Start a neonatal extracorporeal membrane oxygenation program: A multistep team training

Genny Raffaeli, Stefano Ghirardello, Mara Vanzati, Chiara Baracetti, Francesco Canesi, Federica Conigliaro, Valerio Gentilino, Francesco Macchini, Monica Fumagalli, Fabrizio Ciralli, Nicola Pesenti, Sofia Passera, Simona Neri, Stefania Franzini, Ernesto Leva, Laura Plevani, Fabio Mosca, Giacomo Cavallaro

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) is a complex life-saving support for acute cardio-respiratory failure, unresponsive to medical treatment. Emergency events on ECMO are rare but require immediate and proficient management. Multidisciplinary ECMO team members need to acquire and maintain over time cognitive, technical and behavioral skills, to safely face life-threatening clinical scenarios. Methods: A multistep educational program was delivered in a 4-year period to 32 ECMO team members, based on guidelines from the Extracorporeal Life Support Organization. A first traditional module was provided through didactic lectures, hands-on water drills, and laboratory animal training. The second phase consisted of a multi-edition high-fidelity simulation-based training on a modified neonatal mannequin (SimNewB®). In each session, participants were called to face, in small groups, ten critical scenarios, followed by debriefing time. Trainees underwent a pre-test for baseline competency assessment. Once completed the full training program, a post-test was administered. Pre- and post-test scores were compared. Trainees rated the educational program through survey questionnaires. Results: 28 trainees (87.5%) completed the full educational program. ECMO staffskills improved from a median pre-test score of 7.5/18 (IQR = 6-11) to 14/18 (IQR = 14-16) at post-test (P < 0.001, Wilcoxon rank test). All trainees highly rated the educational program and its impact on their practice. They reported high-fidelity simulations to be beneficial to novice learners as it increased self-confidence in ECMO-emergencies (according to 100% of surveyed), theoretical knowledge (61.5%) and team-work/communicative skills (58%). Conclusions: The multistep ECMO team training increased staff' knowledge, technical skills, teamwork, and self-confidence, allowing the successful development of a neonatal respiratory ECMO program. Conventional training was perceived as relevant in the early phase of the program development, while the active learning emerged to be more beneficial to master ECMO knowledge, specific skills, and team performance.

Original languageEnglish
Article number151
JournalFrontiers in Pediatrics
Volume6
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Extracorporeal Membrane Oxygenation
Emergencies
Manikins
Mandrillus
Problem-Based Learning
Program Development
Laboratory Animals
Nonparametric Statistics
Respiratory Insufficiency
Guidelines
Education

Keywords

  • ECLS program development
  • ECMO Team
  • Extracorporeal life support ECLS
  • High-fidelity simulation
  • Neonatal ECMO
  • Skill learning
  • Teamwork

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

@article{5908e2331dde4c2fbced92b2bb2e2779,
title = "Start a neonatal extracorporeal membrane oxygenation program: A multistep team training",
abstract = "Background: Extracorporeal membrane oxygenation (ECMO) is a complex life-saving support for acute cardio-respiratory failure, unresponsive to medical treatment. Emergency events on ECMO are rare but require immediate and proficient management. Multidisciplinary ECMO team members need to acquire and maintain over time cognitive, technical and behavioral skills, to safely face life-threatening clinical scenarios. Methods: A multistep educational program was delivered in a 4-year period to 32 ECMO team members, based on guidelines from the Extracorporeal Life Support Organization. A first traditional module was provided through didactic lectures, hands-on water drills, and laboratory animal training. The second phase consisted of a multi-edition high-fidelity simulation-based training on a modified neonatal mannequin (SimNewB{\circledR}). In each session, participants were called to face, in small groups, ten critical scenarios, followed by debriefing time. Trainees underwent a pre-test for baseline competency assessment. Once completed the full training program, a post-test was administered. Pre- and post-test scores were compared. Trainees rated the educational program through survey questionnaires. Results: 28 trainees (87.5{\%}) completed the full educational program. ECMO staffskills improved from a median pre-test score of 7.5/18 (IQR = 6-11) to 14/18 (IQR = 14-16) at post-test (P < 0.001, Wilcoxon rank test). All trainees highly rated the educational program and its impact on their practice. They reported high-fidelity simulations to be beneficial to novice learners as it increased self-confidence in ECMO-emergencies (according to 100{\%} of surveyed), theoretical knowledge (61.5{\%}) and team-work/communicative skills (58{\%}). Conclusions: The multistep ECMO team training increased staff' knowledge, technical skills, teamwork, and self-confidence, allowing the successful development of a neonatal respiratory ECMO program. Conventional training was perceived as relevant in the early phase of the program development, while the active learning emerged to be more beneficial to master ECMO knowledge, specific skills, and team performance.",
keywords = "ECLS program development, ECMO Team, Extracorporeal life support ECLS, High-fidelity simulation, Neonatal ECMO, Skill learning, Teamwork",
author = "Genny Raffaeli and Stefano Ghirardello and Mara Vanzati and Chiara Baracetti and Francesco Canesi and Federica Conigliaro and Valerio Gentilino and Francesco Macchini and Monica Fumagalli and Fabrizio Ciralli and Nicola Pesenti and Sofia Passera and Simona Neri and Stefania Franzini and Ernesto Leva and Laura Plevani and Fabio Mosca and Giacomo Cavallaro",
year = "2018",
month = "1",
day = "1",
doi = "10.3389/fped.2018.00151",
language = "English",
volume = "6",
journal = "Frontiers in Pediatrics",
issn = "2296-2360",
publisher = "Frontiers Media S. A.",

}

TY - JOUR

T1 - Start a neonatal extracorporeal membrane oxygenation program

T2 - A multistep team training

AU - Raffaeli, Genny

AU - Ghirardello, Stefano

AU - Vanzati, Mara

AU - Baracetti, Chiara

AU - Canesi, Francesco

AU - Conigliaro, Federica

AU - Gentilino, Valerio

AU - Macchini, Francesco

AU - Fumagalli, Monica

AU - Ciralli, Fabrizio

AU - Pesenti, Nicola

AU - Passera, Sofia

AU - Neri, Simona

AU - Franzini, Stefania

AU - Leva, Ernesto

AU - Plevani, Laura

AU - Mosca, Fabio

AU - Cavallaro, Giacomo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Extracorporeal membrane oxygenation (ECMO) is a complex life-saving support for acute cardio-respiratory failure, unresponsive to medical treatment. Emergency events on ECMO are rare but require immediate and proficient management. Multidisciplinary ECMO team members need to acquire and maintain over time cognitive, technical and behavioral skills, to safely face life-threatening clinical scenarios. Methods: A multistep educational program was delivered in a 4-year period to 32 ECMO team members, based on guidelines from the Extracorporeal Life Support Organization. A first traditional module was provided through didactic lectures, hands-on water drills, and laboratory animal training. The second phase consisted of a multi-edition high-fidelity simulation-based training on a modified neonatal mannequin (SimNewB®). In each session, participants were called to face, in small groups, ten critical scenarios, followed by debriefing time. Trainees underwent a pre-test for baseline competency assessment. Once completed the full training program, a post-test was administered. Pre- and post-test scores were compared. Trainees rated the educational program through survey questionnaires. Results: 28 trainees (87.5%) completed the full educational program. ECMO staffskills improved from a median pre-test score of 7.5/18 (IQR = 6-11) to 14/18 (IQR = 14-16) at post-test (P < 0.001, Wilcoxon rank test). All trainees highly rated the educational program and its impact on their practice. They reported high-fidelity simulations to be beneficial to novice learners as it increased self-confidence in ECMO-emergencies (according to 100% of surveyed), theoretical knowledge (61.5%) and team-work/communicative skills (58%). Conclusions: The multistep ECMO team training increased staff' knowledge, technical skills, teamwork, and self-confidence, allowing the successful development of a neonatal respiratory ECMO program. Conventional training was perceived as relevant in the early phase of the program development, while the active learning emerged to be more beneficial to master ECMO knowledge, specific skills, and team performance.

AB - Background: Extracorporeal membrane oxygenation (ECMO) is a complex life-saving support for acute cardio-respiratory failure, unresponsive to medical treatment. Emergency events on ECMO are rare but require immediate and proficient management. Multidisciplinary ECMO team members need to acquire and maintain over time cognitive, technical and behavioral skills, to safely face life-threatening clinical scenarios. Methods: A multistep educational program was delivered in a 4-year period to 32 ECMO team members, based on guidelines from the Extracorporeal Life Support Organization. A first traditional module was provided through didactic lectures, hands-on water drills, and laboratory animal training. The second phase consisted of a multi-edition high-fidelity simulation-based training on a modified neonatal mannequin (SimNewB®). In each session, participants were called to face, in small groups, ten critical scenarios, followed by debriefing time. Trainees underwent a pre-test for baseline competency assessment. Once completed the full training program, a post-test was administered. Pre- and post-test scores were compared. Trainees rated the educational program through survey questionnaires. Results: 28 trainees (87.5%) completed the full educational program. ECMO staffskills improved from a median pre-test score of 7.5/18 (IQR = 6-11) to 14/18 (IQR = 14-16) at post-test (P < 0.001, Wilcoxon rank test). All trainees highly rated the educational program and its impact on their practice. They reported high-fidelity simulations to be beneficial to novice learners as it increased self-confidence in ECMO-emergencies (according to 100% of surveyed), theoretical knowledge (61.5%) and team-work/communicative skills (58%). Conclusions: The multistep ECMO team training increased staff' knowledge, technical skills, teamwork, and self-confidence, allowing the successful development of a neonatal respiratory ECMO program. Conventional training was perceived as relevant in the early phase of the program development, while the active learning emerged to be more beneficial to master ECMO knowledge, specific skills, and team performance.

KW - ECLS program development

KW - ECMO Team

KW - Extracorporeal life support ECLS

KW - High-fidelity simulation

KW - Neonatal ECMO

KW - Skill learning

KW - Teamwork

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DO - 10.3389/fped.2018.00151

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