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Background: Home monitoring programs for infants with shunt-dependent cardiac physiology have significantly reduced mortality, but they demand extensive caregiver education and vigilance before and after hospital discharge., Local Problem: Caregivers in the home monitoring program face complex tasks that can lead to anxiety and decreased confidence., Methods: This quality improvement project aimed to implement a modified simulation-based mastery learning (SBML) curriculum to improve confidence in home monitoring skills and decrease caregiver anxiety. The State Trait Anxiety Index for Adults short form Y was used to assess the impact., Interventions: The SBML intervention allowed caregivers to learn and demonstrate all home monitoring program skills in a simulated environment., Results: All participants met the minimum passing standards during the simulation. State anxiety decreased in 9 of 10 measures, and caregiver confidence increased., Conclusions: The modified SBML intervention effectively decreased caregiver anxiety and increased confidence in home monitoring skills. This is the first intervention of its kind and may improve patient outcomes during this tenuous stage., Competing Interests: CONFLICTS OF INTEREST Grant funding provided by Children's Hospital Association of St. Paul to support the sustainment of the Caregiver Simulation Program. B.D. and S.V. are co-founders of Shifting Frames Consulting. H.S., J.B., and J.H. report no financial interests or potential conflicts of interest. We are submitting this manuscript using the appropriate reporting standards for our work. The pre-post cohort quality improvement study protocol was approved by the Children's Minnesota Institutional Review Board., (Copyright © 2025 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)