Prepare first-year neurology residents to lead stroke alerts (SA) through high-fidelity simulation using crisis-resource management (CRM) principles, a framework developed to help organize safe and effective care during emergencies.

Residents at a comprehensive stroke center are tasked with leading SAs as early as their first day. We sought to better prepare them by creating a team-based simulation applying CRM principles including leadership designation, role clarity, communication, resource mobilization and workload distribution, while improving confidence and fostering professionalism.

We created a scenario in which a standardized patient (SP) presented to the emergency department (ED) with an acute ischemic stroke and large vessel occlusion, within the thrombolytic and mechanical thrombectomy windows. Roles included resident, family, and EMS with participation of a vascular fellow, ED nurse and pharmacist. Residents were provided pre-learning materials and completed NIHSS and mRS certification. They completed pre- and post-assessments evaluating knowledge with Likert scale questions gauging comfort navigating various aspects of the SA. Gather-Analyze-Summarize (GAS) methodology was utilized to debrief learners alongside other participating team members. The simulation was completed by PGY-2 residents during a neurologic emergencies boot camp. Paired T-test was conducted on pre/post-test scores for residents participating in the simulation over two years (n=25).