Off-script diagnosis and differential diagnosis training to improve residents' stroke knowledge

Effectiveness of Off-script Diagnosis & Differential Diagnosis (D&D) Training in Improving Residents' Competence in Acute Ischemic Stroke Diagnosis and Treatment

This program tests whether off-script diagnosis and differential diagnosis (D&D) training helps neurology residents improve their knowledge of managing acute ischemic stroke.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 22 (estimated)
• Sex: All
• Sponsor: Peking Union Medical College Hospital (other)
• Locations: 1 site (Beijing, Beijing Municipality)
• Trial ID: NCT06941753 on ClinicalTrials.gov

What this trial studies

This is a single-center, randomized, open-label, endpoint-blinded educational trial enrolling 22 neurology residents at Peking Union Medical College Hospital. Participants are randomly assigned 1:1 to receive structured off-script D&D training or to a blank control group. Investigators will compare scores on the modified Acute Stroke Management Questionnaire (mASMaQ) 30 days after randomization to measure change in stroke management knowledge. The intervention focuses on practicing unscripted diagnostic reasoning and differential diagnosis in realistic clinical scenarios.

Who should consider this trial

Good fit: Ideal candidates are neurology residents working in neurology wards who currently manage acute ischemic stroke patients and can provide informed consent.

Not a fit: Residents who only manage asymptomatic ischemic stroke cases, who participated in another interventional ischemic stroke training program within the past three months, or who do not care for AIS patients are unlikely to benefit.

Why it matters

Potential benefit: If successful, the training could help residents make faster, more accurate stroke diagnoses and follow guideline-based management more consistently.

How similar studies have performed: Simulation-based and unscripted clinical reasoning trainings in other specialties have shown promising but variable improvements in diagnostic skills, while this specific off-script D&D approach for AIS is relatively novel.

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.

Where this trial is running

Beijing, Beijing Municipality

• Peking Union Medical College Hospital — Beijing, Beijing Municipality, China (RECRUITING)

Study contacts

• Principal investigator: Jun Ni, MD — Peking Union Medical College Hospital
• Study coordinator: Shengde Li, MD

Conditions: Stroke, Acute, Educational Problems, Clinical Course, resident, stroke education