Clinicians' Knowledge, Confidence and Skills: A Retrospective Evaluation of an Interdisciplinary Extracorporeal Membrane Oxygenation Simulation Workshop.

BACKGROUND

Extracorporeal membrane oxygenation (ECMO) is a complex, high-risk therapy requiring interdisciplinary expertise and structured education to optimise patient outcomes. International experts recommend standardised, structured ECMO education, incorporating simulation, to support competency across clinician groups.

AIM: To evaluate changes in intensive care unit (ICU) clinicians' self-reported ECMO knowledge, confidence and skills after participation in a 1-day ECMO interdisciplinary simulation workshop.

STUDY

DESIGN

A retrospective study of pre- and post-survey evaluation data from ECMO simulation workshops delivered at a metropolitan quaternary adult hospital (2014-2019). Participants (registered nurses, medical officers, perfusionists and physiotherapists) self-rated their knowledge of veno-venous (VV) and veno-arterial (VA) ECMO, confidence in providing regular care and emergency management of ECMO in the ICU, and ECMO circuit problem-solving skills on Likert-type scales [1 = lowest (worst possible/most negative), 9 = highest (best possible/most positive)]. Paired t-tests compared pre- and post-scores and were stratified by clinician group. Free-text response data were thematically analysed.

RESULTS

Matched pre- and post-workshop evaluations were analysed (n = 275) across 20 ECMO simulation workshops (99% response rate). Most participants (65%) were self-rated novices at baseline. Significant improvements across all individual domains (p < 0.001) were measured: Clinicians' self-rated knowledge of VV-ECMO (3.63-6.59; mean change 2.95, 95% CI, 2.78-3.12) and VA-ECMO (3.44-6.41; mean change 2.97, 95% CI, 2.80-3.14) as well as confidence in routine ECMO management (3.24-6.31; mean change 3.07, 95% CI, 2.88-3.25) and emergency management (2.42-6.09; mean change 3.68, 95% CI, 3.49-3.87) plus ECMO circuit skills (2.41-6.10; mean change 3.69, 95% CI, 3.50-3.89). Registered nurses demonstrated the greatest improvements in most domains. Themes corroborated workshop effectiveness.

CONCLUSIONS

These findings support incorporating interdisciplinary, simulation-based ECMO education into credentialing and continuing education frameworks, particularly for nurses. Future research should examine how workshop participation translates into sustained learning retention, meaningful changes in clinical practice and improved patient-centred outcomes.

RELEVANCE TO CLINICAL PRACTICE: The findings indicate that the single-day, simulation-based ECMO workshop improved ICU clinicians' self-reported ECMO knowledge, confidence and skill, particularly in managing emergencies and circuit-related complications. All workshop domains were considered appropriate for nurses' ECMO learning. The workshop's interdisciplinary format supports its inclusion in local ECMO credentialing pathways, alongside supervised clinical practice and ongoing education.