Original Publication
Open Access

Stroke Code Simulation for Medical Education

Published: January 19, 2015 | 10.15766/mep_2374-8265.10009

Included in this publication:

  • Stroke Code Scenario Template.docx
  • Stroke Code Checklist.docx
  • Stroke Code Handout.docx
  • Head CT.jpg
  • Head CT Angiogram.jpg

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


This stroke code simulation was developed as an educational tool for neurology junior residents, emergency department residents, medical students, nurses, and any medical learners involved in stroke management. The goal is to offer hands-on practice in running a stroke code effectively and efficiently as leaders of a team, ensuring appropriate critical medical decision-making and patient care. Duration of the simulation is 20 minutes, with a minimum of 20 minutes dedicated to a debriefing. Standardized patients are utilized for role playing to enable presentation of neurologic deficits and use of the National Institute of Health Stroke Scale. Residents ideally participate in these simulations in groups of two or three, giving one person the opportunity to be the team leader running the stroke code and others to take the roles of team members. In addition, emergency medicine residents and intensive care unit nurses are included to act as confederates in the simulations and participate in the debrief. Debriefing sessions are held immediately after each simulation with intent of formative feedback using the "good judgment" and "advocacy inquiry" method. Pre- and postsimulation learner surveys help assess effectiveness and provide critical feedback for future considerations. Out of 13 participating neurology residents during our implementation, all agreed that these simulation sessions met the stated clinical objectives. All residents also agreed that the overall quality and utility of debriefing sessions were good. Approximately 84% agreed that the simulation experience was more useful than reading a chapter or attending a lecture about the clinical scenario. After completing the sessions, all surveyed residents agreed that they will be able to better facilitate future acute stroke care as compared to before the training.

Educational Objectives

After completing this simulation, learners will be able to:

  1. Demonstrate the ability to lead a stroke code.
  2. Demonstrate efficiency in delivery of acute stroke care.
  3. Distinguish stroke from stroke mimics based on clinical features.
  4. Perform a neurologic exam using the National Institute of Health Stroke Scale in less than 5 minutes.
  5. Gather relevant information (historical, clinical, laboratory, imaging) in order to make a treatment determination.
  6. Assess indications and contraindications of thrombolytic administration.
  7. Identify the appropriate clinical context for interventional procedures.
  8. Consent a patient/family for acute stroke intervention.
  9. Formulate a plan for disposition and further management.

Author Information

  • Muna Irfan, MD: University of Minnesota Medical School
  • Nauman Tariq, MD: University of Minnesota Medical School
  • Haitham Hussein, MD: HealthPartners
  • Lisa Fitzgerald-Swenson, RN, BSN, PHN: Hennepin County Medical Center
  • Danielle Hart, MD: Hennepin County Medical Center
  • Ezgi Tiryaki, MD: University of Minnesota Medical School

None to report.

None to report.

Prior Presentations
Poster presented at: Annual Meeting of American Academy of Neurology; 2014.


Irfan M, Tariq N, Hussein H, Fitzgerald-Swenson L, Hart D, Tiryaki E. Stroke code simulation for medical education. MedEdPORTAL. 2015;11:10009. https://doi.org/10.15766/mep_2374-8265.10009