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Updated: Nov 15, 2025

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Realistic simulation is associated with healthcare professionals' increased self-perception of confidence in
Suzete Nascimento Farias DA Guarda1,2,3, João Pedro Souza Santos4, Mariana Sampaio Motta Reis4
1Rede D'Or São Luiz, Hospital São Rafael, Unidade de Cuidado Intensivo, Salvador BA, Brazil.
Background:
Simulations are becoming widely used in medical education, but there is little evidence of their effectiveness on neurocritical care. Because acute stroke is a neurological emergency demanding prompt attention, it is a promising candidate for simulation training.
Objective:
To assess the impact of a stroke realistic simulation course on clinicians' self-perception of confidence in the management of acute stroke.
Methods:
We conducted a controlled, before-after study. For our intervention, 17 healthcare professionals participated in a stroke realistic simulation course. As controls, participants were chosen from a convenience sample of attendees to the courses Emergency Neurologic Life Support (ENLS) (18 participants) and Neurosonology (20 participants). All participants responded pre- and post-test questionnaires evaluating their self-perception of confidence in acute stroke care, ranging from 10 to 50 points. We evaluated the variation between pre- and post-test results to assess the change on trainees' self-perception of confidence in the management of acute stroke. Multivariate analysis was performed to control for potential confounders.
Results:
Forty-six (83.63%) subjects completed both questionnaires. The post-test scores were higher than those from the pretests in the stroke realistic simulation course group [pretest median (interquartile range - IQR): 41.5 (36.7-46.5) and post-test median (IQR): 47 (44.7-48); p=0.033], but not in the neurosonology [pretest median (IQR): 46 (44-47) and post-test median (IQR): 46 (44-47); p=0.739] or the ENLS [pretest median (IQR): 46.5 (39-48.2), post-test median (IQR): 47 (40.2-49); p=0.317] groups. Results were maintained after adjustment for covariates.
Conclusions:
This stroke realistic simulation course was associated with an improvement on trainees' self-perception of confidence in providing acute stroke care.

