Effectiveness of Off-script Diagnosis & Differential Diagnosis (D&D) Training in Improving Residents' Competence in Acute Ischemic Stroke Diagnosis and Treatment
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 22
- 试验地点
- 1
- 主要终点
- mASMaQ
研究概览
简要总结
This study is a single-center, randomized, open-label, controlled, endpoint-blinded study to assess the effect of off-script diagnosis & differential diagnosis (D&D) training in improving the residents' knowledge of acute ischemic stroke in China. The investigators will enroll 22 residents and assess the score of mASMaQ 30 days after randomization.
详细描述
Ischemic stroke is characterized by high incidence and disability rates, with a critical time window for reperfusion therapy, necessitating prompt recognition, diagnosis, and treatment by frontline physicians. In clinical practice, residents across all specialties may encounter acute ischemic stroke (AIS) patients in emergency departments, outpatient clinics, or inpatient wards. However, many residents face challenges in managing AIS cases, often leading to missed diagnoses, treatment delays, and non-adherence to clinical guidelines. A primary contributing factor is their insufficient mastery of key AIS management principles and inability to effectively apply stroke knowledge in clinical contexts.
Enhancing residents' AIS management competence represents a significant challenge in stroke education. Traditional "Initial Progress Note" training overemphasizes comprehensive differential diagnoses, with most residents relying on scripted presentations. The actual clinical application of stroke knowledge remains uncertain. This study aims to evaluate whether off-script diagnosis & differential diagnosis (D&D) training (i.e., "Structured off-script D&D") can significantly improve residents' AIS management knowledge.
The investigators will enroll 22 neurology residents and randomly assign them to two groups: the off-script diagnosis & differential diagnosis (D&D) training group (n=11) and a blank control group (n=11). The modified Acute Stroke Management Questionnaire (mASMaQ) will be used to assess residents' AIS knowledge 30 days after randomization.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Outcomes Assessor)
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Residents (physicians in postgraduate training).
- •Currently in neurology wards
- •Managing acute ischemic stroke (AIS) patients, defined as: 1)Time from onset to randomization ≤ 2 weeks; 2) If onset time is unknown, the last known well time is considered the onset time.
- •Signed informed consent
排除标准
- •Managing asymptomatic ischemic stroke patients.
- •Residents who are currently participating or have participated in another interventional ischemic stroke training program within the past 3 months.
研究组 & 干预措施
Off-script D&D training group
Off-script D&D training is required within 72 hours after randomization.
干预措施: Off-script diagnosis & differential diagnosis (D&D) training (Other)
No-Intervention Control Group
Off-script D&D training is not required within 72 hours after randomization.
结局指标
主要结局
mASMaQ
时间窗: 30 days
Modified Acute Stroke Management Questionnaire (mASMaQ), with a range of 33-165 scores. Higher scores indicate superior acute ischemic stroke management knowledge. Blinded Assessment Protocol:1) Participant Requirements: Strict 10-minute time limit for independent completion; External references are prohibited; 2) Assessment Supervision: certified neurologists as proctors, who are blinded to group assignment throughout the trial. 3) Centralized Adjudication: based on participants' questionnaire responses. Note: Details of the modified ASMaQ has been on file with the ethics committee and cannot be changed. To prevent disclosure of the measures and bias in resident measurement, we do not disclose the scales until the trial is completed. Details of mASMaQ will be made public with the publication of the article.
次要结局
- Hyperacute stroke management(30 days)
- Advanced stroke management(30 days)
- General stroke knowledge(30 days)