Effect of deliberate practice in rapid cycles on nurses' performance during implementation of extracorporeal cardiopulmonary resuscitation

INTRODUCTION: Cardiac arrest is a critical event that requires swift and effective interventions. When the return of spontaneous circulation is not achieved despite efforts, some patients may benefit from extracorporeal cardiopulmonary resuscitation (E-CPR). This is a high-cost, complex, and infrequent therapeutic modality that necessitates a skilled team capable of quickly and accurately assembling the extracorporeal membrane oxygenation (ECMO) circuit. Given the low incidence of the procedure, ensuring that professionals maintain mastery of acquired skills through training becomes a challenge, as the success of E-CPR is strongly linked to the technical ability of the involved professionals. Simulation provides an opportunity for the team to develop technical proficiency in complex scenarios. Thus, rapid cycle deliberate practice (RCDP) was evaluated as a strategy for training nurses in the assembly and priming of the ECMO circuit. GENERAL OBJECTIVE: To analyze the effect of simulation-based training using Rapid Cycle Deliberate Practice on the technical performance of nurses in assembling and priming the ECMO circuit during extracorporeal cardiopulmonary resuscitation. METHODOLOGY: Open randomized experimental study. The simulation strategy applied to the intervention group was rapid cycle deliberate practice (RCDP), and to the control group, it was the wet lab skill training. The sample consisted of 30 nurses providing direct care to ECMO patients in hospital units in the city of Rio de Janeiro. In both groups, the participants' performance was assessed through a post-test in a simulated scenario of extracorporeal cardiopulmonary resuscitation. A structured checklist was used to evaluate the tests. The analysis considered the accuracy rate and the execution time of the ECMO circuit assembly and priming procedure. Statistical tests of Mann Whitney and Fisher were used. RESULTS: In the assessment of the accuracy rate for the assembly and priming items, both groups exhibited high success rates. The overall accuracy average was 85.4% in the control group (CG) and 82.2% in the intervention group (IG). Regarding execution time, participants trained with Rapid Cycle Deliberate Practice (RCDP) showed an average of 1.20 minutes less, however, statistical tests did not indicate a difference between the two groups (p > 5%), neither in accuracy rates nor in the time taken to perform the procedure. It was observed that professionals with postgraduate degrees in perfusion completed the tasks in shorter times, suggesting that prior experience contributes to efficiency in assembling and priming the ECMO circuit. The research also emphasized the importance of continuous and systematized training to achieve mastery of the 10 technique. The results indicate that RCDP proved to be an effective strategy for training nurses in the assembly and priming of the circuit as much as the wet lab skill training.