ABSTRACT #26

CREATION OF A MULTI-MODAL SIMULATION-BASED ECMO CURRICULUM FOR PULMONARY-CRITICAL CARE FELLOWS

Jonathan Taylor, Patrick Maher, Gary Oldenburg, Samuel Acquah

PURPOSE AND GOALS: Extracorporeal membrane oxygenation (ECMO) usage for refractory cardiac and respiratory failure is recognized as a key component of critical care training, however concerns surrounding inadequate fellowship preparation in ECMO care have been identified in the literature. ECMO patient management remains challenging, requiring familiarity with cardiopulmonary physiology, experience with complex circuits, and the ability to rapidly respond to complications. Clinician error has been recognized as a cause for ECMO complications, and both practitioner education and high-fidelity simulation have been recommended to improve patient care. To address training gaps and improve patient outcomes, a new curriculum for ECMO education was developed at this institution.

METHODS: Using Kern’s model of curriculum development, a multi-modal ECMO curriculum was developed for Pulmonary-Critical Care Medicine (PCCM) fellows which included bedside clinical training, self-directed educational materials, pertinent high-yield literature publications, scholarly videos from professional societies, recorded lectures by international experts, in-person didactics, and repeated regular high-fidelity simulations. The Extracorporeal Life Support Organization (ELSO) core curricular requirements and learning objectives were used as a guide to ensure the curriculum was comprehensive.

EVALUATION PLAN: An interim-analysis survey was completed four months after the roll-out of the program to gauge reception to the new educational initiative. Five high-fidelity simulation sessions were completed by fellows prior to data collection. Using a five-point Likert scale (1= strongly disagree, 5= strongly agree), fellows self-reported perceptions of comfort in various aspects of ECMO management.

SUMMARY OF RESULTS: 12 fellows completed the interim analysis survey (67% of PCCM program participants). All respondents (n = 12) felt ECMO should be a part of PCCM fellowship training, with 58% of fellows reporting < 1 hour of total ECMO education prior to curriculum roll-out. 100% of fellows (n = 12) reported an improvement in knowledge of ECMO with the new curriculum, and similarly 100% of respondents felt that this new curriculum would help them care for patients in the future. Following the training, fellows selfreported high levels of confidence in various aspects of ECMO management, with mean Likert scores ranging from 3.9 – 4.6 for all assessed skills (table 1).

REFLECTIVE CRITIQUE: The educational gap in ECMO was successfully addressed by the development of a multi-modal curriculum involving a variety of learning methods and regular high-fidelity simulations. The curriculum was well received by fellows. Future research will focus on evaluating whether these benefits transfer to novel simulation scenarios, bedside patient care, and are maintained over time to further guide the refinement of the curriculum.