Simulators and Simulations for Extracorporeal Membrane Oxygenation: An ECMO Scoping Review

Abstract

High-volume extracorporeal membrane oxygenation (ECMO) centers generally have better outcomes than (new) low-volume ECMO centers, most likely achieved by a suitable exposure to ECMO cases. To achieve a higher level of training, simulation-based training (SBT) offers an additional option for education and extended clinical skills. SBT could also help to improve the interdisciplinary team interactions. However, the level of ECMO simulators and/or simulations (ECMO sims) techniques may vary in purpose. We present a structured and objective classification of ECMO sims based on the broad experience of users and the developer for the available ECMO sims as low-, mid-, or high-fidelity. This classification is based on overall ECMO sim fidelity, established by taking the median of the definition-based fidelity, component fidelity, and customization fidelity as determined by expert opinion. According to this new classification, only low- and mid-fidelity ECMO sims are currently available. This comparison method may be used in the future for the description of new developments in ECMO sims, making it possible for ECMO sim designers, users, and researchers to compare accordingly, and ultimately improve ECMO patient outcomes.

Understanding the complexity of cardiogenic shock management: the added value of advanced computational modeling

“…The former have recently been evaluated systematically, which revealed that two different models are currently even evaluated in randomized controlled trials [13 && ]. Models specifically dedicated to ECMO can still be improved in terms of fidelity as shown in a recent review focusing on educational simulation, while their clinical reliability might more be within reach in the years to come [9,11,14,15].…”

Experiencia con un programa de simulación clínica avanzada con oxigenación con membrana extracorpórea. Un nuevo horizonte y oportunidad

“…[7][8][9][10] De hecho, la formación y entrenamiento en ECMO, basado en la simulación, está emergiendo como una herramienta fundamental para mejorar las habilidades técnicas. 11 Analizamos nuestra experiencia en la formación médica especializada con cursos de simulación avanzada en el uso y manejo de la ECMO, basados sus conceptos fundamentales en las recomendaciones internacionales. [12][13][14] Revisamos el impacto educativo con nuestras actividades formativas teórico-prácticas.…”

“Let’s play a different game” – virtual reality in extracorporeal membrane oxygenation simulation

“…The paradigm shift is underway in teaching and ECMO simulation, most evident by the recent development of simulation models and commercial systems that incorporate game-type elements in scenarios based on problem-based learning (trouble shooting) or various training components. 2 These systems or training models have evolved from mechanical low fidelity systems to more decision-based learning by higher fidelity systems. Virtual team building or individual mentoring are also conceivable over long distances to increase patient safety through training.…”