Establishing International Expert Consensus for Psychomotor Competency in Percutaneous Extracorporeal Membrane Oxygenation Cannulation

Objectives Despite the growing use of extracorporeal membrane oxygenation (ECMO) for respiratory and circulatory failure, a standardized curriculum to obtain the skills essential to percutaneous cannulation is lacking. This study aimed to establish expert consensus on the key psychomotor skills required for this procedure. Methods A three-round modified Delphi process was employed via electronic surveys to an international, multidisciplinary cohort of physicians, advanced practice providers, and nurses with expertise in ECMO management and percutaneous cannulation. Results Thirty-two experts representing 15 countries from 6 continents and 8 medical subspecialities were recruited as panelists. Expert response rates were 32 out of 32 (100%), 29 out of 32 (91%), and 29 out of 32 (91%) for rounds 1, 2, and 3 respectively. Consensus was achieved on 60 out of 66 (91%) initially proposed psychomotor steps for the first survey that was derived from published literature. Modifications and suggestions for additional essential psychomotor steps were surveyed in Round 2 and final approval of derived sections of psychomotor steps was accomplished in Round 3. At the conclusion of the study, consensus was achieved for a total of 77 unique psychomotor and resource allocation steps for inclusion in a percutaneous cannulation curriculum. Conclusion This study identified core psychomotor skills for percutaneous ECMO cannulation and related procedures. These steps lay the foundational framework for the development of a curriculum that can be utilized to develop and assess psychomotor skills required for ECMO cannulation globally.