Hypercoagulable states in young adults with ischemic stroke in a Stroke Belt state: a retrospective study.

We theorize that the southeastern United States has a higher stroke mortality rate and higher recurrent ischemic stroke rate than the rest of the United States due to (1) an increased prevalence of hypercoagulable states among young adults in the region, (2) failure to diagnose hypercoagulable states as the cause of ischemic stroke in young adults, and (3) underutilization of anticoagulation for ischemic stroke secondary prevention in young adults with hypercoagulable states. In an attempt to investigate this hypothesis, we conducted a retrospective chart review of 311 inpatients with first-ever ischemic stroke from age 18 to 55 years at an Oklahoma academic medical center from 1 July 2011 to 30 April 2017. Using Chi-squared test, we compared the stroke etiologic diagnosis of the attending neurologist at discharge-when hypercoagulable profile results were rarely available-to the diagnosis of a vascular neurologist postdischarge who had access to all available etiologic test results.

Decrease of thyroid function after ischemic stroke is related to stroke severity.

Background: Thyroid hormones are of fundamental importance for brain function. While low triiodothyronine levels during acute ischemic stroke (AIS) are associated with worse clinical outcomes, dynamics of thyroid function after AIS remains unknown. Thus, we longitudinally evaluated thyroid hormones after stroke and related them to stroke severity.

Criteria for Emergency Brain MRI During Stroke-Alert.

Objectives: Intravenous (IV) tissue plasminogen activator (tPA) should be given to patients with acute ischemic stroke (AIS) and avoided in stroke mimics (SM). Select use of emergency brain magnetic resonance imaging (eMRI-brain) in stroke-alerts aids diagnosis, but accepted utilization criteria for eMRI-brain do not currently exist. We developed criteria for eMRI-brain and report the yield of eMRI-brain in stroke-alert patients.

Skill improvement during emergency response to terrorism training.

Objectives: To assess the individual and team skills acquired from an interactive training program to prepare emergency personnel to respond to terrorist acts.

Methods: We developed a 16-hour, two-day, multimedia- and simulation-enhanced course that places learners in realistic situations using the equipment required to respond to various chemical, biologic, radiologic, and explosive acts of terrorism. Small-group sessions and drills were conducted.

Development, implementation and outcomes of a training program for responders to acts of terrorism.

Introduction: Responding to acts of terrorism requires the effective use of public-safety and medical-response resources. The knowledge, skills and attitudes necessary to respond to future threats is unfamiliar to most emergency responders.

Objectives: The purpose of this report to describe the development, implementation and evaluation of a multidisciplinary, interactive and simulation-enhanced course to prepare responders to acts of terrorism.

A multicenter study to provide evidence of construct validity in a computer-based outcome measure of neurology clinical skills.

Background: Using computer-based simulation to assess clinical skill-a key competence for medical trainees-enables standardization and exposure to a broad sample of physical findings. The purpose of this study is to provide evidence of construct validity for a computer-based outcome measure of neurology clinical skills.

Method: A total of 128 medical students and neurology residents at four institutions volunteered to take a 34-question computer-based test designed to measure neurology clinical skills.

Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review.

Review Date: 1969 to 2003, 34 years.

Background And Context: Simulations are now in widespread use in medical education and medical personnel evaluation. Outcomes research on the use and effectiveness of simulation technology in medical education is scattered, inconsistent and varies widely in methodological rigor and substantive focus.

Stroke training of prehospital providers: an example of simulation-enhanced blended learning and evaluation.

Since appropriate treatment of patients in the first few hours of ischemic stroke may decrease the risk of long-term disability, prehospital providers should recognize, assess, manage and communicate about stroke patients in an effective and time-efficient manner. This requires the instruction and evaluation of a wide range of competencies including clinical skills, patient investigation and management and communication skills. The authors developed and assessed the effectiveness of a simulation-enhanced stroke course that incorporates several different learning strategies to evaluate competencies in the care of acute stroke patients.

Development of a reliable multimedia, computer-based measure of clinical skills in bedside neurology.

Purpose: This study reports the development of reliable multimedia, computer-based measures of bedside neurology skills.

Method: A consortium of neurologists and medical educators (1) identified bedside skills and (2) created a computer-based test. Test-item stems were multimedia clips of standardized patients.

Effectiveness of a cardiology review course for internal medicine residents using simulation technology and deliberate practice.

Background: Objective evaluations of residents' clinical skills reveal serious deficits.

Purpose: To develop, implement, and evaluate outcomes from a review course in cardiology bedside skills for internal medicine residents.

Methods: We used a 1-group pretest-posttest design with historical comparisons.

Simulation and new learning technologies.

Changes in medical practice that limit patient availability and instructors' time have resulted in poor physical diagnosis skills by learners at all levels. Advanced simulation technology, including the use of sophisticated multimedia computer systems, helps to address this problem. For many years 'Harvey', the Cardiology Patient Simulator, and the UMedic Multimedia Computer system have proven to be effective tools to teach and assess bedside cardiovascular skills when they are integrated into the required curriculum of medical school and postgraduate training.