Background: Simulation training for emergency response teams is frequently used in critical care disciplines but less commonly included in neurological education. Increasing evidence indicates that Code Stroke simulation training is associated with improved door-to-needle times and patient outcomes. However, why simulation is effective in this setting is unknown. Understanding how learning occurs may provide information to optimise Code Stroke simulation programs.
Aim: To explore how and why Code Stroke simulation supports effective learning
Methods: Debriefs of six simulation sessions from St Vincent’s Hospital, Melbourne were recorded and transcribed. Participants included stroke, radiology and Education and Learning Faculty teams. A simulated participant played the stroke patient. Data were analysed using reflexive thematic analysis. Topic summaries and themes were developed and then evaluated using a Situated Learning Theory Lens
Results: Six topics were identified: Communication, Knowledge and Education, Processes Efficiency and Logistics, Team Factors, Feedback, Self-Reflection. Several sub-topics could be mapped to the elements of Crisis Resource Management, but this did not explain all content. A central theme, “Development of identity as a stroke team member,” was constructed with three sub-themes: “Development of individual identity”, “Communication with senior clinicians”, and “Behaviour as a Team Member”. A key finding was participant use of reflective practice not only to acquire new knowledge or skills but also to develop clinician identity which was both influenced and supported by belonging to the stroke team. Considering the stroke team as a Community of Practice provides insight for debriefing multi-level learner simulations as each participant will be at a different peripherality within their team.
Conclusion: This is the first study investigating learning in Code Stroke simulation. These results provide insight, particularly for neurologists facilitating stroke simulation, for optimising scenarios and debriefing and ultimately translation to clinical outcomes. Further research is required to determine the most effective educational design.