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

<h2>Abstract</h2><h3>Objectives</h3> 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. <h3>Methods</h3> 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. <h3>Results</h3> 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. <h3>Conclusion</h3> 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.