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Loza-Avalos S, DeAtkine E, Cox J, Lussier B, Leveno M, Dultz LA, Hackmann A, Park C. ECMO simulation: How much, who to train, and a review of cost, fidelity and performance. Perfusion 2023:2676591231200988. [PMID: 37684100 DOI: 10.1177/02676591231200988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
BACKGROUND Extracorporeal Membrane Oxygenation (ECMO) is a high-risk, low-volume procedure requiring repetition, skill and multiple disciplines with fidelity of communication. Yet many barriers exist to maintain proficiency and skills with variable cost and fidelity. We designed and implemented a low-cost monthly ECMO simulation and hypothesized providers would have increased familiarity and improved teamwork. We also review some key elements of cost, fidelity and evaluation of effectiveness. METHODS A structured, 1-hour ECMO simulation was performed on a customized mannikin on a monthly basis in 2022. Qualitative surveys were administered to each member post-simulation. Answers were categorized by theme, including satisfaction of patient care, evaluation of self and team dynamics, and areas for improvement. RESULTS Most participants were satisfied with their ability to take care of the patient, with common themes of communication and coordination of roles. Identified areas of improvement were mostly limited to technical skills, and soft skills such as communication and teamwork. CONCLUSIONS We designed and implemented a low-cost, monthly and multi-disciplinary ECMO simulation program with overall positive feedback and identified areas for improvement. There remains variability in cost, fidelity and evaluation of performance and retention. There may be a need to create guidelines for ECMO simulation training that can be applied at all institutions utilizing ECMO for patient care.
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Affiliation(s)
- Sandra Loza-Avalos
- Department of Surgery, Division of Burns, Trauma and Acute Care Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elizabeth DeAtkine
- Department of Surgery, Division of Burns, Trauma and Acute Care Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Julie Cox
- Cardiovascular and ECMO Program, Parkland Memorial Hospital, Dallas, TX, USA
| | - Bethany Lussier
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Matthew Leveno
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Linda A Dultz
- Department of Surgery, Division of Burns, Trauma and Acute Care Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Amy Hackmann
- Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Caroline Park
- Department of Surgery, Division of Burns, Trauma and Acute Care Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Golicnik A, Berden J, Goslar T, Gorjup V. High fidelity ECMO simulation: a reality check with reality-use of simulation in ECMO teaching program. J Artif Organs 2023; 26:36-44. [PMID: 35575949 DOI: 10.1007/s10047-022-01336-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
Simulation based learning is becoming a crucial part in ECMO education. Simulation can provide a safe but also very realistic learning experience depending on simulation fidelity. In our institution we developed a simulation based ECMO training program that incorporates low- and high-fidelity simulation. Aim of this study was to evaluate effectiveness of low- and high-fidelity simulation teaching strategies in ECMO novices. We conducted four consecutive ECMO training courses that included fifty-one ECMO novices. We describe ECMO training execution and evaluate training effectiveness and perception by structured pre- and post-training questionnaires analysis. Results of our study show extremely high satisfaction rate with simulation training (4.9 ± 0.3, Lickert 5 point scale). High-fidelity simulation was perceived as very realistic and as such represents an important tool in learning immersion and experience. However, participants reported significant decline from their expectations with regard to structured approach to troubleshooting (4.7 ± 0.5 vs 4.3 ± 0.7, p = 0.02) and efficiency improvement (4.7 ± 0.5 vs 4.3 ± 0.6, p = 0.002) after high-fidelity simulation. There was also a significant decline from their expectation on self-confidence improvement (4.7 ± 0.5 vs 4.2 ± 0.7, p = 0.001). Our results therefore show, that complex high-fidelity simulation should probably be used with caution in novice participants, not to discourage them from further learning.
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Affiliation(s)
- Alenka Golicnik
- Department for Intensive Internal Medicine, University Medical Center Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia.
| | - Jernej Berden
- Department for Intensive Internal Medicine, University Medical Center Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia.
| | - Tomaz Goslar
- Department for Intensive Internal Medicine, University Medical Center Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Vojka Gorjup
- Department for Intensive Internal Medicine, University Medical Center Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia
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3
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Olson T, Anders M, Burgman C, Stephens A, Bastero P. Extracorporeal cardiopulmonary resuscitation in adults and children: A review of literature, published guidelines and pediatric single-center program building experience. Front Med (Lausanne) 2022; 9:935424. [PMID: 36479094 PMCID: PMC9720280 DOI: 10.3389/fmed.2022.935424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/04/2022] [Indexed: 09/19/2023] Open
Abstract
Extracorporeal cardiopulmonary resuscitation (ECPR) is an adjunct supportive therapy to conventional cardiopulmonary resuscitation (CCPR) employing veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in the setting of refractory cardiac arrest. Its use has seen a significant increase in the past decade, providing hope for good functional recovery to patients with cardiac arrest refractory to conventional resuscitation maneuvers. This review paper aims to summarize key findings from the ECPR literature available to date as well as the recommendations for ECPR set forth by leading national and international resuscitation societies. Additionally, we describe the successful pediatric ECPR program at Texas Children's Hospital, highlighting the logistical, technical and educational features of the program.
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Affiliation(s)
- Taylor Olson
- Pediatric Critical Care Medicine, Children's National Hospital, Washington, DC, United States
| | - Marc Anders
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Pediatric Critical Care Medicine, Texas Children's Hospital, Houston, TX, United States
| | - Cole Burgman
- ECMO, Texas Children's Hospital, Houston, TX, United States
| | - Adam Stephens
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
- Congenital Heart Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Patricia Bastero
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Pediatric Critical Care Medicine, Texas Children's Hospital, Houston, TX, United States
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4
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Wilhelm MJ, Inderbitzin DT, Malorgio A, Aser R, Gülmez G, Aigner T, Vogt PR, Reser D. Acute limb ischemia after femoro-femoral extracorporeal life support implantation: a comparison of surgical, percutaneous or combined vascular access in 402 patients. Artif Organs 2022; 46:2284-2292. [PMID: 35723219 DOI: 10.1111/aor.14344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/25/2022] [Accepted: 06/13/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Extracorporeal life support (ECLS) is a salvage treatment for acute circulatory failure. Our high-volume tertiary centre performs more than 100 implants annually and provides ECLS-transports. With this study, we aimed to analyse the incidence and risk factors of limb ischemia depending on the vascular access. METHODS Between January 1st 2007 and December 31st 2018, 937 patients received an ECLS. Preoperative, intraoperative, in-hospital and up to 5 years follow-up data was collected. Outcome measures were limb ischemia and survival. RESULTS In total, 402 femoro-femoral veno-arterial ECLS patients were identified. Mean age was 56±16.7years, 26.9% were female, 7.9% had a history of peripheral vascular disease. Cannulation was performed percutaneously in 82.1% (n=330), surgically in 5.7% (n=23) and combined in 12.2% (n=49). Mortality was not significantly different between the groups (51.1% percutaneous, 43.5% surgical, 44.9% combined (p=0.89)). There was no significant difference in limb ischemia either, but a trend towards an increased frequency in the percutaneous group (p=0.0501). No amputation was necessary. Limb ischemia slightly increased in-hospital mortality (54.6%) but did not affect long-term survival beyond 30 days. Univariate analysis adjusted for cannulation methods revealed younger age and female gender as risk factors of limb ischemia and younger age for limb ischemia after percutaneous cannulation. CONCLUSIONS Our study shows that percutaneous, surgical and combined vascular access techniques for ECLS implantation are associated with comparable and low incidence of limb ischemia which slightly increases in-hospital mortality. Special precaution has to be taken in young and female patients.
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Affiliation(s)
- Markus J Wilhelm
- Clinic for Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland
| | | | - Amos Malorgio
- Clinic for Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Raed Aser
- Clinic for Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Gökhan Gülmez
- Clinic for Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Tobias Aigner
- Clinic for Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Paul Robert Vogt
- Clinic for Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Diana Reser
- Clinic for Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.,Hirslanden Heart Clinic, Witellikerstrasse 40, 8032, Zürich, Switzerland
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5
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Wong AS, Marwali EM, Maclaren G, Ogino M, Fraser J, Chi Keung PL, Fitria L, Adriane P, Sin SW. ECMO simulation training during a worldwide pandemic: The role of ECMO telesimulation. Perfusion 2022:2676591221093868. [PMID: 35543363 DOI: 10.1177/02676591221093868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Extracorporeal membrane oxygenation (ECMO) is a supportive therapy used in the most severe forms of acute respiratory distress syndrome. Due to its intrinsic complexity and relatively low annual volume, simulation is essential for efficient and appropriate ECMO management. COVID-19 has limited the opportunities for high-fidelity in-person simulation training when many hospitals are looking to expand their ECMO services to battle the ongoing pandemic. To meet this demand, the National Cardiovascular Center Harapan Kita, Jakarta, Indonesia, conducted a 3-day ECMO course entailing online didactic lectures (adult and paediatric stream), water drills and telesimulation. PURPOSE The purpose of the study is to report the evaluation result of this novel model of education during COVID-19 outbreak. DATA COLLECTION Participants were given an ECMO knowledge pre-course and post-course test and a telesimulation evaluation survey at the conclusion and these data were collected. RESULTS The course was attended by 104 physicians, critical care nurses and perfusionists. Pre-course and post-course assessments showed a significant improvement in ECMO knowledge (60.0% vs 73.3%, respectively). Overall, the participants rated the telesimulation positively, and most found it acceptable to in-person simulation training considering the pandemic restrictions. CONCLUSION Despite the complexities of ECMO, our recent experience demonstrates ECMO education and simulation delivered online is feasible, welcomed and supportive of a change in ECMO training course format. As we incorporate more innovative digital technologies, telesimulation may further enhance the quality of future ECMO training.
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Affiliation(s)
- Alfred Sk Wong
- Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong, China
| | - Eva M Marwali
- Pediatric Cardiac ICU Division, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | | | - Mark Ogino
- Division of Neonatology, The Alfred I. DuPont Hospital for Children, Wilmington, Delaware, United States
| | - John Fraser
- Faculty of Medicine, University of Queensland, Critical Care Research Group, The Prince Charles Hospital, School of Medicine, Brisbane, QLD, Australia
| | | | - Liza Fitria
- Pediatric Cardiac ICU Division, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Prieta Adriane
- Perioperative Cardiac Care and Anesthesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Simon Wc Sin
- Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong, China.,Department of Anaesthesiology, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China
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6
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Driscoll J, Elkins J. Characteristics of Extracorporeal Membrane Oxygenation Education Vary in Entry-Level Doctor of Physical Therapy Programs. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2022. [DOI: 10.1097/jat.0000000000000188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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7
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Herrera-Aliaga E, Estrada LD. Trends and Innovations of Simulation for Twenty First Century Medical Education. Front Public Health 2022; 10:619769. [PMID: 35309206 PMCID: PMC8929194 DOI: 10.3389/fpubh.2022.619769] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
In the last two decades there has been an enormous growth in the use of clinical simulation. This teaching-learning methodology is currently the main tool used in the training of healthcare professionals. Clinical simulation is in tune with new paradigms in education and is consistent with educational theories that support the use of experiential learning. It promotes the development of psychomotor skills and strengthens executive functions. This pedagogical approach can be applied in many healthcare topics and is particularly relevant in the context of restricted access to clinical settings. This is particularly relevant considering the current crisis caused by the COVID-19 pandemic, or when trying to reduce the frequency of accidents attributed to errors in clinical practice. This mini-review provides an overview of the current literature on healthcare simulation methods, as well as prospects for education and public health benefits. A literature search was conducted in order to find the most current trends and state of the art in medical education simulation. Presently, there are many areas of application for this methodology and new areas are constantly being explored. It is concluded that medical education simulation has a solid theoretical basis and wide application in the training of health professionals at present. In addition, it is consolidated as an unavoidable methodology both in undergraduate curricula and in continuing medical education. A promising scenario for medical education simulation is envisaged in the future, hand in hand with the development of technological advances.
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Affiliation(s)
| | - Lisbell D. Estrada
- Faculty of Health Sciences, Universidad Bernardo O'Higgins, Santiago, Chile
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8
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Swol J, Brodie D, Willers A, Zakhary B, Belezzo J, Shinar Z, Weingart SD, Haft JW, Lorusso R, Peek GJ. Human factors in ECLS - A keystone for safety and quality - A narrative review for ECLS providers. Artif Organs 2021; 46:40-49. [PMID: 34738639 PMCID: PMC9298045 DOI: 10.1111/aor.14095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/12/2021] [Accepted: 10/20/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Although the technology used for extracorporeal life support (ECLS) has improved greatly in recent years, the application of these devices to the patient is quite complex and requires extensive training of team members both individually and together. Human factors is an area that addresses the activities, contexts, environments, and tools which interact with human behavior in determining overall system performance. HYPOTHESIS Analyses of the cognitive behavior of ECLS teams and individual members of these teams with respect to the occurrence of human errors may identify additional opportunities to enhance safety in delivery of ECLS. RESULTS The aim of this article is to support health-care practitioners who perform ECLS, or who are starting an ECLS program, by establishing standards for the safe and efficient use of ECLS with a focus on human factor issues. Other key concepts include the importance of ECLS team leadership and management, as well as controlling the environment and the system to optimize patient care. CONCLUSION Expertise from other industries is extrapolated to improve patient safety through the application of simulation training to reduce error propagation and improve outcomes.
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Affiliation(s)
- Justyna Swol
- Department of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University, Nuremberg, Germany
| | - Daniel Brodie
- Department of Medicine and Center for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York, New York, USA
| | - Anne Willers
- ECLS Centrum, Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Bishoy Zakhary
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Joseph Belezzo
- Emergency Room Sharp Memorial Hospital, San Diego, California, USA
| | - Zachary Shinar
- Emergency Room Sharp Memorial Hospital, San Diego, California, USA
| | - Scott D Weingart
- Department of Emergency Medicine, Division of Emergency Critical Care, Resuscitation and Acute Critical Care Unit, Stony Brook Hospital, Stony Brook, New York, USA
| | - Jonathan W Haft
- Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Roberto Lorusso
- ECLS Centrum, Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Giles J Peek
- UF Health Shands Children's Hospital, UF Health Congenital Heart Center, Gainesville, Florida, USA
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9
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Puslecki M, Dabrowski M, Ligowski M, Zakhary B, Said AS, Ramanathan K, Cooley E, Puslecki L, Stefaniak S, Ziemak P, Kiel-Puslecka I, Dabrowska A, Klosiewicz T, Sip M, Zalewski R, Ladzinska M, Mrowczynski W, Ladzinski P, Szlanga L, Baumgart K, Kupidlowski P, Szarpak L, Jemielity M, Perek B. Comprehensive assessment of a nationwide simulation-based course for artificial life support. PLoS One 2021; 16:e0257162. [PMID: 34618829 PMCID: PMC8496826 DOI: 10.1371/journal.pone.0257162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/24/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Successful implementation of medical technologies applied in life-threatening conditions, including extracorporeal membrane oxygenation (ECMO) requires appropriate preparation and training of medical personnel. The pandemic has accelerated the creation of new ECMO centers and has highlighted continuous training in adapting to new pandemic standards. To reach high standards of patients' care, we created the first of its kind, National Education Centre for Artificial Life Support (NEC-ALS) in 40 million inhabitants' country in the Central and Eastern Europe (CEE). The role of the Center is to test and promote the novel or commonly used procedures as well as to develop staff skills on management of patients needing ECMO. METHOD In 2020, nine approved and endorsed by ELSO courses of "Artificial Life Support with ECMO" were organized. Physicians participated in the three-day high-fidelity simulation-based training that was adapted to abide by the social distancing norms of the COVID-19 pandemic. Knowledge as well as crucial cognitive, behavioral and technical aspects (on a 5-point Likert scale) of management on ECMO were assessed before and after course completion. Moreover, the results of training in mechanical chest compression were also evaluated. RESULTS There were 115 participants (60% men) predominantly in the age of 30-40 years. Majority of them (63%) were anesthesiologists or intensivists with more than 5-year clinical experience, but 54% had no previous ECMO experience. There was significant improvement after the course in all cognitive, behavioral, and technical self-assessments. Among aspects of management with ECMO that all increased significantly following the course, the most pronounced was related to the technical one (from approximately 1.0 to more 4.0 points). Knowledge scores significantly increased post-course from 11.4 ± SD to 13 ± SD (out of 15 points). The quality of manual chest compression relatively poor before course improved significantly after training. CONCLUSIONS Our course confirmed that simulation as an educational approach is invaluable not only in training and testing of novel or commonly used procedures, skills upgrading, but also in practicing very rare cases. The implementation of the education program during COVID-19 pandemic may be helpful in founding specialized Advanced Life Support centers and teams including mobile ones. The dedicated R&D Innovation Ecosystem established in the "ECMO for Greater Poland" program, with developed National Education Center can play a crucial role in the knowledge and know-how transfer but future research is needed.
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Affiliation(s)
- Mateusz Puslecki
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
- Polish Society of Medical Simulation, Slupca, Poland
- * E-mail:
| | - Marek Dabrowski
- Polish Society of Medical Simulation, Slupca, Poland
- Chair and Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
| | - Marcin Ligowski
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Bishoy Zakhary
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR, United States of America
| | - Ahmed S. Said
- Division of Pediatric Critical Care Medicine, Washington University School of Medicine in St Louis and St Louis Children’s Hospital, St. Louis, Missouri, United States of America
| | - Kollengode Ramanathan
- Cardiothoracic Intensive Care Unit, National University Hospital, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Bond University, Robina, QLD, Australia
| | - Elaine Cooley
- Extracorporeal Life Support Organization, Ann Arbor, Michigan, United States of America
| | - Lukasz Puslecki
- Department of International Management, Poznan University of Economics and Business, Poznan, Poland
| | - Sebastian Stefaniak
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Ziemak
- Center of Medical Simulation, Poznan University of Medical Sciences, Poznan, Poland
| | - Ilona Kiel-Puslecka
- Center of Medical Simulation, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Dabrowska
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Polish Society of Medical Simulation, Slupca, Poland
| | - Tomasz Klosiewicz
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Sip
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Radoslaw Zalewski
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Malgorzata Ladzinska
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Mrowczynski
- Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Ladzinski
- Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Lidia Szlanga
- Polish Society of Medical Simulation, Slupca, Poland
| | - Konrad Baumgart
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Lukasz Szarpak
- Polish Society of Medical Simulation, Slupca, Poland
- Sklodowska-Curie Medical Academy, Warsaw, Poland
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartlomiej Perek
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
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Education and Training in Extracorporeal Life Support: The Structured, Visionary, and Needed Mission of the Extracorporeal Life Support Organization…Not Forgetting Problem-Based Learning, Ethics, and Leadership. Crit Care Med 2020; 48:435-437. [PMID: 32058383 DOI: 10.1097/ccm.0000000000004196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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