arterial desaturation. Results: In the hands-on portion, residents had difficulty identifying the gas source and flow rate, centrifugal pump head inlet, and oxygenator outflow line. Timely and accurate ECMO component identification improved significantly after training. The arterial desaturation crisis scenario gave the residents difficulty, with only 22% providing the appropriate treatment recommendations in a timely and accurate fashion. At the end of the simulation training, most residents were able to manage the crises correctly in a timely manner. Posttraining confidence-related scores increased significantly. Most of the residents strongly recommended the course to their peers and reported simulation-based training was helpful in their postcardiotomy ECMO education. Conclusions: We developed a simulation-based postcardiotomy ECMO training program that resulted in improved ECMO confidence in thoracic surgery residents. Crisis management in a simulated environment enabled residents to acquire technical and behavioral skills that are important in managing critical ECMO-related problems.
UR - http://www.scopus.com/inward/record.url?scp=84874619072&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874619072&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2012.12.015
DO - 10.1016/j.athoracsur.2012.12.015
M3 - Article
C2 - 23374448
AN - SCOPUS:84874619072
VL - 95
SP - 901
EP - 906
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 3
ER -