Abstract Details

Title Stroke Simulation during a Neurology Bootcamp

Topic Research Methodology, �鶹��ýӳ��, and History

Presentation(s) P6 - Poster Session 6 (12:00 PM-1:00 PM)

Poster/Presentation
Number 13-014

Objective To improve junior resident acute stroke education and clinical preparedness using simulation based training.

Background The transition from medicine intern to neurology resident can be daunting, especially when it comes to managing stroke codes and neurologic emergencies. We developed a case based stroke simulation to allow residents to practice problem solving and clinical decision making skills and improve their confidence in acute stroke care.

Design/Methods The simulation consisted of four cases (patient out of the tPA window, patient with contraindication to tPA, patient eligible for tPA, and patient eligible for endovascular therapy) during which key teaching points were emphasized including tPA inclusion/exclusion criteria, recognition of hemorrhage and early ischemia on CT, and detection of large vessel syndromes. During each scenario, one junior resident assumed the role of team leader and ran a timed code, while the other team members observed. Senior neurology residents acted as standardized patients in order to maximize the teaching potential of each case, and each room was staffed by a stroke attending or fellow. Participating junior residents completed a six question survey before and after the simulation, which consisted of four multiple choice questions regarding stroke code specifics (e.g. tPA exclusion criteria) and two questions graded on a Likert scale from 1-5 (1=extremely comfortable, 5=not at all comfortable).

Results

Of the 16 participating junior residents, only 31% reported they felt confident running a stroke code prior to the simulation, which improved to 94% after the simulation (mean Likert score= 2.75/5). Whereas only 19% of participants were able to correctly identify tPA exclusion criteria prior to the simulation, 75% correctly identified exclusion criteria on the post-test.

Conclusions

Simulation based training in acute stroke can improve junior resident comfort level and enable practice of critical clinical decision making skills under direct supervision and with real time feedback.

Authors/Disclosures
Alexandra Kvernland, MD (NYU Department of Neurology) PRESENTER	Dr. Kvernland has nothing to disclose.
Brandon Giglio, MD (NYU Langone Medical Center)	Dr. Giglio has nothing to disclose.
Marco J. Russo, MD, PhD (Rutgers Robert Wood Johnson Medical School)	Dr. Russo has nothing to disclose.
Sara K. Rostanski, MD (NYU School of Medicine)	Dr. Rostanski has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Individual law firms.