Document Type: Original Article


1 1Department of Emergency and Disaster Medicine, Kagawa University Faculty of Medicine, Miki, Japan; 2Mitoyo General Hospital, Kanonji, Japan

2 Department of Medical Technology, Kagawa Prefectural University of Health Sciences, Takamatsu, Japan

3 Department of Emergency and Disaster Medicine, Kagawa University Faculty of Medicine, Miki, Japan

4 Department of Crisis Medicine, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan


Introduction: The present study aimed to determine the validity
and usefulness of scales and training programs for clinical staff to
evaluate nerve signs as an initial response to stroke. We developed
a stroke workshop, using the analysis, design, development,
implementation, and evaluation (ADDIE) model method based on
instructional systems design theory.
Methods: The workshop aimed to improve the basic first aid
skills of clinical staff for stroke. The participants (n=46) were
randomly assigned to conventional Cincinnati Pre-hospital Stroke
Scale (CPSS) or modified CPSS groups (simple randomization).
Short-term case simulation was conducted immediately after the
training as well as 6 months later to evaluate the nurses’ skills.
We conducted evaluations, using an instructional framework
throughout the ADDIE process. We used the Kirkpatrick model
to evaluate the educational effect of up to level 3 in this study.
The Wilcoxon signed-rank test was used to analyze differences
between the pre-test and post-test groups.
Results: The evaluation of the new clinical staff stroke emergency
training program, either using the conventional CPSS or the
modified CPSS, showed that the participants were highly satisfied
and exhibited improved knowledge and skills (conventional CPSS:
3.05±0.73 vs 3.64±0.59, P=0.012 and modified CPSS: 2.95±0.97 vs
3.61±0.49, P=0.111, before training vs after training, respectively).
On the other hand, it was difficult for the participants to evaluate
neurologic conditions using the modified CPSS compared with
the conventional CPSS.
Conclusion: These results demonstrated that stroke care training
is effective in reaction, learning, and behavior. The modified
CPSS could be useful as with the conventional CPSS. In future,
evaluation of neurological conditions should be improved.