Improvement of Confidence and Knowledge Retention for Stroke Management Among Internal Medicine Trainees During an Institution-Specific, Protocol-Oriented Lecture Based Intervention

Abstract

BACKGROUND: Acute stroke management is an essential component of neurology residency education. Internal medicine trainees are less likely to receive dedicated training in acute stroke care despite having to care for hospitalized patients with a stroke diagnosis. OBJECTIVE: The objectives of this survey-based quality improvement study were to: 1) assess pre-existing confidence and knowledge about acute stroke care among internal medicine trainees and 2) measure change after an institution-specific, protocol-oriented “value added lecture” (intervention). METHODS: Pre-intervention survey and knowledge assessment was given to internal medicine physicians, residents, and students, followed by the intervention on acute stroke management, during academic year 2019-2020. Post-intervention assessment was administered immediately post-intervention, and again at end of rotation. A 10-point Likert scale was used to indicate confidence. Statistics were performed using Student’s T-Test. RESULTS: Fifty-one respondents participated, out of a possible 162 (31% participation rate); 13 (25%) of the 51 respondents completed the delayed post-intervention survey. Only twenty-six (51%) participants had previously received a lecture on acute stroke management. Respondents’ knowledge and confidence on acute stroke management improved after intervention (p<0.0001), with no change in these scores by end of rotation (p=0.31). Forty-five (88%) respondents agreed or strongly agreed that a targeted stroke didactic was a useful part of internal medicine training. CONCLUSIONS: An institution-specific, protocol-oriented lecture improved stroke management knowledge and confidence among internal medicine trainees, particularly among earlier trainees. A dedicated stroke management lecture should be considered as an addition to internal medicine training programs’ curricula.