To improve inpatient stroke recognition and speed of intervention, we sought to assess resident stroke knowledge across disciplines and provide education.

Swift stroke recognition, diagnostic workup, and intervention improve patient morbidity and mortality.  Stroke codes allow efficient evaluation for determining candidacy for tPA and/or thrombectomy.  Inpatient strokes are not uncommonly missed or recognized outside therapeutic windows.  Neurology trainee education has been shown to improve stroke care, for example reducing door-to-needle time.  Yet there is a paucity of literature on educating non-neurology trainees to recognize stroke, and education varies by department and institution.

At a monthly, institution-wide Housestaff Patient Safety Council meeting, an anonymous survey assessed trainees’ comfort level identifying a stroke and current stroke education in their respective departments.  A neurology resident then discussed clinical presentations of stroke, acute interventions, and their respective therapeutic windows.  An anonymous post-didactic survey was distributed to determine educational value.

The surveys were completed by residents from various departments: Medicine, Surgery, Obstetrics, Pediatrics, ENT, Orthopedics, Physiatry.  Based on the pre-didactic survey (N=16), 37% of residents received a lecture on stroke in the preceding 12 months or during orientation; only 19% said their department discussed when to call a stroke code, as opposed to a less time sensitive consult.  Comfort level varied in response to the statement “I know the difference between calling a stroke code and stroke consult” (19% strongly agree, 25% agree, 25% neutral, 19% disagree, 12% strongly disagree).  Based on the post-didactic survey (N=10), the distribution narrowed (40% strongly agree, 20% agree, 40% neutral, 0% disagree, 0% strongly disagree).  80% found the talk helpful and 60% felt their department should have more education on stroke.

Trainees across fields benefit from dedicated education on stroke recognition and acute interventions.  This may ultimately decrease missed strokes, delayed diagnoses and delayed interventions.