Stroke Simulation with Deliberate Practice Method Significantly Increases Knowledge and Confidence Among Incoming Neurology Residents
Alena Makarova1, Michael Brannick2, Charles Schutt3, Shreyas Gangadhara4, Swetha Renati1, Kanita Beba Abadal1, Clifton Gooch1, Andrea Bozeman1, William Burgin1, David Rose1
1Neurology, University of South Florida Morsani College of Medicine, 2Psychology, University of South Florida College of Arts and Sciences, 3Neurology, Ascension Health, 4Neurology, University of Mississippi Medical Center
Objective:
Our objective was to investigate the effect of a stroke simulation on knowledge and confidence in managing stroke alerts among first-year neurology residents.
Background:
For incoming neurology residents, stroke alerts can be a daunting new practice of timely recognition of acute symptoms they have not witnessed in the real world yet. Nevertheless, optimal diagnosis and treatment of stroke requires knowledge of options available for hyperacute intervention and effective communication with patients and other healthcare workers in an expedited manner. Medical simulation programs have shown promising results utilizing the “deliberate practice method” (DPM), which allows a focused “safe space” to allow errors and learn from them through repetition. A longitudinal evaluation of neurology residents’ participation in stroke training with DPM, simultaneously comparing pre- and post-simulation knowledge and confidence assessments, has not yet been reported.
Design/Methods:
For 10 years (2015-2024), we investigated the effect of DPM with stroke simulations on knowledge and confidence in managing a stroke alert among first-year neurology residents. The simulation included a robot mannequin and standardized patient actors with various case scenarios that mimicked stroke syndromes. After each scenario, a vascular neurologist debriefed each case with participants, who were given pre- and post-tests on knowledge and confidence of stroke management, including thrombolytic shared decision-making.
Results:
Ninety first-year neurology residents underwent a “Stroke Patient Simulation” course, which was offered every year for a decade. Residents’ knowledge significantly improved from 8.07/10 (pre-test mean, SD 1.96) to 9.78/10 (post-test mean, SD 1.47), p<0.05 (overall effect size 0.98). Confidence significantly improved from 2.84/5 (pre-test mean SD 1.01) to 3.92/5 (post-test mean, SD 0.74), p<0.05 (overall effect size 1.17).
Conclusions:
DPM optimizes residents’ stroke management strategies before practicing upon real-world patients in the hyperacute setting by significantly improving knowledge and confidence with annual stroke simulation programs.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.