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  • Title: Stroke training of prehospital providers: an example of simulation-enhanced blended learning and evaluation.
    Author: Gordon DL, Issenberg SB, Gordon MS, LaCombe D, McGaghie WC, Petrusa ER.
    Journal: Med Teach; 2005 Mar; 27(2):114-21. PubMed ID: 16019329.
    Abstract:
    Since appropriate treatment of patients in the first few hours of ischemic stroke may decrease the risk of long-term disability, prehospital providers should recognize, assess, manage and communicate about stroke patients in an effective and time-efficient manner. This requires the instruction and evaluation of a wide range of competencies including clinical skills, patient investigation and management and communication skills. The authors developed and assessed the effectiveness of a simulation-enhanced stroke course that incorporates several different learning strategies to evaluate competencies in the care of acute stroke patients. The one-day, interactive, emergency stroke course features a simulation-enhanced, blended-learning approach that includes didactic lectures, tabletop exercises, and focused-examination training and small-group sessions led by paramedic instructors as standardized patients portraying five key neurological syndromes. From January to October 2000, 345 learners were assessed using multiple-choice tests as were randomly selected group of 73 learners using skills' checklists during two pre- and two post-course simulated patient encounters. Among all learners there was a significant gain in knowledge (pre: 53.9%+/-13.9 and post: 85.4%+/-8.5; p<0.001), and for the 73 learners a significant improvement in their clinical and communication skills (p<0.0001 for all). By using a simulation-enhanced, blended-learning approach, pre-hospital paraprofessionals were successfully trained and evaluated in a wide range of competences that will lead to the more improved recognition and management of acute stroke patients.
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