title: Stroke training of prehospital providers: an example of simulation-enhanced blended learning and evaluation.
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.
authors: University of Miami Center for Research in Medical Education, Florida 33101, USA.
authors: David Lee
authors: DL
authors: Gordon
authors: S Barry
authors: SB
authors: Issenberg
authors: Michael S
authors: MS
authors: Gordon
authors: David
authors: D
authors: LaCombe
authors: William C
authors: WC
authors: McGaghie
authors: Emil R
authors: ER
authors: Petrusa
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis* / Q000628:therapy; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians / Q000193:education* / Q000592:standards; D004638:Emergency Treatment / Q000379:methods* / Q000592:standards; D006801:Humans; D018794:Problem-Based Learning; D014481:United States