To describe the impact of using live, neurology-trained standardized patients (SPs) in a case-based simulation curriculum for clerkship students.

Simulation in neurology is limited by the inadequacy of manikins to portray neurologic exam findings. We designed a simulation curriculum using live, neurology-trained resident SPs residents for clerkship students to (1) practice taking a neurologic history, (2) perform a neurologic exam, and (3) recognize and triage neurological emergencies.

Two scenarios were developed: (1) evaluation of dizziness and management of acute stroke and (2) treatment of new-onset seizure. Monthly sessions involved 4-5 students. Residents SPs mimicked expected exam findings. Pre- and post-session surveys evaluated students’ self-rated knowledge, clinical skills, and confidence in gathering a history, performing a neurological exam, presenting a case, and recognizing, working up, and managing strokes and seizures. Students also rated the overall session quality and provided feedback about the experience. Paired t-tests were performed for quantitative items.

54 students participated. Post-session, students reported significantly higher self-confidence in all neurological knowledge domains and clinical skills (p<0.003 for all). Over 90% of students agreed sessions met the learning objectives, the course was valuable, and the simulation was a safe learning environment and would improve their clinical performance. 94% would recommend the session to others. Over 80% agreed the simulation was realistic, well-organized, and an effective way to practice teamwork and clinical skills. In open responses, students reported they appreciated evaluating neurologic emergencies, performing the exam with a trained SP, and making treatment decisions. Students wanted more cases and time; they suggested smaller groups.

A simulation curriculum with neurology residents portraying the patient increased students’ knowledge, clinical skills, and self-confidence in recognizing and managing acute neurological emergencies. Resident SPs were cited as the most effective educational component. Future research should evaluate the sustainability of benefits gained and assess clinical skills objectively.