A Scoping Review and Appraisal of Extracorporeal Membrane Oxygenation Education Literature

Abstract

Background: Despite a recent rise in publications describing extracorporeal membrane oxygenation (ECMO) education, the scope and quality of ECMO educational research and curricular assessments have not previously been evaluated.

Objective: The purposes of this study are 1) to categorize published ECMO educational scholarship according to Bloom's educational domains, learner groups, and content delivery methods; 2) to assess ECMO educational scholarship quality; and 3) to identify areas of focus for future curricular development and educational research.

Methods: A multidisciplinary research team conducted a scoping review of ECMO literature published between January 2009 and October 2021 using established frameworks. The Medical Education Research Study Quality Instrument (MERSQI) was applied to assess quality.

Results: A total of 1,028 references were retrieved; 36 were selected for review. ECMO education studies frequently targeted the cognitive domain (78%), with 17% of studies targeting the psychomotor domain alone and 33% of studies targeting combinations of the cognitive, psychomotor, and affective domains. Thirty-three studies qualified for MERSQI scoring, with a median score of 11 (interquartile range, 4; possible range, 5-18). Simulation-based training was used in 97%, with 50% of studies targeting physicians and one other discipline.

Conclusion: ECMO education frequently incorporates simulation and spans all domains of Bloom's taxonomy. Overall, MERSQI scores for ECMO education studies are similar to those for other simulation-based medical education studies. However, developing assessment tools with multisource validity evidence and conducting multienvironment studies would strengthen future work. The creation of a collaborative ECMO educational network would increase standardization and reproducibility in ECMO training, ultimately improving patient outcomes.

Keywords: Medical Education Research Study Quality Instrument; curricula; education; extracorporeal membrane oxygenation; scoping review.

Figure 1.

Screening diagram and Preferred Reporting Items for Systematic Reviews and Meta-Analyses data from three databases (PubMed, Embase, and CINAHL) representing the flowchart of the study selection process. CINAHL = Cumulative Index to Nursing and Allied Health Literature; ECMO = extracorporeal membrane oxygenation.

Figure 2.

MERSQI outcomes domain reflective of Kirkpatrick’s levels of learning evaluation. Numbers in the left column represent the points for each outcomes domain, with higher scores implying more robust outcomes. ECMO = extracorporeal membrane oxygenation; MERSQI = Medical Education Research Study Quality Instrument.