Impact of an Interactive, Animation-based Electroencephalography (EEG) Curriculum on Learner Confidence and Knowledge
Andrew Silverman1, Sarah Hilgenberg2, Sa Shen3, Emily Spelbrink1, Jenna Klotz4
1Neurology, 2Pediatrics, 3Quantitative Sciences Unit, Stanford, 4Stanford Children'S Hospital-Child Neurology
Objective:

To create a novel electroencephalography (EEG) curriculum and evaluate pre- and post-curricular assessments of learner self-efficacy and knowledge regarding epilepsy/EEG interpretation.

Background:
There is a national need for innovative EEG education with efficacy evaluated by rigorous statistical analysis. We thus created a dynamic, expert-adjudicated online resource that includes a series of animated videos for learners at a single academic medical center. 
Design/Methods:
For the animations and interactive module, we used VideoScribe and Articulate©, respectively. The module comprised three chapters: (1) Origin & Technical Aspects of EEG, (2) Normal Adult EEG in Wakefulness & Sleep, (3) Abnormal EEG, with optional appendices on artifacts, variants, activation procedures, seizure/epilepsy classification, and neonatal/pediatric EEG. The curriculum and knowledge assessments were reviewed independently by two fellowship-trained, board-certified physicians before distribution to medical students and training programs. Linear mixed-effects models with bootstrapping were used to compare paired pre- and post-tests as well as Likert scale questionnaires.
Results:
Forty-nine learners participated in the pre-test survey (20 in neurology, 8 anesthesiology, 3 critical care, 1 psychiatry, 15 medical students, 2 other); 38 matched participants completed post-tests (78%). Learners across fields perceived benefit from the module (100% would recommend to colleagues), indicated improved self-efficacy (p<0.0001), and performed better on post-test knowledge assessments (54.1 vs. 88.2%, p<0.0001). In the neurology providers subgroup, pre-test scores correlated with years in training (Spearman’s r=0.52, p=0.039), neurology rotations (r=0.70, p=0.003), epilepsy/EEG rotations (r=0.6, p=0.014), and hours of EEG teaching (r=0.62, p=0.01); content knowledge and self-efficacy improvement for neurology providers remained significant in a multivariate model adjusting for these covariates.
Conclusions:
This animation-based, interactive EEG module proved effective in elevating learner confidence and knowledge across several medical specialties and training levels. Further study across institutions and subspecialties is needed to substantiate broad applicability, but our data appear promising for early EEG learners.
10.1212/WNL.0000000000205106