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Active, Not Recruiting

NCT Number: NCT06941753

Off-script Diagnosis & Differential Diagnosis (D&D) Training and Residents' Stroke Knowledge

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.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Stroke, Acute Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Clinical Course Disease Attributes Disease Progression Educational Problems Nervous System Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Stroke Vascular Diseases

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Peking Union Medical College Hospital

Beijing, Beijing Municipality, 100730, China

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Residents (physicians in postgraduate training).
  • Currently in neurology wards
  • 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.
  • Signed informed consent

Exclusion criteria

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

Treatment and study plan

Off-script diagnosis & differential diagnosis (D&D) training

Other
  • Training Timeline: Must be completed within 72 hours post-randomization; Requires standardized structured off-script D&D analysis.
  • Structured Analysis Framework: 1)Epidemiology: Incidence, mortality, and disability rates; 2) Etiologic Classification: TOAST classification system; 3) Vascular Mechanisms: Culprit vessel, vascular territory, pathophysiology; 4) Differential Diagnosis: Stroke mimics and stroke subtype differentiation; 5) Acute Management: Hyperacute interventions (thrombolysis/EVT), secondary prevention strategies, and evidence-based case analysis; 6) Patient Education: Stroke prevention education for patients/public; 7) Research Gaps: Current limitations and future directions.
  • Presentation Requirements: 1)Mandatory off-script delivery (no prepared text); 2) Time limit: 15+3 minutes for complete analysis.

Primary outcomes

  1. mASMaQ

    Time frame: 30 days

    Modified Acute Stroke Management Questionnaire (mASMaQ), with a range of 33-165 scores. Higher scores indicate superior acute ischemic stroke management knowledge.

    Blinded Assessment Protocol:1) Participant Requirements: Strict 10-minute time limit for independent completion; External references are prohibited; 2) Assessment Supervision: certified neurologists as proctors, who are blinded to group assignment throughout the trial. 3) Centralized Adjudication: based on participants' questionnaire responses.

    Note: Details of the modified ASMaQ has been on file with the ethics committee and cannot be changed. To prevent disclosure of the measures and bias in resident measurement, we do not disclose the scales until the trial is completed. Details of mASMaQ will be made public with the publication of the article.

Secondary outcomes

  1. General stroke knowledge

    Time frame: 30 days

    Part of mASMaQ, with a range of 10-50. Higher scores indicate superior general stroke knowledge.

  2. Hyperacute stroke management

    Time frame: 30 days

    Part of mASMaQ, with a range of 9-45. Higher scores indicate superior hyperacute stroke management knowledge.

  3. Advanced stroke management

    Time frame: 30 days

    Part of mASMaQ, with a range of 14-70. Higher scores indicate superior advanced stroke management knowledge.

Sponsors and collaborators

Lead sponsor

Peking Union Medical College Hospital

Other

Registry information

Official study title

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

Acronym: CAST-AIS

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Apr 24, 2025
Registry last updated
Jul 14, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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