Building confident cohesive stroke response teams: Design, implementation and outcomes of a stroke code simulation...

Area of Science:

• Medical Education
• Neurology
• Healthcare Systems

Background:

• Traditional didactic training methods are common for hyperacute stroke care in low- and middle-income countries (LMICs).
• There is a need for innovative training to improve interprofessional teamwork, communication, and clinical decision-making in stroke management.

Purpose of the Study:

• To develop and evaluate a high-fidelity simulation-based interprofessional stroke code training course in Pakistan.
• To assess the impact of this training on healthcare professionals' skills and confidence in managing hyperacute stroke.

Main Methods:

• A quasi-experimental mixed-methods study was conducted with 25 participants across 5 stroke centers in Pakistan.
• Training involved a high-fidelity simulation course focusing on interprofessional collaboration and stroke management protocols.

Main Results:

• Significant improvements were observed in self-efficacy for most stroke management tasks, including communication, triage, ASPECT/NIHSS calculation, and r-tPA eligibility assessment (p < 0.001).
• Questionnaire results showed 25%-40% improvement in cognitive, affective, and psychomotor learning objectives.
• Qualitative analysis identified challenges such as lack of standardized pathways and workflow inefficiencies, highlighting the need for structured training and improved coordination.

Conclusions:

• High-fidelity simulation-based training effectively enhances stroke code management skills among healthcare professionals in LMICs.
• Implementing structured, team-based simulation programs can improve acute stroke care, patient outcomes, and workflow efficiency.