Simulation Based Training for Acute Stroke Alerts (P07.228)

Abstract

Objective: To determine if simulation based training for acute stroke alerts provide improved learning outcomes and skills. Background Simulation based training provides a controlled environment that recreates a real-life patient care setting without putting patients at risk. Acute stroke alerts are critical scenarios that require multiple competencies in history taking, physical examination, neuro-imaging interpretation, communication skills, and medical knowledge of acute stroke and tPA. Underperforming in any of these categories during acute stroke alerts may lead to adverse events. Design/Methods: 5 subjects were evaluated. A pre-test of 8 items was given before simulation. Items assessed the subject9s comfort ability regarding stroke management, inclusion/exclusion criteria of tPA, history taking, NIHSS examination, neuroimaging interpretation, stroke differential diagnosis, communication skills, and knowledge of tPA, with a 1 (strongly disagree) to 5 (strongly agree) scale. Subjects performed the simulation with a standardized patient. After simulation and debriefing, subjects were then given a post-test. Paired t-test assessed pre/post test score differences. McNemar test assessed strongly agree pre/post test percentage differences. Results: Simulation improved post test scores on all 8 items. Simulation improved learning outcomes and skills when all 8 item scores were averaged (P=.03). Comfort ability of identifying acute ischemic changes/ruling out ICH on CT (P=0.02), knowledge of inclusion/exclusion criteria of tPA (P=0.02), and knowledge of tPA (P=0.05) improved after simulation. The percentage of strongly agree scores per item were higher in the post-test. However, only knowledge of tPA and its inclusion/exclusion criteria achieved borderline significance (P=0.08). Conclusions: Simulation based medical education for acute stroke alerts provide trainees with improved learning outcomes and skills without putting patients at risk. Trainees have a better understanding of tPA, its inclusion/exclusion criteria, and have an enhanced foundation of neuroimaging interpretation during acute stroke. Studies are needed to translate simulation based training to patient outcomes. Disclosure: Dr. Capampangan has nothing to disclose. Dr. Hentz has nothing to disclose. Dr. Hoerth has nothing to disclose.

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