Simulation-Based Mastery Learning Improves Patient and Caregiver Ventricular Assist Device Self-Care Skills: A Randomized Pilot Trial

Jeffrey H. Barsuk, Jane E. Wilcox, Elaine R. Cohen, Rebecca S. Harap, Kerry B. Shanklin, Kathleen L. Grady, Jane S. Kim, Gretchen P. Nonog, Lauren E. Schulze, Alison M. Jirak, Diane B. Wayne, Kenzie A. Cameron

Research output: Contribution to journalArticle

Abstract

BACKGROUND: No recognized standards exist for teaching patients and their caregivers ventricular assist device (VAD) self-care skills. We compared the effectiveness of a VAD simulation-based mastery learning (SBML) self-care training curriculum with usual VAD self-care training. METHODS AND RESULTS: VAD patients and their caregivers were randomized to SBML or usual training during their implant hospitalization. The SBML group completed a pretest on 3 VAD self-care skills (controller, power source, and dressing change), then viewed videos and participated in deliberate practice on a simulator. SBML participants took a posttest and were required to meet or exceed a minimum passing standard for each of the skills. The usual training group completed the existing institutional VAD self-care teaching protocol. Before hospital discharge, the SBML and usual training groups took the same 3 VAD self-care skills tests. We compared demographic and clinical information, self-confidence, total participant training time, and skills performance between groups. Forty participants completed the study in each group. There were no differences in demographic and clinical information, self-confidence, or training time between groups. More participants in the SBML group met the minimum passing standard compared with the usual training group for controller (37/40 [93%] versus 25/40 [63%]; P=0.001), power source (36/40 [90%] versus 9/40 [23%]; P<0.001), and dressing change skills (19/20 [95%] versus 0/20; P<0.001). CONCLUSIONS: SBML provided superior VAD self-care skills learning outcomes compared with usual training. This study has important implications for patients due to the morbidity and mortality associated with improper VAD self-care. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT03073005.

Original languageEnglish (US)
Pages (from-to)e005794
JournalCirculation. Cardiovascular quality and outcomes
Volume12
Issue number10
DOIs
StatePublished - Oct 1 2019

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Heart-Assist Devices
Self Care
Caregivers
Learning
Electric Power Supplies
Bandages
Teaching
Demography
Curriculum
Hospitalization
Clinical Trials
Morbidity
Mortality

Keywords

  • caregivers
  • health education
  • heart failure
  • heart-assist devices
  • patients
  • self care
  • simulation training

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{f6a7ec6e55574d98b02f2041bc6d9b3d,
title = "Simulation-Based Mastery Learning Improves Patient and Caregiver Ventricular Assist Device Self-Care Skills: A Randomized Pilot Trial",
abstract = "BACKGROUND: No recognized standards exist for teaching patients and their caregivers ventricular assist device (VAD) self-care skills. We compared the effectiveness of a VAD simulation-based mastery learning (SBML) self-care training curriculum with usual VAD self-care training. METHODS AND RESULTS: VAD patients and their caregivers were randomized to SBML or usual training during their implant hospitalization. The SBML group completed a pretest on 3 VAD self-care skills (controller, power source, and dressing change), then viewed videos and participated in deliberate practice on a simulator. SBML participants took a posttest and were required to meet or exceed a minimum passing standard for each of the skills. The usual training group completed the existing institutional VAD self-care teaching protocol. Before hospital discharge, the SBML and usual training groups took the same 3 VAD self-care skills tests. We compared demographic and clinical information, self-confidence, total participant training time, and skills performance between groups. Forty participants completed the study in each group. There were no differences in demographic and clinical information, self-confidence, or training time between groups. More participants in the SBML group met the minimum passing standard compared with the usual training group for controller (37/40 [93{\%}] versus 25/40 [63{\%}]; P=0.001), power source (36/40 [90{\%}] versus 9/40 [23{\%}]; P<0.001), and dressing change skills (19/20 [95{\%}] versus 0/20; P<0.001). CONCLUSIONS: SBML provided superior VAD self-care skills learning outcomes compared with usual training. This study has important implications for patients due to the morbidity and mortality associated with improper VAD self-care. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT03073005.",
keywords = "caregivers, health education, heart failure, heart-assist devices, patients, self care, simulation training",
author = "Barsuk, {Jeffrey H.} and Wilcox, {Jane E.} and Cohen, {Elaine R.} and Harap, {Rebecca S.} and Shanklin, {Kerry B.} and Grady, {Kathleen L.} and Kim, {Jane S.} and Nonog, {Gretchen P.} and Schulze, {Lauren E.} and Jirak, {Alison M.} and Wayne, {Diane B.} and Cameron, {Kenzie A.}",
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Simulation-Based Mastery Learning Improves Patient and Caregiver Ventricular Assist Device Self-Care Skills : A Randomized Pilot Trial. / Barsuk, Jeffrey H.; Wilcox, Jane E.; Cohen, Elaine R.; Harap, Rebecca S.; Shanklin, Kerry B.; Grady, Kathleen L.; Kim, Jane S.; Nonog, Gretchen P.; Schulze, Lauren E.; Jirak, Alison M.; Wayne, Diane B.; Cameron, Kenzie A.

In: Circulation. Cardiovascular quality and outcomes, Vol. 12, No. 10, 01.10.2019, p. e005794.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Simulation-Based Mastery Learning Improves Patient and Caregiver Ventricular Assist Device Self-Care Skills

T2 - A Randomized Pilot Trial

AU - Barsuk, Jeffrey H.

AU - Wilcox, Jane E.

AU - Cohen, Elaine R.

AU - Harap, Rebecca S.

AU - Shanklin, Kerry B.

AU - Grady, Kathleen L.

AU - Kim, Jane S.

AU - Nonog, Gretchen P.

AU - Schulze, Lauren E.

AU - Jirak, Alison M.

AU - Wayne, Diane B.

AU - Cameron, Kenzie A.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - BACKGROUND: No recognized standards exist for teaching patients and their caregivers ventricular assist device (VAD) self-care skills. We compared the effectiveness of a VAD simulation-based mastery learning (SBML) self-care training curriculum with usual VAD self-care training. METHODS AND RESULTS: VAD patients and their caregivers were randomized to SBML or usual training during their implant hospitalization. The SBML group completed a pretest on 3 VAD self-care skills (controller, power source, and dressing change), then viewed videos and participated in deliberate practice on a simulator. SBML participants took a posttest and were required to meet or exceed a minimum passing standard for each of the skills. The usual training group completed the existing institutional VAD self-care teaching protocol. Before hospital discharge, the SBML and usual training groups took the same 3 VAD self-care skills tests. We compared demographic and clinical information, self-confidence, total participant training time, and skills performance between groups. Forty participants completed the study in each group. There were no differences in demographic and clinical information, self-confidence, or training time between groups. More participants in the SBML group met the minimum passing standard compared with the usual training group for controller (37/40 [93%] versus 25/40 [63%]; P=0.001), power source (36/40 [90%] versus 9/40 [23%]; P<0.001), and dressing change skills (19/20 [95%] versus 0/20; P<0.001). CONCLUSIONS: SBML provided superior VAD self-care skills learning outcomes compared with usual training. This study has important implications for patients due to the morbidity and mortality associated with improper VAD self-care. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT03073005.

AB - BACKGROUND: No recognized standards exist for teaching patients and their caregivers ventricular assist device (VAD) self-care skills. We compared the effectiveness of a VAD simulation-based mastery learning (SBML) self-care training curriculum with usual VAD self-care training. METHODS AND RESULTS: VAD patients and their caregivers were randomized to SBML or usual training during their implant hospitalization. The SBML group completed a pretest on 3 VAD self-care skills (controller, power source, and dressing change), then viewed videos and participated in deliberate practice on a simulator. SBML participants took a posttest and were required to meet or exceed a minimum passing standard for each of the skills. The usual training group completed the existing institutional VAD self-care teaching protocol. Before hospital discharge, the SBML and usual training groups took the same 3 VAD self-care skills tests. We compared demographic and clinical information, self-confidence, total participant training time, and skills performance between groups. Forty participants completed the study in each group. There were no differences in demographic and clinical information, self-confidence, or training time between groups. More participants in the SBML group met the minimum passing standard compared with the usual training group for controller (37/40 [93%] versus 25/40 [63%]; P=0.001), power source (36/40 [90%] versus 9/40 [23%]; P<0.001), and dressing change skills (19/20 [95%] versus 0/20; P<0.001). CONCLUSIONS: SBML provided superior VAD self-care skills learning outcomes compared with usual training. This study has important implications for patients due to the morbidity and mortality associated with improper VAD self-care. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT03073005.

KW - caregivers

KW - health education

KW - heart failure

KW - heart-assist devices

KW - patients

KW - self care

KW - simulation training

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