Abstract
Introduction
On graduation medical students need to be equipped to recognise and manage acute stroke and TIA (Transient Ischemic Attack). Despite inclusion of acute stroke and TIA in our local curriculum less than 10% of students (2/30) reported directly observing stroke thrombolysis during their placement. Due to COVID restrictions no student had been able to attend TIA clinic. To improve students practical understanding of the assessment and management of acute stroke and TIA a simulation-based teaching session was designed.
Method
The simulation session consisted of a hyperacute stroke assessment and management simulation (2 scenarios) and a simulated TIA clinic (3 scenarios). Students were asked to complete a pre-course and post-course questionnaire regarding their confidence in 8 domains, on a continuous scale 0 to 5.
Results
There were 23 participants over 2 sessions. 18/23 completed the pre-course questionnaire and 16/23 the post-course questionnaire. The mean confidence reported by students increased in all domains: recognition of acute stroke from 3.3 to 4.8; identifying candidates for thrombolysis from 3.1 to 4.6; discussing thrombolysis with a patient or carer from 2.3 to 4.1; knowing when to call for senior support from 3.1 to 4.3; asking for a patient to be transferred to facilitate acute stroke care from 2.2 to 4.2; recognising a TIA from 2.8 to 4.9; requesting investigations for TIA from 2.5 to 4.6; and discussing anticoagulation with a patient from 2.9 to 4.4.
Conclusion
Improvements in the confidence of medical students in assessing and managing acute stroke (including thrombolysis) and TIA can be achieved through a stroke medicine themed simulation session.