Bridging Theory and Nursing Practice in the Management of Patients on Percutaneous Ventricular Assist Device Through Simulation-Based Training

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BACKGROUND: Simulation-based training has emerged as a promising strategy to enhance clinical competence in managing complex devices like percutaneous ventricular assist device (pVAD), addressing a critical gap between theoretical knowledge and practical nursing proficiency. OBJECTIVES: This study aims to examine whether simulation-based training improves nurses' knowledge and self-efficacy in managing the pVAD. METHODS: A mixed-methods pilot study was conducted in a tertiary hospital in Hong Kong involving 27 critical care nurses. Participants engaged in high-fidelity simulation scenarios focused on emergency pVAD management. Quantitative measures include pre-month, immediate post-month, and 3-month follow-up assessments of pVAD knowledge and self-efficacy (Self-efficacy Scale relating to pVAD management, SES-Impella). Qualitative data from semi-structured focus group interviews explored participants' learning experiences, perceptions, and recommendations for training improvement. RESULTS: Median knowledge scores increased from 11 (Interquartile range [IQR]: 9 to 14) at baseline to 14 (IQR: 14 to 15) immediately post-training (P < .001) and were maintained at 14 (IQR: 12 to 15) at 3 months (P = .015 vs. baseline). Median SES-Impella self-efficacy scores increased from 21 (IQR: 18 to 26) at baseline to 30 (IQR: 30 to 32) immediately post-training (P < .001). Qualitative findings revealed that participants valued structured debriefing, realistic scenarios, and opportunities for hands-on practice, and reported enhanced confidence in troubleshooting alarms in managing real pVAD cases. DISCUSSION: Simulation-based training seems to be an effective and feasible approach to strengthening nurses' knowledge and self-efficacy in pVAD management and to supporting standardized team-based care. Future research should investigate optimal refresher intervals and explore direct links between simulation training and patient outcomes.

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