Crannell W Christian, Zakhary Bishoy, Hamilton Heather, Brasel Karen, Zonies David
Oregon Health and Science University/Mail Code L223/3181 SW Sam Jackson Park Rd/Portland, OR 97239.
Oregon Health and Science University/Mail Code UHN67/3181 SW Sam Jackson Park Rd/Portland, OR 97239.
Surg Open Sci. 2019 Oct 21;2(1):42-45. doi: 10.1016/j.sopen.2019.09.001. eCollection 2020 Jan.
Extracorporeal membrane oxygenation supports severe cardiac or pulmonary failure. There are currently no competency-based standards for extracorporeal membrane oxygenation training.
Extracorporeal membrane oxygenation experts were interviewed using a structured interview. Responses were audio recorded, transcribed, and validated by respondents. Interviews were coded using grounded theory with a constant comparison method. Themes were developed and used to construct the entrustable professional activity, which was reviewed by the extracorporeal membrane oxygenation experts.
Nine experts were interviewed; all had experience with trainees. Interview themes identified include patient selection, circuit and medical management, multidisciplinary communication, problem-based learning and simulation, and entrustment decisions. Essential functions of the entrustable professional activity were patient selection, circuit management, cannula selection, responding to circuit emergencies/complications, anticoagulation management, weaning, and family/team communication.
Essential functions of an extracorporeal membrane oxygenation entrustable professional activity were defined using data from structured interviews. The resultant entrustable professional activity could be implemented by critical-care programs as a scaffolding for competency-based fellow training.
体外膜肺氧合可支持严重的心功能或肺功能衰竭。目前尚无基于能力的体外膜肺氧合培训标准。
采用结构化访谈对体外膜肺氧合专家进行访谈。访谈内容进行了录音、转录，并经受访者验证。访谈采用扎根理论和持续比较法进行编码。确定了主题并用于构建可托付专业活动，该活动由体外膜肺氧合专家进行了审查。
采访了9位专家；他们都有带教实习生的经验。确定的访谈主题包括患者选择、回路及医疗管理、多学科沟通、基于问题的学习与模拟以及托付决策。可托付专业活动的基本职能包括患者选择、回路管理、插管选择、应对回路紧急情况/并发症、抗凝管理、撤机以及与家属/团队沟通。
利用结构化访谈数据定义了体外膜肺氧合可托付专业活动的基本职能。由此产生的可托付专业活动可由重症监护项目实施，作为基于能力的专科培训的框架。
