Objective:

Our objective is to determine if the redesign of an EEG rotation as well as the separation from the clinical Epilepsy rotation improves resident confidence and performance.

Background:

Traditionally, EEG interpretation is learned by apprenticeship, with a resident/fellow reading in-person side by side with an epileptologist. Since the start of the COVID19 pandemic, various aspects of medical education have changed to on-line platforms. This created a barrier to traditional EEG learning and a decline in the EEG competency amongst the residents in our program.

Design/Methods:

The study was conducted at a single Neurology residency program at Cooper University Hospital. During EEG blocks, residents meet virtually with an epileptologist to interpret EEGs in real time. During separate Epilepsy blocks, residents diagnose, counsel and treat patients with epilepsy or epilepsy related conditions. A six question Linkert survey was designed to determine current perceptions of EEG training. A six item competency questionnaire was designed based on the EEG milestones by ACGME. The baseline survey and competency questionnaire were completed by 91% of the Neurology residency cohort at the conclusion of the 2024 academic year, prior to the implementation of those changes. A repeat survey and competency questionnaire will be re-administered. 

Results:

At baseline (n=11), 18% of residents felt strong in identifying generalized-tonic-clonic (GTC) seizure on EEG. At baseline, 50% residents correctly identified a GTC, 27% could identify the posterior dominant rhythm (PDR), and 50% identified lateralized periodic discharges (LPDs) on an epoch. Preliminary data shows that after our redesign of EEG and Epilepsy training, (n=6) 33% of residents feel strong in identifying a GTC seizure on EEG and that 100% of residents correctly identified a GTC, 91% identified the PDR and 83% identified LPDs on EEG. 

Conclusions:

Re-introduction of dedicated time for synchronous EEG interpretation, even if virtually, seems to  increase confidence and competency of EEG interpretation.