An interventional study of Off-script diagnosis & differential diagnosis (D&D) training in Stroke, Acute, Educational Problems and Clinical Course, sponsored by Peking Union Medical College Hospital. Completed at 1 site in China. Per ClinicalTrials.gov, last updated 2026-08-12.
Sponsored by Peking Union Medical College Hospital · Not applicable, Interventional, and Other
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.
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.
7,287 studies on the registry are indexed under Stroke; 2,006 are open to participants now.
This study's enrollment of 22 is below the median of 50 across 5,370 interventional studies indexed under Stroke.
Browse Stroke studies →Peking Union Medical College Hospital is the lead sponsor of 1,115 studies on the registry; 463 are open to participants now.
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Exclusion Criteria:
Off-script D\&D training is required within 72 hours after randomization.
Other: Off-script diagnosis & differential diagnosis (D&D) training
Off-script D\&D training is not required within 72 hours after randomization.
1. Training Timeline: Must be completed within 72 hours post-randomization; Requires standardized structured off-script D\&D analysis. 2. 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. 3. Presentation Requirements: 1)Mandatory off-script delivery (no prepared text); 2) Time limit: 15+3 minutes for complete analysis.
mASMaQ
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.
Time frame: 30 days
General stroke knowledge
Part of mASMaQ, with a range of 10-50. Higher scores indicate superior general stroke knowledge.
Time frame: 30 days
Hyperacute stroke management
Part of mASMaQ, with a range of 9-45. Higher scores indicate superior hyperacute stroke management knowledge.
Time frame: 30 days
Advanced stroke management
Part of mASMaQ, with a range of 14-70. Higher scores indicate superior advanced stroke management knowledge.
Time frame: 30 days
Plan to share: No
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This study is completed, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.
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Peking Union Medical College Hospital