Cardiovascular Perfusion Department, College of Health Sciences, SUNY Upstate Medical University, Syracuse, New York; and.
Centers for Programs in Allied Health, The Vanderbilt University Medical Center, Nashville, Tennessee.
J Extra Corpor Technol. 2021 Dec;53(4):245-250. doi: 10.1182/ject-2100008.
The dramatic increase in the use of extracorporeal membrane oxygenation (ECMO) over the last decade with the concomitant need for ECMO competent perfusionists has raised questions of how well perfusion education programs are preparing entry-level perfusionists to participate in ECMO. While all perfusion schools teach ECMO principles, there is no standardized or systematic approach to the delivery of didactic knowledge and clinical skills in ECMO. Given this variability of ECMO education across and within perfusion schools, the CES-A exam may provide a metric for comparing curricular approaches. The purpose of this study is to examine three different curricular approaches to prepare new perfusion graduates to master the Adult ECMO Specialist Certification exam (CES-A). We examined three different curricular approaches to prepare new perfusion graduates to master the Adult ECMO Specialist Certification exam (CES-A). We hypothesized that there would be no difference in CES-A pass rate, exam score, Rasch measure, and item category scores between SUNY Cardiovascular Perfusion Program (CVP) graduates who completed SUNY's ECMO Capstone experience (Group III) and CVP graduates who did not select the ECMO Capstone experience (Group II). Further, we studied the performance of a third group of new graduates from an external program that does not offer formal ECMO courses or an ECMO Capstone experience (Group I). Every perfusion graduate in all groups passed the adult ECMO specialist exam. The graduates who as students completed an ECMO Capstone experience (Group III) scored higher on the exam and significantly higher on four exam categories: coagulation and hemostasis ( = .058), lab analysis point of care ( = .035), and monitor patient and circuit ( = .073), and the safety and failure modes ( = .017). Overall the median graduate Rasch measures ranked with Group III demonstrating the highest measure to Group I the lowest measures (not significant at = .085). There is a positive educational effect due to CVP graduates completion of the ECMO Capstone experience compared to the program standard ECMO-related curricula in the two perfusion programs participating in this study. From this observation a structured ECMO simulation-based program appears to be equally effective as a traditional, typical lecture-only, clinical perfusion preceptorship, while demonstrating a more satisfactory experience with a higher reported case experience. In this study the standard perfusionist education curriculum prepared the new graduate to be successful on the CES-A exam. The three curricular approaches appear to prepare perfusionist graduates to be successful on the Adult ECMO Specialist exam.
体外膜肺氧合(ECMO)在过去十年中的使用急剧增加,同时需要有 ECMO 能力的灌注师,这引发了一个问题,即灌注教育计划在多大程度上能使入门级灌注师有能力参与 ECMO。虽然所有的灌注学校都教授 ECMO 原则,但在 ECMO 的理论知识和临床技能教学方面,并没有标准化或系统的方法。鉴于灌注学校之间和内部的 ECMO 教育存在这种差异,CES-A 考试可能为比较课程方法提供一个衡量标准。本研究的目的是研究三种不同的课程方法,以准备新的灌注毕业生掌握成人 ECMO 专家认证考试(CES-A)。我们研究了三种不同的课程方法,以准备新的灌注毕业生掌握成人 ECMO 专家认证考试(CES-A)。我们假设,在 SUNY 心血管灌注项目(CVP)毕业生中,完成 SUNY 的 ECMO 顶点体验(第 III 组)和未选择 ECMO 顶点体验(第 II 组)的毕业生之间,在 CES-A 通过率、考试成绩、Rasch 测量和项目类别分数方面没有差异。此外,我们还研究了一个来自外部项目的第三组新毕业生的表现,该项目不提供正规的 ECMO 课程或 ECMO 顶点体验(第 I 组)。所有组的灌注毕业生都通过了成人 ECMO 专家考试。作为学生完成 ECMO 顶点体验的毕业生(第 III 组)在考试中得分更高,在四个考试类别中得分显著更高:凝血和止血( = .058)、实验室分析即时护理( = .035)、监测患者和电路( = .073)以及安全和故障模式( = .017)。总体而言,研究生的 Rasch 测量中位数排名为第 III 组最高,第 I 组最低( = .085 时无显著差异)。与参与本研究的两个灌注项目的标准 ECMO 相关课程相比,CVP 毕业生完成 ECMO 顶点体验具有积极的教育效果。从这一观察结果可以看出,与传统的、典型的仅讲座式临床灌注实习相比,基于 ECMO 模拟的结构化方案似乎同样有效,同时报告的病例经验更多,体验更令人满意。在这项研究中,标准的灌注师教育课程使新毕业生能够成功通过 CES-A 考试。这三种课程方法似乎使灌注师毕业生能够成功通过成人 ECMO 专家考试。