Integration of Train-the-Trainer Model for Improving Stroke Care among Nurses and Caregivers: A Quasi-Experimental Study
(Received: 2025/11/24, Accepted: 2026/04/12)
Authors:
Anshika Bhatt; Sukhpal Kaur; Manju Dhandapani; N Banumathy; Dheeraj Khurana;
Keywords:
stroke, caregivers, nurses, train-the-trainer, patient education, training of trainers
Abstract:
<p><strong>Background: </strong>Competent nurses and well-prepared caregivers are essential for preventing stroke complications and supporting recovery. The Train-the-Trainer (TTT) model addresses challenges in ensuring consistent and scalable patient education in clinical settings.</p>
<p><strong>Objectives: </strong>To evaluate the effectiveness of a TTT program in improving stroke care knowledge and skills among nurses and caregivers.</p>
<p><strong>Methods:</strong> A sequential, multi-phase study was conducted from July to September 2023 in a tertiary care hospital. In Phase 1, 90 stroke unit nurses were enrolled using a pre-experimental design to assess baseline stroke care knowledge and skills. Their assigned patients and caregivers were non-randomly recruited as a historical control group (n = 31) and assessed similarly. In Phase 2, a master trainer delivered structured training to the nurses. These trained nurses educated their newly assigned patients and caregivers, enrolled as the experimental group (n = 31). Outcomes were measured using structured knowledge questionnaires and skill checklists.</p>
<p><strong>Results</strong>: Nurses showed significant improvement in post-training knowledge and skills (mean difference = 5.6; p < .05). Caregivers in the experimental group demonstrated significantly higher post-test scores in both knowledge and skills compared with historical controls (mean difference = 8.78; p < .05).</p>
<p><strong>Conclusion:</strong> The TTT model enhanced stroke care competencies among nurses and caregivers and offers a sustainable approach for improving education and clinical preparedness.</p>
<p><strong>Implications for nursing: </strong>The model strengthens nursing capacity, promotes sustainable skill transfer, improves caregiver readiness, standardized patient education, and can be integrated into routine training and discharge planning.</p>