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Updated: Oct 19, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
World Stroke Organization mechanical thrombectomy workshops combined with the Global Stroke Alliance builds regional
Violiza Inoa1, Ryna Then2, Nicole M Cancelliere3
1Semmes-Murphey Clinic, University of Tennessee Health Science Center, Memphis, TN, United States.
Introduction:
Access to mechanical thrombectomy (MT) remains limited in many low- and middle-income or resource-limited regions because of gaps in trained personnel, procedural experience, public awareness, and stroke-system readiness. The World Stroke Organization paired simulation-based MT workshops with the Global Stroke Alliance to combine hands-on neurointerventional education with regional advocacy, Ministry of Health engagement, public awareness activities, and stakeholder collaboration. This study evaluated the feasibility, scalability, and self-reported educational impact of MT workshops delivered within this broader WSO/GSA capacity-building framework.
Methods:
A comprehensive 22-h curriculum was developed, incorporating didactic sessions, hands-on simulations, and complex case studies in collaboration with the Global Stroke Alliance between August 2023 and July 2025. The workshops were designed for neurointerventional physicians and tailored to regional needs. Pre- and post-course assessments measured physician confidence in MT procedures, while a three-month follow-up survey evaluated changes in MT volumes and clinical practice. Data were analyzed using summary statistics, chi-square tests, and McNemar's tests as appropriate.
Results:
Among 112 participating physicians from 24 countries, 81% completed the pre-test and 72% completed the post-test; 67% had paired pre- and post-test responses. The proportion of participants rating themselves as "very comfortable" increased from 15% pre-workshop to 41% post-workshop (p < 0.001), with notable improvements in patient selection for MT (15-48%, p < 0.001), procedural access knowledge (15-46%, p < 0.001), thrombectomy technique (9-41%, p < 0.001), and avoiding harmful maneuvers (7-33%, p < 0.001). At 3 months, 32 participants completed follow-up, of whom 37.5% self-reported an increase in overall thrombectomy numbers.
Conclusion:
Simulation-based MT workshops are feasible and scalable across multiple regions and were associated with improved self-reported procedural confidence and early self-reported changes in clinical practice. These findings support structured hands-on training as one component of broader capacity-building efforts, while highlighting the need for objective procedural volume, patient outcome, and registry-based data to determine the effect of such programs on MT access and stroke care delivery.
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