Between 2017-18, a total of 24 internal medicine residents from a community hospital participated in acute stroke simulation before starting stroke calls.

Two different case scenarios using standardized patients were used –acute ischemic stroke within 3 hours and acute ischemic stroke within 24 hours.

The simulation was video & audio taped. Historic controls consisting of PGY2 residents without simulation were used. Pre & post simulation survey, SP comments and debriefing was done for each scenario.

Residents reported 100 % satisfaction with quality of demonstrations and hands-on learning experience.

The accuracy and timing of decision making - IV thrombolytic, No Thrombolytic and catheter based reperfusion was significantly better than historic controls and pre and post simulation competency. Median Door to needle time post simulation improved by 100%.

Significant improvement also seen in patient interaction, utilization of NIHSS score in decision making, indications and contraindications to thrombolytic, utilization of resources including CT & CTA, and MRI of brain, door to needle time and consulting Neurointerventionlist.

Simulation training using SPs is a superior teaching method in the management of acute stroke . Residents felt that this way of learning was superior to classroom didactics. It may be a useful teaching tool for smaller hospitals where patient volume is very low, in addition to being utilized as an annual competency test.