Effect of E-learning Training on National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) Assessment Performance: a Web-based Randomized Controlled Trial

The goal of this web-based randomized clinical trial is to evaluate whether an e-learning training program improves the accuracy of National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) assessments among practicing paramedics in French-speaking Switzerland who have not previously received formal training in these scales.

The main questions it aims to answer are:

• Does e-learning training improve performance on a standardized NIHSS assessment quiz compared with no prior training?
• Does e-learning training improve the accuracy of mRS assessment using case-based clinical vignettes compared with no prior training?

Researchers will compare paramedics who complete the NIHSS and mRS e-learning modules before assessment (intervention group) with paramedics who complete the assessments without prior training (control group) to determine whether e-learning training leads to higher assessment performance scores.

Participants will:

• Provide electronic informed consent via a secure web-based platform
• Be randomly assigned to either the intervention group or the control group
• Complete either the e-learning modules before assessment or the assessments before training, depending on group allocation
• Complete an online NIHSS quiz and mRS case-based vignettes
• Receive access to the NIHSS and mRS e-learning modules by the end of the study