Abstract WP259: Simulation Based Medical Education in Interprofessional Education Acute Stroke Management Model


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Abstract

Introduction: Simulation-based medical education (SBME) is an established tool for training and certifying providers for critical situations such as ACLS. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is a program developed by the Agency for Healthcare Research and Quality and the Department of Defense to improve teamwork. Previous work has demonstrated the effectiveness of SBME in stroke team performance among neurology residents and ICU nurses. Our aim was to develop an SBME interprofessional education (IPE) program for nursing and medical students on stroke team performance.Method: Using a quantitative descriptive one group pretest/posttest design, acute stroke care (14 items), TeamSTEPPS knowledge (14 items) and attitudes toward IPE (16 items) were assessed. After the initial survey, students were given modules on acute stroke care and TeamSTEPPS. Students were randomly assigned into small mixed groups before participating in 2 high-fidelity simulations: an IV tPA-eligible ischemic stroke and a warfarin-associated ICH requiring INR reversal. During each case, trained faculty assessed students using a standardized checklist focusing on stroke management and teamwork. Faculty underwent inter-rater reliability and recalibration training prior to participation. A standardized debriefing was conducted immediately after each case. A 1-hour reinforced learning session was provided by physician and nursing experts in stroke and TeamSTEPPS between cases.Result: 65 nursing and 26 medical students participated. Improvement was seen in the cognitive assessment (p<0.0001 for composite score) and each affective item (p<0.0001) after SBME. Psychomotor scores improved (p<0.01) in most items on the team performance checklist and improved for 5 items on the stroke task checklist.Conclusion: SBME is feasible and effective for supporting IPE in team-based stroke training among nursing and medical students. Although impact on real-world metrics such as door-to-needle time and protocol deviation remains uncertain, SBME using TeamSTEPPS principles should be incorporated within stroke education curricula. Moreover, a stroke code certification process similar to ACLS should be contemplated.

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