Neurologists Get Expert Training with Simulations | Loyola Medicine
Friday, February 13, 2015

New neurologists receive expert training using mannequins and other simulation techniques

MAYWOOD, Ill. (Feb. 13, 2015) –  One of the most challenging cases that a first-year neurology resident physician can face is a stroke patient in the emergency department. 

The physician must quickly decide whether the patient is a candidate for the clot-busting drug tPA, which can minimize stroke damage. But giving tPA to the wrong patient can make the stroke worse. There’s no time to waste, because in one minute, a stroke can kill nearly 2 million brain cells.

A new study indicates that using a high fidelity patient simulator and other simulation-based education techniques can significantly improve the knowledge, skills and confidence of first-year neurology residents.

The study, conducted by neurologists at Loyola University Medical Center, was presented at the American Heart Association’s International Stroke Conference 2015 in Nashville, Tenn.

Simulation-based medical education (SBME) enables students, residents, nurses and other medical personnel to practice under safe, controlled and forgiving conditions. Previous studies have found that SBME is superior to the traditional style of medical education and has shown improved outcomes of knowledge, skills and behaviors.

The Loyola study evaluated SBME for teaching neurology residents how to treat stroke patients. Six incoming neurology residents participated in a simulation of a stroke patient arriving in the emergency department. The resident physician managed every step of care, including assessing the mannequin-patient, paging other members of the stroke team, ordering and interpreting lab tests and CT scans, etc. The simulations were performed during the first and third weeks of the residents’ orientation.

The physicians’ skills improved significantly from the first to the third week. Surveys given to the residents showed their confidence also improved. The new physicians also showed a 16.1 percent improvement on a multiple-choice test about treating stroke patients in the emergency department. 

The authors concluded that simulation-based medical education can help new physicians acquire technical and non-technical skills such as leadership, teamwork, communication, situational awareness and decision making.

The study is titled “Simulation-Based Medical Education for Incoming Neurology Trainees to Improve Hospital Stroke Emergency Performance.”

Authors of the study are Rick Gill, MD, (first author); Esteban Golombievski, MD; Michael Star, MD; Matthew McCoyd, MD; and Sean Ruland, DO (senior author). Drs. Gill and Star are neurology residents; Dr. Golombievski is a vascular neurology fellow;  Dr. McCoyd is an assistant professor; and Dr. Ruland is an associate professor in the Department of Neurology of Loyola University Chicago Stritch School of Medicine.

The national goal for stroke treatment in the emergency department is to administer tPA intravenously, when appropriate, to an ischemic stroke patient within 60 minutes of the patient’s arrival at the emergency department door. (This is known as door-to-needle time). Loyola strives for a 45-minute door-to-needle time.

For six years in a row, Loyola has received the Get with the Guidelines® Stroke Gold-Plus Quality Achievement Award from the American Heart Association/American Stroke Association.

Loyola also received the association’s Target: Stroke Honor Roll for meeting stroke quality measures that reduce the time between hospital arrival and treatment with tPA.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 92 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 129,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.