Stroke Simulation Improves Acute Stroke Management: A Systems-Based Practice Experience

Journal of Graduate Medical Education
Tapan MehtaNora Lee

Abstract

Literature on the effectiveness of simulation-based medical education programs for caring for acute ischemic stroke (AIS) patients is limited. To improve coordination and door-to-needle (DTN) time for AIS care, we implemented a stroke simulation training program for neurology residents and nursing staff in a comprehensive stroke center. Acute stroke simulation training was implemented for first-year neurology residents in July 2011. Simulations were standardized using trained live actors, who portrayed stroke vignettes in the presence of a board-certified vascular neurologist. A debriefing of each resident's performance followed the training. The hospital stroke registry was also used for retrospective analysis. The study population was defined as all patients treated with intravenous tissue plasminogen activator for AIS between October 2008 and September 2014. We identified 448 patients meeting inclusion criteria. Simulation training independently predicted reduction in DTN time by 9.64 minutes (95% confidence interval [CI] -15.28 to -4.01, P = .001) after controlling for age, night/day shift, work week versus weekend, and blood pressure at presentation (> 185/110). Systolic blood pressure higher than 185 was associated with a...Continue Reading

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Citations

Apr 25, 2018·Stroke; a Journal of Cerebral Circulation·Mitchell S V Elkind, Stephanie Mohl
Oct 2, 2019·Frontiers in Neurology·Ferdinand O BohmannUNKNOWN STREAM Trial Investigators
Jan 9, 2020·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Atul P Kulkarni
Jul 8, 2021·Revue neurologique·B Casolla
Sep 4, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Ferdinand O BohmannUNKNOWN STREAM Trial investigators

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