Introduction/Aim: The patient’s condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants’ suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations. Methods: Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding. Results: A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change. Conclusion: The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect.

Background: Extracorporeal membrane oxygenation relies heavily on didactic teaching, emphasizing on essential cognitive skills, but overlooking core behavioral skills such as leadership and communication. Therefore, simulation-based training has been adopted to instill clinical knowledge through immersive experiences. Despite simulation-based training’s effectiveness, training opportunities are lessened due to high costs. This is where screen-based simulators come into the scene as affordable and realistic alternatives. Aim: This article evaluates the educational efficacy of ECMOjo, an open-source screen-based extracorporeal membrane oxygenation simulator that aims to replace extracorporeal membrane oxygenation didactic instruction in an interactive and cost-effective manner. Method: A prospective cohort skills acquisition study was carried out. A total of 44 participants were pre-assessed, divided into two groups, where the first group received traditional didactic teaching, and the second used ECMOjo. Participants were then evaluated through a wet lab assessment and two questionnaires. Results: The obtained results indicate that the two assessed groups show no statistically significant differences in knowledge and efficacy. Hence, ECMOjo is considered an alternative to didactic teaching as per the learning outcomes. Conclusion: The present findings show no significant dissimilarities between ECMOjo and didactic classroom-based teaching. Both methods are very comparable in terms of the learner’s reported self-efficacy and complementary to mannequin-based simulations.

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Introduction: Patients under the error-prone and complication-burdened extracorporeal membrane oxygenation (ECMO) are looked after by a highlytrained, multidisciplinary team. Simulation-based training (SBT) affords ECMO centers the opportunity to equip practitioners with the technical dexterity required to manage emergencies. The aim of this article is to review ECMO SBT activities and technology and suggest a novel solution to current challenges. 2 ECMO Simulation: The commonly-used simulation approach is easy-to-build as it requires a functioning ECMO machine and an altered circuit. Complications are simulated through manual circuit manipulations. However, scenario diversity is limited and often lacks physiological and/or mechanical authenticity. It is also expensive to continuously operate due to the consumability of highlyspecialized equipment. Technological Aid: Commercial extensions can be added to enable remote control and automate circuit manipulation but do not improve on the realism or cost effectiveness.

Using low-cost yet high-fidelity simulation mechanisms, we implemented the central subsystem of our modular ECMO simulator, which creates the look and feel of an ECMO circuit without using an actual one.

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?? 2017 Alsalemi, Aldisi, Alhomsi, Ahmed, Bensaali, Alinier, Amira, licensee HBKU Press. This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. Alsalemi A, Aldisi M, Alhomsi Y, Ahmed I, Bensaali F, Alinier G, Amira A., 'Using thermochromic ink for medical simulations', Qatar Medical Journal, 4th Annual ELSO-SWAC Conference Proceedings 2017:63 http://dx.doi.org/10.5339/qmj.2017.swacelso.63Background: In medical simulation and training, blood is used to exhibit its different behaviors in context. In some cases, blood color differential is an imperative visual effect to ensure high-fidelity training and practical understanding. High simulation realism is usually achieved by using animal or artificial blood (which mimics some biological features of blood), which has high cost, requires disposable equipment such as oxygenators, and entails contamination or infection risks. Methods: A novel method for blood simulation is introduced. Using the thermal properties of thermochromic ink, its color can be altered by adjustment of temperature. 1 The unique red color of blood can be mimicked to a high fidelity using a custom hue of thermochromic ink. Then, by adjusting its temperature, realistic dark and bright red can be employed to simulate the low and high oxygen concentrations of blood, respectively. Although thermochromic ink currently does not imitate other blood properties such as viscosity and clotting, it has superior merits when color change simulation is a paramount priority. The major advantages of the proposed solution are reusability and cost. Thermochromic ink can be used for multiple simulations without any noticeable change in quality. It also costs significantly less than using actual or artificial blood. Results: Testing results of the proposed solution in extracorporeal membrane oxygenation (ECMO) simulation has proven its efficacy as a practical solution for medical simulations (see Figure 1). To prevent membrane occlusion because of the thermochromic ink, the latter needs to be pierced. In addition to ECMO simulation, other medical applications are being considered. Conclusions: The use of thermochromic ink in medical training provides reproducible color change simulation features of blood while maintaining significantly lower equipment costs and contamination risks as all circuit components can be reused