Authors: (including presenting author): :
Lau, FM (1), Ma, SKT (1), Lau, KY (1), Leung, MSA (1), Tai, WHP (1), Chui, ETF (1), Chan, MH (1), Ng, PY (1) (2), Sin, WC (1) (2), Lai, CKP (1), Chan, WK (1), Ngai, CW (1)
Affiliation: :
(1) Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong (2) Critical Care Medicine Unit, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
Keyword 1: :
Percutaneous ventricular assist device
Keyword 2: :
Simulation-based Training
Keyword 4: :
Multidisciplinary
Keyword 5: :
Quality Improvement
Introduction: :
Percutaneous ventricular assist device (pVAD) is increasingly essential for cardiogenic shock rescue, yet operator competency training remains limited to theoretical web modules. Knowledge gaps in alarm recognition and troubleshooting increase risks of delayed clinical response and device-related complications. This quality improvement initiative implemented simulation-based training to systematically bridge theory into clinical practice and enhance operator competency for safe pVAD management across multidisciplinary teams.
Objectives: :
(1): Demonstrate competence in troubleshooting pVAD clinical scenarios and emergencies. (2): Develop skills in recognising and troubleshooting pVAD alarms. (3): Achieve safe and coordinated pVAD management across multidisciplinary teams.
Methodology: :
Healthcare professionals from intensive care, coronary care, and cardiothoracic surgery units participated across three training cohorts. Each three-hour session featured four high-fidelity simulation scenarios (30 minutes each): suction alarm, improper pVAD positioning, cardiopulmonary resuscitation, and global perfusion inadequacy, along with hands-on practice and debriefing. Pre-post training standardised assessments (15-item multiple-choice questionnaire) and satisfaction surveys (6-point Likert scale) were analysed using paired t-tests and Cohen’s d effect size.
Result & Outcome: :
A total of 16 identical simulation sessions were delivered to three training cohorts from January 2024 to May 2025. These cohorts engaged 87 healthcare professionals across three clinical specialities, including 52 from Adult ICU, 22 from coronary care, and 15 from cardiothoracic units. The professional breakdown comprised 14 physicians and 73 nurses. Pre-training baseline score (out of 15) was 11.2 ± 2.4; post-training score (out of 15) was 13.8 ± 1.5, representing an improvement of 2.6 points (p < 0.001, Cohen’s d = 1.08). Effect size exceeded established simulation training benchmarks. Role-stratified analysis confirmed equivalent gains across professional groups (p = 0.443). Clinical scenario mastery was demonstrated through 92.1% post-test proficiency. Participants recounted the themes of “troubleshooting”, “emergency management”, and “complication handling” as most transferable to real-world pVAD patient care. Program quality remained consistently valued across three cohorts. Participants rated overall satisfaction 5.5 ± 0.8, scenario realism 5.4 ± 0.9, debriefing effectiveness 5.6 ± 0.8, and self-efficacy in pVAD management 5.5 ± 0.8, confirming program efficacy. Feedback identified opportunities for comprehensive pre-reading materials, various pVAD models, and structured weaning protocols. Structured multidisciplinary simulation-based training enhanced provider efficacy and team competency essential for safe pVAD care. Equivalent gains across physicians and nurses and high participant valuation validate this as a worthy training model of pVAD. These Kirkpatrick Level 2 outcomes establish foundation for prospective Level 3 or 4 evaluation of clinical behaviour change and patient safety outcomes.
