Introduction: Didactic lectures on acute stroke do not teach neurology residents nuances of the stroke code process. Successful execution of this process requires functioning in a high stress environment, interaction with a multidisciplinary team, and ability to enter the correct orders. Simulation technology is increasingly available for resident education, but underutilized in neurology.
Hypothesis: Medical education innovation with stroke code simulation can improve resident understanding of the stroke code process and achievement of learning goals in preparation for call.
Methods: Learning goals derived from the stroke code process were written into 4 clinical scenarios enacted by a standardized patient, nurse, CT technician, and stroke fellow at the institution’s simulation center (see Table 1). Junior neurology residents alternated leading or observing simulated stroke codes, followed by debriefing sessions to review learning goals. Achievement of learning goals was measured with a pre- and post- multiple-choice quiz. Residents submitted anonymous written feedback that the authors analyzed with thematic coding.
Results: Between July 2016 and July 2017, 22 junior adult and pediatric neurology residents completed stroke code simulation. Quiz grades improved from 67.5% to 78.3% after the simulation. Common feedback themes reference comfort with code logistics, imaging order entry, team member roles, benefit of realistic scenarios, and desire for more scenarios. The residents perceived simulation would relieve the stress of stroke call. The use of simulation was overall highly valued.
Conclusions: Medical education innovation with stroke code simulation targeting specific learning goals improves residents comprehension of the acute stroke code process and can prepare junior neurology residents for call.