Evaluating the effects of simulation training on stroke thrombolysis: a systematic review and meta-analysis

Background: Strokes are medical emergencies, thrombolysis administration relies on well-organised pathways of care . Simulation training is often used as part of quality improvement strategies however results from studies on the impact of simulation on door-to-needle (DTN) times in stroke have yet to be synthesised.
Methods: Systematic review and meta-analysis. Primary outcome was thrombolysis DTN time in patients with ischaemic stroke.

Results: 11 studies were included in the meta-analysis and 19 in the qualitative synthesis (n=20,189 total patients). There were statistically significant effects of simulation training in reducing DTN time; mean difference of 15 min [95%CI 8-21]

Conclusion This meta-analysis showed that simulation training improves DTN times for the delivery of thrombolysis in ischaemic stroke (a high-level Kirkpatrick outcome) and provides further evidence for transformational simulation as part of quality improvement strategies.