Clinical trial NCT06941753: Off-script Diagnosis & Differential Diagnosis (D&D) Training and Residents' Stroke Knowledge
Official title: Effectiveness of Off-script Diagnosis & Differential Diagnosis (D&D) Training in Improving Residents' Competence in Acute Ischemic Stroke Diagnosis and Treatment
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Stroke, Acute
Educational Problems
Clinical Course
Keywords: resident
stroke education
Lead sponsor: Peking Union Medical College Hospital
Sponsor class: OTHER
First posted: 2025-04-24
Enrollment: 22
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: 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.

Detailed description: 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.

Eligibility criteria: Inclusion Criteria:

1. Residents (physicians in postgraduate training).
2. Currently in neurology wards
3. 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.
4. Signed informed consent

Exclusion Criteria:

1. Managing asymptomatic ischemic stroke patients.
2. Residents who are currently participating or have participated in another interventional ischemic stroke training program within the past 3 months.

Primary outcomes:
measure: mASMaQ
timeFrame: 30 days
Secondary outcomes:
measure: General stroke knowledge
timeFrame: 30 days
measure: Hyperacute stroke management
timeFrame: 30 days
measure: Advanced stroke management
timeFrame: 30 days
Other outcomes:
Locations:
city: Beijing
country: China
facility: Peking Union Medical College Hospital
state: Beijing
Study officials:
affiliation: Peking Union Medical College Hospital
name: Jun Ni, MD
role: PRINCIPAL_INVESTIGATOR
References: