• Natalie Kruit, Aidan Burrell, David Tian, Nicholas Barrett, Jan Bělohlávek, Stephen Bernard, Darren Braude, Hergen Buscher, Yih-Sharng Chen, Dirk W Donker, Simon Finney, Paul Forrest, Jo-Anne Fowles, Toru Hifumi, Carol Hodgson, Alice Hutin, Akihiko Inoue, Jae-Seung Jung, J M Kruse, Lionel Lamhaut, Ming-Hui LinRichardRDirector of Emergency and Critical Care Services, Lin Shin Hospital, Taichung, Taiwan. Electronic address: rmlin07@gmail.com., Reis MirandaDinisDErasmus MC - University Medical Center, Netherlands. Electronic address: d.dosreismiranda@erasmusmc.nl., Thomas Müller, Bhagyalakshmi NanjayyaVinodhVThe Alfred Hospital, Victoria, Australia. Electronic address: vinodh_bn@yahoo.co.in., Christopher Nickson, Vin Pellegrino, Brian Plunkett, Carla Richardson, Sacha Alexander Richardson, Kiran Shekar, Zachary Shinar, Ben Singer, Dion Stub, Richard J Totaro, Alain Vuylsteke, Demetris Yannopoulos, Bishoy Zakhary, and Mark Dennis.
• Department of Perioperative Medicine, Westmead Hospital, Hawksbury Rd, Westmead, NSW 2145, Australia. Electronic address: natalie.kruit@health.nsw.gov.au.
• Resuscitation. 2023 Nov 1; 192: 109989109989.

BackgroundA multidisciplinary group of stakeholders were used to identify: (1) the core competencies of a training program required to perform in-hospital ECPR initiation (2) additional competencies required to perform pre-hospital ECPR initiation and; (3) the optimal training method and maintenance protocol for delivering an ECPR program.MethodsA modified Delphi process was undertaken utilising two web based survey rounds and one virtual meeting. Experts rated the importance of different aspects of ECPR training, competency and governance on a 9-point Likert scale. A diverse, representative group was targeted. Consensus was achieved when greater than 70% respondents rated a domain as critical (> or = 7 on the 9 point Likert scale).Results35 international ECPR experts from 9 countries formed the expert panel, with a median number of 14 years of ECMO practice (interquartile range 11-38). Participant response rates were 97% (survey round one), 63% (virtual meeting) and 100% (survey round two). After the second round of the survey, 47 consensus statements were formed outlining a core set of competencies required for ECPR provision. We identified key elements required to safely train and perform ECPR including skill pre-requisites, surrogate skill identification, the importance of competency-based assessment over volume of practice and competency requirements for successful ECPR practice and skill maintenance.ConclusionsWe present a series of core competencies, training requirements and ongoing governance protocols to guide safe ECPR implementation. These findings can be used to develop training syllabus and guide minimum standards for competency as the growth of ECPR practitioners continues.Copyright © 2023 Elsevier B.V. All rights reserved.

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