Rapid cycle deliberate practice for training nontechnical skills in extracorporeal cardiopulmonary resuscitation

INTRODUCTION: E-CPR refers to VA-ECMO during CA for perfusion of vital organs to fix reversible causes of CA. The procedure is low frequency and high risk, with simulation training, specifically RCDP, being a valuable tool in improving non-technical skills, as it is a simulation strategy for acquiring skills to achieve mastery. OBJECTIVES: To evaluate the effect of Rapid Cycle Deliberate Practice, as an educational technology, on nurses' non-technical skills in extracorporeal cardiopulmonary resuscitation; To evaluate the effect of two different types of simulated training strategies on nurses' non-technical skills in extracorporeal cardiopulmonary resuscitation; Compare the effect of two different types of simulated training strategies on nurses' non-technical skills in extracorporeal cardiopulmonary resuscitation. METHOD: Singlecenter, experimental, randomized open study, with a quantitative approach, with a control group and intervention group. The intervention group's strategy was RCDP and the control group's strategy was skills training. Final sample composed of 30 nurses experienced in ECMO from hospitals in Rio de Janeiro. 4 stages were carried out: preparation, characterization, intervention and testing. Data on non-technical skills were analyzed from the test videos by three professionals using the TEAM scale. RESULTS: Participant profile: Female (86.7%), average of 33 years old, professional experience of 8 years and ECMO experience of 3 years. More than 80% do not have training in non-technical skills, 66.7% had not assembled and filled the ECMO circuit. There was no agreement among the three evaluators in the scale categories, in the global assessment and in the total score, since all coefficients were not statistically different from zero (p ≥ 0.415). No statistically significant differences (p ≥ 0.05) were observed between the two groups in the comparisons, either by the unadjusted models or by the models adjusting for the covariates, indicating that there were no differences between the control and intervention groups in the TEAM scale scores. It is noteworthy that the variables included in the adjusted models did not show multicollinearity between them. CONCLUSION: RCDP should be considered as an option to improve non-technical skills in E-CPR, especially because it is a low-recurrence, high-risk procedure with different well-defined and rehearsed functions, and because of its comparison with a well-established strategy over time, skills training, has presented noninferior results in the behaviors expected by nurses, evidenced by the scores of both groups not having presented statistically significant differences. Hence, it can be concluded that RCDP can be applied as an educational technology for the training of non-technical skills in the context of E-CPR, interpreting that the application of RCDP in a public and context different from the original study appears to be promising and feasible.