Novel Simulation Lab Exercises for Training Neurology Residents How To Manage Acute Stroke (P07.230)

Abstract

Objective: We aimed to develop simulation lab training exercises that improve our residents9 competency in managing acute stroke. Background Medical simulation has rarely been used in Neurology resident education. The simulation lab can potentially provide a better method of assessing residents9 clinical abilities and providing constructive feedback. Design/Methods: Between December of 2009 and September of 2011, stroke simulation exercises were developed and implemented to enhance the training of neurology residents. Role playing was done by a live professional patient and stroke-fellowship trained attendings. SimMan software (Laerdal Medical AS) was used to simulate and display alterations in vital signs. Two standardized scenarios were used: one with a typical patient with an ischemic stroke eligible for intravenous thrombolysis and another with a progressive cerebellar hemorrhage needing evacuation. Goals including the identification of stroke mimics, proper administration of the NIH Stroke Scale, correction of hypoglycemia, treatment of acute hypertension, discussion of the risks and benefits of thrombolysis, correction of coagulopathy, interpretation of head computed tomographic scans, prioritizing simultaneous outside telephone calls, and communication with nursing staff and other consultants were re-enforced. All sessions were videotaped. For each scenario, a checklist based on these goals was used to calculate the percentage of items done satisfactorily (score). A survey for residents to critique the exercises was used in debriefing sessions. Results: To date, 25 sessions have been completed and analyzed. The median, average, range and standard deviation for the scores on scenario 1 (ischemic stroke/thrombolysis were: 64%, 62%, 32-77%, and 12.5. The median, average, range and standard deviation for the scores on scenario 2 (cerebellar hemorrhage) were: 85%, 86%, 80-100%, and 6.7. Residents9 evaluation of the exercise was consistently very positive. Conclusions: Medical simulation appears to be a feasible and useful method for training neurology residents in the management of acute ischemic and hemorrhagic stroke. Disclosure: Dr. Lukovits has nothing to disclose. Dr. Goddeau has nothing to disclose.