Development of Validated Checklists to Evaluate Clinical Specialists in Pediatric ECMO Emergencies Using Delphi...

Area of Science:

• Cardiovascular Medicine
• Critical Care Medicine
• Medical Education

Background:

• Extracorporeal membrane oxygenation (ECMO) is a high-risk procedure with variable clinical specialist (CS) training.
• Inconsistent approaches to ECMO circuit emergencies can impact patient care quality.
• Validated performance assessment tools are needed to standardize ECMO emergency management.

Purpose of the Study:

• To develop and validate checklists for assessing CS performance in three critical ECMO circuit emergencies: venous air, arterial air, and oxygenator failure.
• To establish content validity evidence for these novel assessment tools.

Main Methods:

• A research team developed initial checklist drafts.
• A modified Delphi technique involving 11 national ECMO experts was employed for content validation.
• A 7-point rating scale and consensus-based item selection were utilized over three rounds.

Main Results:

• Checklists for venous air, arterial air, and oxygenator failure were refined from initial item counts to 12, 12, and 10 items, respectively.
• A Cronbach's alpha of 0.74 indicated acceptable inter-rater agreement.
• The study achieved content validation for the developed ECMO emergency checklists.

Conclusions:

• The study successfully developed and content-validated three checklists for assessing ECMO CS performance in critical circuit emergencies.
• These checklists, validated through expert consensus, provide a foundation for standardized performance evaluation.
• Further research is recommended to establish validity evidence through simulation-based implementation.