2023 American Academy of Neurology Abstract Website

Objective:

To assess the impact of an acute ischemic stroke (AIS) simulation course on residents’ performance, confidence, and knowledge.

Background:

Previous studies have demonstrated that simulation can promote mastery learning in non-stroke neurological emergencies.

Design/Methods:

We designed an AIS simulation course with three independent scenarios based on previously reported consensus. For each scenario a Minimum Passing Score (MPS) and Mastery Score (MS) was determined by the Angoff method. Thirteen junior neurology residents completed a 20-point knowledge test and 7-point Likert scale confidence survey about AIS before the course and after didactic teaching. A week later, each resident participated in a scored AIS case and then practiced stroke care in second unscored case. Residents again completed the knowledge and confidence assessments. Several weeks later, without notice, each resident was evaluated in a third AIS scenario.

For comparison, eight senior residents completed the knowledge test, confidence survey, and the third acute stroke case.

Pre-post and between groups comparisons were conducted using paired t-tests and independent t-tests, respectively.

Results:

Junior residents scored better on the knowledge test after the didactic session (mean score pre: 40% to post: 52.2%, p<0.05), but only 3 (23%) initially achieved the MPS score in the first AIS simulation. After the simulation course, 9 junior residents (69%) achieved the MPS threshold. Although none achieved Mastery, junior residents’ mean score in the simulation improved (10.3 (SD=2.8) vs 15.7 (SD=2.6), p<0.001) and their confidence increased (pre mean=3.3 (SD=1.9) vs. post mean =4.9 (SD=1.2), p< 0.001).

Eight seniors completed the simulation: five reached MPS (63%) and one achieved Mastery. The simulation scores of the post-course juniors and seniors were similar (mean=15.7 (SD=2.6) vs mean=16.0 (SD=2.5), p=0.793).

Conclusions:

This pilot study suggests that a brief AIS simulation course may improves junior residents’ performance and confidence to a level similar to senior residents, but not to mastery.