Learning Objective #1: Describe the impact of technology, specifically the use of telemedicine, in educating medically underserved populations

Learning Objective #2: List several methods of providing stroke education to the medically underserved community

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Background and Purpose: Increasing community stroke awareness is important because therapies are time sensitive. Traditional community education is conducted using classroom style, face-to-face format but lack of stroke experts to provide this education remains a national problem. The Maryland Statewide Health Network connects medically underserved regions with specialists via telemedicine link. We hypothesized that use of telemedicine ™ for regional stroke education would be both feasible and have an equal impact on stroke learning as compared to traditional methods.

Methods: Three geographic regions were targeted including Baltimore City (control group), Western, and Eastern Shore regions of Maryland (intervention groups). A standardized 90-minute stroke lecture was presented simultaneously to all three sites and repeated. The control group received face-to-face education and the intervention groups received the education via live telemedicine link. Participants completed a five question pre-test prior to the educational session and a post-test at the end of the session. The speaker completed an evaluation after each session noting any technological issues. The difference between pre and posttest for control and intervention groups was analyzed using 2-sample ttest. We preset significance at the .05 level.

Results: The mean differences of the post minus pre test scores in the two groups was 1.56+1.39 for the intervention and 2.16 + 1.31 for the control group (p=0.12). Both groups also showed significant improvement in stroke knowledge (1.56 point improvement in the intervention group [p-value <.00005] and 2.16 point improvement in the control group [p-value <.00005]). The few technological issues identified were easily remedied and did not interfere with session conduct.

Conclusions: Use of TM for regional stroke education is feasible. The study suggests that stroke education via TM link may have a similar educational impact as traditional face-to-face modalities and can extend stroke specialist education to underserved areas.