Abstract:

Objective　To evaluate the effectiveness of Case-Based Learning (CBL) combined with Simulation-based Case Training (SCT) in enhancing the quality of acute stroke teaching for neurology residents, focusing on its overall impact on image interpretation skills, clinical decision-making abilities, time efficiency, and theoretical knowledge.Methods　A retrospective cohort study design was adopted, including 135 residents who received acute ischemic stroke training at the Department of Neurology, First Affiliated Hospital of Zhengzhou University, from January 2022 to December 2024. Based on the introduction of the hybrid teaching model on January 15, 2023, participants were divided into two groups: the unexposed group (CBL, n=65), who received traditional CBL teaching, and the exposed group (CBL+SCT, n=70), who participated in CBL+SCT teaching, including simulated image interpretation, thrombolysis/thrombectomy decision-making systems, and green channel process simulations. All participants received the same acute ischemic stroke theoretical course before the teaching intervention. Changes in image interpretation accuracy, clinical decision-making accuracy, image interpretation time, process formulation time, and theoretical exam scores were compared between the two groups post-intervention. All teaching data were recorded by an automated teaching management system.Results　There were no significant differences in demographic data and baseline ability indicators between the two groups prior to the intervention (P>0.05). Post-intervention, the exposed group outperformed the unexposed group in all core skill dimensions. In image interpretation, the exposed group showed significantly higher ASPECTS interpretation accuracy (82.9%), large vessel occlusion recognition accuracy (84.3%), and "hemorrhage vs. infarction" differentiation accuracy (88.6%) compared to the unexposed group (P<0.001). In clinical decision-making, the exposed group had significantly higher accuracy in thrombolysis indications, thrombolysis contraindications, and thrombectomy indications (all P<0.001). In terms of time efficiency, the exposed group had significantly reduced image interpretation time (82.07±4.63) s and process formulation time (48.91±5.34) s compared to the unexposed group (P<0.001). In theoretical exam scores, the exposed group scored significantly higher (90.63±2.15) points compared to the unexposed group (87.62±3.16) points (P<0.001).Conclusion　The combination of CBL and SCT can significantly improve residents' ability in imaging interpretation, clinical decision-making, and workflow management in acute stroke, and is an efficient teaching model superior to traditional methods.