好色先生

好色先生

Explore the latest content from across our publications

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Confidence in a Crisis: Results After Implementation of a Stroke Alert Simulation for First-Year Neurology Residents
好色先生, Research, and Methodology
S28 - Novel Approaches to Teaching, Assessment, and Beyond in Neurology 好色先生 (3:42 PM-3:54 PM)
002

Residents at a comprehensive stroke center are tasked with leading SAs as early as their first day. We sought to better prepare them by creating a team-based simulation applying CRM principles including leadership designation, role clarity, communication, resource mobilization and workload distribution, while improving confidence and fostering professionalism.

Prepare first-year neurology residents to lead stroke alerts (SA) through high-fidelity simulation using crisis-resource management (CRM) principles, a framework developed to help organize safe and effective care during emergencies.


We created a scenario in which a standardized patient (SP) presented to the emergency department (ED) with an acute ischemic stroke and large vessel occlusion, within the thrombolytic and mechanical thrombectomy windows. Roles included resident, family, and EMS with participation of a vascular fellow, ED nurse and pharmacist. Residents were provided pre-learning materials and completed NIHSS and mRS certification. They completed pre- and post-assessments evaluating knowledge with Likert scale questions gauging comfort navigating various aspects of the SA. Gather-Analyze-Summarize (GAS) methodology was utilized to debrief learners alongside other participating team members. The simulation was completed by PGY-2 residents during a neurologic emergencies boot camp. Paired T-test was conducted on pre/post-test scores for residents participating in the simulation over two years (n=25).

Combined data indicate increased confidence running SA after simulation (M=3.68, SD=.95) when compared to prior, t(24)=4.11, p=0.0004. Other measures including comfort with team dynamics, communicating with patients/family and performing NIHSS demonstrated statistically significant increases post simulation. Post-testing results did not demonstrate an increase in knowledge of NIHSS or intervention exclusion criteria.
High-fidelity SA simulation implementing CRM is feasible and enhances resident comfort as leaders of a multidisciplinary team. Further investigation is needed to determine if integration of this simulation into resident education improves other functional outcomes such as door-to-needle time.
Authors/Disclosures
Natalia A. Crenesse-Cozien, MD
PRESENTER
Dr. Crenesse-Cozien has nothing to disclose.
Mai Kau Yang, MD (University of Miami) Dr. Yang has nothing to disclose.
Ilya Shekhter (UM-JMH Center for Patient Safety) Ilya Shekhter has nothing to disclose.
Jason H. Margolesky, MD, FAAN (University of Miami School of Medicine) The institution of Dr. Margolesky has received research support from Parkinson Foundation .
Erika T. Marulanda, MD, FAAN (University of Miami) Dr. Marulanda has nothing to disclose.
Nina M. Massad, MD (University of Miami) Dr. Massad has nothing to disclose.