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Abstract Details

Medical Simulation without a High-Fidelity Setting as a Non-Inferior, Practical Modality for Acute Stroke Education of Junior Neurology Residents
Research Methodology, Education, and History
Research Methodology and Education Posters (7:00 AM-5:00 PM)
012

Medical simulation has been shown to be an effective modality of teaching hyperacute stroke management. With limited resources during the COVID-19 pandemic, we aim to assess whether carrying out medical simulation outside our standard, high-fidelity simulation would confer a comparable educational benefit.
To evaluate the effectiveness of acute code stroke workshop without a high-fidelity setting as an alternative mode of medical simulation during the COVID-19 pandemic.
First-year neurology residents at our center individually participated in a 3-hr course, consisting of pre-sim didactic, individual breakout simulation, and de-brief. During individual breakouts, a standard stroke patient case was presented and the learner proceeded with a simulated code stroke using an actor as a patient.  Vital signs, labs, and imaging data were provided by the moderator. Personal protective equipment was used, and only the learner and stroke actor physically interacted. Social distancing was otherwise maintained. Participants completed tests to evaluate stroke competency and Likert-scale surveys pre/post-simulation. Unpaired t-test was used for comparison of pre vs. post-sim results. Results were compared to those from prior years (2018, 2019) that used an established high-fidelity stroke simulation.

Residents performed significantly better on post-sim tests than pre-sim (11.29 ± 3.04 vs. 14.43 ± 1.51, p=0.03, n=7), with changes in scores similar to those observed with high-fidelity simulation in 2018 and 2019.  After completion of the workshop, all 7 participants agreed or strongly agreed that they would feel confident being the first neurologist on stroke code.

A code stroke workshop without standard high-fidelity simulation and using adequate safety precautions is effective in improving first-year neurology residents’ code stroke competency and comfort in managing hyperacute stroke, and is not inferior to an established high-fidelity simulation program. This is important when resources are not available during the COVID-19 pandemic, and added safety precautions are needed.
Authors/Disclosures
Philip Y. Sun, MD
PRESENTER 		Dr. Sun has nothing to disclose.
Peggy Nguyen, MD Dr. Nguyen has nothing to disclose.
Gene Y. Sung, MD, MPH (U.S.C. Neurology) The institution of Dr. Sung has received research support from NIH.
Amy Towfighi, MD Dr. Towfighi has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Law firms. The institution of Dr. Towfighi has received research support from NINDS.
Nerses Sanossian, MD, FAAN (Department of Neurology, USC) Dr. Sanossian has received personal compensation for serving as an employee of Univeristy of Southern California. Dr. Sanossian has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Sanossian has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Sanossian has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Portola. The institution of Dr. Sanossian has received research support from Diffusion Pharma.
Roy A. Poblete, MD (Keck Medicine of The University of Southern California) No disclosure on file