Effect of E-learning Training on National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) Assessment

Effect of E-learning Training on National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) Assessment Performance: a Web-based Randomized Controlled Trial

The goal of this web-based randomized clinical trial is to evaluate whether an e-learning training program improves the accuracy of National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) assessments among practicing paramedics in French-speaking Switzerland who have not previously received formal training in these scales.

The main questions it aims to answer are:

• Does e-learning training improve performance on a standardized NIHSS assessment quiz compared with no prior training?
• Does e-learning training improve the accuracy of mRS assessment using case-based clinical vignettes compared with no prior training?

Researchers will compare paramedics who complete the NIHSS and mRS e-learning modules before assessment (intervention group) with paramedics who complete the assessments without prior training (control group) to determine whether e-learning training leads to higher assessment performance scores.

Participants will:

• Provide electronic informed consent via a secure web-based platform
• Be randomly assigned to either the intervention group or the control group
• Complete either the e-learning modules before assessment or the assessments before training, depending on group allocation
• Complete an online NIHSS quiz and mRS case-based vignettes
• Receive access to the NIHSS and mRS e-learning modules by the end of the study

Study Overview

• Status: Not yet recruiting
• Conditions: Education; Distance Learning-Online Learning; Clinical Competence; National Institutes of Health Stroke Scale; Modified Rankin Scale; Stroke Assessment
• Intervention / Treatment: Other: Educational intervention

• Study Type: Interventional
• Enrollment (Estimated): 120
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Loric Stuby; Phone Number: +41228001212; Email: l.stuby@gt-ambulances.ch
• Study Contact Backup: Name: Laurent Suppan; Email: laurent.suppan@hug.ch

Study Locations

• Switzerland
  • Canton of Geneva
    • Geneva, Canton of Geneva, Switzerland, 1201
      • Genève TEAM Ambulances
      • Contact: Loric Stuby; Phone Number: +41228001212; Email: l.stuby@gt-ambulances.ch

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Holding a paramedic title (recognized in Switzerland)
• Currently actively practicing in Switzerland
• Fluent in French (all study material will be provided in French)

Exclusion Criteria:

• Previously completed formal training on either the NIHSS or the mRS.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control group; Control group: Participants will first complete the NIHSS quiz and mRS case vignettes without prior training.
Experimental: Intervention group; Participants will follow the e-learning modules (NIHSS and mRS).	Other: Educational intervention; Educational intervention by the mean of an e-learning modules (NIHSS and mRS).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Performance on a NIHSS 50-item quiz	The primary outcome will be the performance on a NIHSS 50-item quiz consisting in 3 full assessments of a patient (3x15 items) plus 5 general questions (each question scores 1 point if correct, maximum total of 50 points).	From enrollment to the end of the study path in a timeframe of maximum 4 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Performance of mRS assessment	The secondary outcome will be the performance of mRS assessment of about 10 newly developed case-based vignettes (each question scores 1 point if correct, maximum total of 10 points).	From enrollment to the end of the study path in a timeframe of maximum 4 weeks.

Collaborators and Investigators

• Sponsor: Stuby Loric
• Collaborators: University Hospital, Geneva; Geneve TEAM Ambulances
• Investigators: Principal Investigator: Loric Stuby, Genève TEAM Ambulances

Study record dates

Study Major Dates

• Study Start (Estimated): April 1, 2026
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): July 1, 2026

Study Registration Dates

• First Submitted: December 23, 2025
• First Submitted That Met QC Criteria: December 23, 2025
• First Posted (Estimated): January 6, 2026

Study Record Updates

• Last Update Posted (Actual): January 7, 2026
• Last Update Submitted That Met QC Criteria: January 5, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Randomized controlled trial; Emergency Medical Services; Educational intervention; Paramedics; Prehospital care; E-learning; Distance education; Web-based training; Modified Rankin Scale (mRS); Clinical competence; Stroke assessment; National Institutes of Health Stroke Scale (NIHSS); Performance assessment; Continuing professional education
• Additional Relevant MeSH Terms: Health Services; Health Care Facilities Workforce and Services; Child Health Services; Community Health Services; Preventive Health Services; Early Intervention, Educational
• Other Study ID Numbers: NIHSS-6

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Study data will be made available by deposition in a public repository (Yareta.org).

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No