Impacts of a Pediatric Extracorporeal Cardiopulmonary Resuscitation (ECPR) Simulation Training Program.

OBJECTIVE: To examine the impacts of a large-scale simulation-based extracorporeal cardiopulmonary resuscitation (ECPR) training program in an academic children's hospital. METHODS: The study followed a quasi-experimental, mixed-method, time series design. Two-hour high-fidelity ECPR simulations were held monthly in the pediatric, cardiac, and neonatal intensive care units. Intensive care unit-specific cases were used in each unit. The learning objectives for all cases were the same. Each simulation included an average of 11 health care professionals, including nurses, physicians, respiratory therapist, and perfusionists. Impacts of training were examined using Kirkpatrick's 4-level model: reactions, learning, behaviors, and results. Participant surveys, semistructured interviews, facilitator observations, applied cognitive task analysis, and hospital code data were used to examine the impacts of training. RESULTS: From February 2014 to October 2016, a total of 332 health care professionals participated in 29 ECPR simulations. Participants enjoyed the simulations and reported learning gains. Applied cognitive task analysis revealed 2 specific behaviors, coordination of compressions with surgical cannulation and performing sterile compressions, that were targeted for further training. The rate of adherence to the ECPR activation protocol improved from 83% (48/58) before simulations started to 95% (92/97) after simulations (P = .02). ECPR activation time decreased from 7 minutes (interquartile range, 4-9 minutes) before simulations started to 2 minutes (interquartile range, 1-4 minutes) after simulations (P < .01). CONCLUSIONS: Large-scale simulation-based ECPR training was associated with positive reactions, learning gains, behavioral change, improved adherence to the ECPR activation protocols, and faster activation times. Other children's hospital that perform ECPR should consider simulation-based training.

Impact of a unique international conference on pediatric mechanical circulatory support and pediatric cardiopulmonary perfusion research.

There is no question that the International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion is a unique event that has had a significant impact on the treatment of neonatal, infantile, and pediatric cardiopulmonary patients around the globe since 2005. This annual event will continue as long as there is a need to fill the gap for underserved patient population. It will also continue to recognize promising young investigators based on their full manuscripts for young investigator awards.

Pediatric extracorporeal life support systems: education and training at Penn State Hershey Children's Hospital.

The following is a description of the training offered to extracorporeal life support (ECLS)-trained staff at the Penn State Hershey Children's Hospital. Changes with the ECLS circuit prompted the need for an initiative to train staff in the care of patients requiring ECLS support. In addition to didactic material, we incorporated a "hands-on" approach in designing the education. During the didactic portion, the circuit was demonstrated as a wet lab. The final step offered a voluntary visit to the animal research facility utilizing clinical case scenarios which allowed participants to articulate and demonstrate proper circuit management.The effort throughout this process was to build a competent ECLS team which will ultimately provide our patients with the greatest chance for a full recovery.

Evaluation of basic perfusion techniques, ECCSIM-Lite simulator.

Although serious accidents during extracorporeal circulation are infrequent, potential adverse events with both equipment and operation do still occur and require immediate and well-coordinated responses. Hence, perfusionists need to be well trained in both standard and emergency procedures, and this would be aided by the establishment of an official education and training curriculum. In particular, the establishment of a simulator-based educational program and corresponding evaluation methods will spur development of increasingly medical simulators. ExtraCorporeal Circulation SIMulator (ECCSIM-Lite) was used during repeated sessions of undergraduate students (n = 12) using a simple training scenario. Trainees aimed to maintain reservoir volume around a constant mean, and increase or decrease the arterial flow avoiding rapid variations, and their performance was monitored. Ability to prevent backflow was also recorded as a measure of accomplishment. Skills in performances were evaluated by using a scoring system based on task accomplishment. Accomplishment score was improved in all participants after 1 week of training. Accomplishment scores reflecting ability to maintain flow improved to an average of 78%; in the third and final practice session backflow was prevented in 100% of cases. The average reservoir level maintenance score in the flow-up phase was 75%, in the flow-maintenance phase was 92%, and in the flow-down phase was 58%. During skill training, in which trainees learn methods of avoiding adverse events, the use of simulators combined with tractable skills scores can ease the transition from training session to clinical practice. Use of these training scenarios within a perfusion education system also has the advantage of providing an index of trainees' current proficiency and improvement by providing tractable skill scores. In conclusion, the use of ECCSIM-Lite simulations, together with evaluation of task accomplishment over repeated training sessions, is an effective method of basic skill training for perfusionists.

2010 John H. Gibbon Lecture. Just say yes!

Advancing anything requires change and a new method. It can be a challenge to bring about the change that you believe in. This change however requires you to plan and say no to the old way of doing things. Fortunately there is a positive way to say no whereby important needs are met. As Ury suggests, we need to focus on how the two opposing forces need to be addressed. There is your internal focus of what's important to you and the opposing external focus of others--what's important to them. We can't lose sight of this because when we do, we risk disrespecting others. As technicians we are in a unique position as perfusionists whereby we work closely with physicians and on occasion will direct them to perform tasks. Additionally, many other non-physicians are not familiar with our responsibilities. We need to make others knowledgeable of the education, skill, and passion we possess. I really enjoy what I do as a perfusionist and I am proud to be recognized for my team's contribution and of having received the Gibbon award. Bob Parsons, the CEO and founder of The Go Daddy Group, Inc., said "We're not here for a long time, we're here for a good time!" This all has been a real good time. Thank you. My Perfusion Team is currently: Barbara Elmer, Marie Kilcullen, Jim McVey, Marie Zanichelli, Junli Liu, Anthony Lamonica, Karen Hussey, Lilia Voevidko, Haleh Ebrahimi, Sergey Savy, Akilah Richards, Diana Froehlich.