One of the 12 patient care competencies of the ACGME Neurology Milestones involves identifying both normal and abnormal findings on electroencephalogram (EEG) and gaining competence in recognizing status epilepticus (SE), normal EEG variants, and other common abnormalities. Prior research suggests nearly half of neurology residents feel they cannot read EEGs even under supervision. However, little research has been done to prospectively examine how EEG interpretation skills evolve throughout residency, and whether electives or training tasks enhance these skills.

Neurology residents participated in an anonymous survey that tracks, in part, subjective confidence in EEG interpretation and subjective ratings on ability to interpret EEG findings. In addition, eight EEG clips from the ACNS critical care training modules were included in which residents selected whether a clip showed SE or electrographic seizure, an ictal interictal continuum pattern, or neither. Surveys were sent out twice per academic year.

To date, we have collected data at three unique points over two academic years with a total of 34 unique responses. The average score on the identification task was 60% with a standard deviation of 1.6. There was a significant difference (p<0.005) in accuracy on the ACNS clips between residents in their first two years of training (52% correct) and those in the latter two years (73% correct). Increased comfort with interpreting EEGs moderately correlated with each additional year of training (R²=0.58) but never averaged above the level of “neutral.”