Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.



Degree Program

Nursing, PhD

Committee Chair

Hall, Lynne

Committee Member

Shawler, Celeste

Committee Member

Centimole, Zohn N.

Committee Member

Abusalem, Said

Committee Member

Alkhalil, Bassel

Author's Keywords

Clinical judgment; mechanical circulatory support; hemodynamics; pressure-volume loops; simulation


Introduction: Education on acute mechanical circulatory support (AMCS), a therapy used in the cardiovascular intensive care unit (CICU) to manage cardiogenic shock (CGS) is limited for CICU nurses. There is a need to explore clinical judgment in CICU nurses and provide innovative learning experiences that foster judgment when managing AMCS. Methods: This mixed methods feasibility study investigated the effects of an interactive cardiovascular dynamics simulation program on CICU nurses’ knowledge, clinical reasoning, and clinical judgment. Semi-structured interviews explored the participants’ perceptions of the learning experience. Results: Twenty-one nurses completed the cardiovascular dynamics simulation program. The majority were white (85.7%), female (71.4%), resided in the United States (81%), were CCRN certified (66.7%), and had 2-7 years of experience (80.9%). After completing the cardiovascular dynamics simulation program, nurses’ mean knowledge scores (M = 55.00, SE = 3.87) and median clinical judgment scores (Mdn = 41.00) were higher than their mean knowledge (M = 39.52, SE = 3.52) and median clinical judgment scores (Mdn = 41.00) before completing the program. Conclusion: In an international sample of experienced CICU nurses, a cardiovascular dynamics simulation program using pressure-volume loop analysis significantly improved nurses’ knowledge of hemodynamics and AMCS, clinical judgment when managing AMCS, and reflection skills. After completing the program, nurses were highly satisfied with the program and reported a high degree of self-confidence in managing AMCS. The program has high practical applicability and utility for CICU nurses, with the potential to improve their daily clinical practice and, ultimately, to improve patient outcomes.