Designing a Patient-Centred Educational Extracorporeal Membrane Oxygenation Simulator (EduECMO) – A training needs analysis with international experts

Introduction: 

Extracorporeal membrane oxygenation (ECMO) is a complex, invasive technique to provide prolonged cardiac and respiratory support. A variety of simulators are available to train advanced technical skills and interdisciplinary team communication. However, high-fidelity simulators are lacking, yet are needed. In the EduECMO project, such a simulator is designed following the design method of Van Meurs. This design process starts with a training needs analysis (TNA) to investigate mission, task, trainee, and training. This study aims to perform an ECMO simulator TNA, and provide guidelines for ECMO simulator design.

Methods: 

Training needs assessment was based on the INACSL Standards of Best Practice. Experts were invited by email to participate in an online survey (July-October 2023). All participants signed informed consent. The study was approved by the University of Twente Ethics Committee (NES:230117). Descriptive statistics were used to describe the data.

Results: 

41 participants from 11 countries responded. Participants were medical specialists (n=23) and allied healthcare professionals, e.g. nurses, perfusionists (n=18). The number of ECMO cases per year varied between centres from less than 6 cases (18%) to over 30 cases (40%) per year. Participants indicated the main tasks for an ECMO simulator to be provision of optimal diagnostics, cannulation, circuit priming, and monitoring. Respondents stated that trainees should train their skills on an ECMO simulator regardless of background. Desired simulator parts should allow for patient-specific differences in sex, skin tone, and body surface area. ECMO challenges and risks should be addressed in varying scenarios.

Discussion & Conclusion: 

The TNA resulted in implementable guidelines for the EduECMO simulator. Strengths of this study were that an international multidisciplinary expert group from low-, mid-, and high-volume ECMO centres was included. Follow-up observations of experts performing ECMO are proposed to validate findings from the survey and identify attitudes of the learners.