The Value of Simulation

ECMO SimulationHow do you learn best? Lecture? Reading materials? Demonstration? They all have value – but the new kid on the block is Simulation! Ok, maybe not that new – the airline industry has been using it forever! Medical and Nursing schools – simulation started in animal labs and human studies. Now we have mannikins to practice on and realistic environments that can produce just about any situation that may present in real life.

ECMO or ECLS is a highly technical skill, requiring both familiarity with equipment (all those buttons!) and circuitry – and of course how they interact with patients. As educators, we deliver the material to ECMOlogists in training – books, slides, checklists – but how do we assure that everything is absorbed? How well did your students retain that information? And more importantly, can the students use the information in a real life situation?

I believe that ECMO education is layering process. Exposure should be varied and repetitive. Starting with a lecture or an elearning module to introduce new skills. These are followed with water-drills, hands on sessions with an expert or super-user. The student then begins to interact with the ECMO system directly and becomes more and more familiar with it.

Simulation allows a realistic atmosphere to be presented. Many institutions have a dedicated simulation lab with personnel to run very hi-fi simulations. But, many institutions are not quite that lucky. Don’t despair! Any one can learn to set up their own simulation lab in a patient room or a conference room. Borrow a CPR manikin and a bed. Set-up a patient room! Include a ventilator if you can and IV poles, etc. Use some of those nursing skills and make your patient comfy. Now you need your ECMO pump with a circuit. The circuit can be ‘primed’ with ‘blood’ to increase the realistic atmosphere. Some people describe using food coloring, chocolate syrup, or drink mixes – anything to give you that nice deep red/blue color. Now here is where the creativity comes in – your patient needs a ‘heart’. A reservoir where volume may be added, removed or air introduced. There are many, many ways to do this. Then add a computer and monitor and start practicing running scenarios where everything that can happen – does!

Simulation is an incredibly valuable tool in education. Perhaps even more so in teaching extracorporeal life support skills. There are so many things that can go wrong, but rarely do on ECMO patients. The ability to ‘practice’ managing these situations before they happen to a real patient will increase the likelihood of successful outcomes.

What about you? Do you use simulation in teaching ECMO? Let me know your experience by sending a comment!

Authored by Micheal Heard, Director of Training and Development …a discussion of all things related to ECMO…