Introduction: Stroke is the second leading cause of death worldwide (7.3 million/year). Early detection and effective management are critical for survival and neurological recovery. Comprehensive stroke education for healthcare providers in prehospital and hospital settings can lead to improved outcomes. Advanced Stroke Life Support (ASLS®) is a simulation-based interprofessional course consisting of interactive instruction, including standardized patient-based cases where learners diagnose strokes and develop a management plan for the patients. This study evaluated the course’s effect on participants’ knowledge of stroke diagnosis and management, translation to patient care, and clinical outcomes. Methods: We conducted an observational, mixed-methods study of participants completing the 11th ASLS version (2015–2022) at U.S. and international sites. All learners received the same educational intervention. A total of 40,434 prehospital and hospital providers participated. Outcomes were evaluated using the Kirkpatric model: Level 1 (Reactions), Level 2 (Learning), Level 3 (Application), and Level 4 (Impact). Knowledge was measured by validated 25-item pre-and post-course assessments. We used a comprehensive questionnaire to determine translation to clinical practice (Level 3) and its impact on outcomes (Level 4). Results: ASLS course completion improved outcomes at all evaluation levels. Paired-samples t-tests showed significant knowledge gains (pretest mean 64.66, SD 13.17; posttest mean 89.51, SD 7.55; p < .001) (Image 1). Of 21,945 eligible survey recipients emailed 750 responded. Most (96%) reported applying ASLS skills in clinical practice. On a 5-point scale, 64% said participation improved stroke care and outcomes “a lot” or “a great deal.” Hospital-based respondents estimated a 76.14% reduction in door-to-needle time (Images 2&3). Conclusions: This large study demonstrates that a structured, simulation-based stroke curriculum significantly enhances providers’ knowledge, skills, and application in patient care. Over eight years, data from 40,434 learners across 31 U.S. states and eight countries confirmed the ASLS course’s impact on stroke diagnosis, management, and outcomes. Participants consistently reported using acquired skills and perceiving substantial improvements in patient care. Future work includes a multicenter analysis of tangible and intangible outcomes, including cost-benefit evaluation of ASLS implementation for stroke training.
Motola et al. (2026) studied this question.