Objective:

To determine if a longitudinal approach to EEG and EMG education with annual individual formative “check-ins” resulted in meaningful changes in quality and quantity of resident Milestone assessments.

Background:

By graduation, neurology residents are expected to achieve Level 4 ACGME Milestone proficiency at EEG and EMG interpretation. Surveys on EEG/EMG education in neurology residency reveal a wide range of exposure to these topics, approaches to assessment, and discrepancies between programs’ assessments of competence versus residents’ confidence in these skills.

Design/Methods:

Starting in 2020, residents in our program underwent annual individual “check-ins” with faculty to review a standard set of EEG and EMG studies. Anonymized semi-annual Milestone scores from 2014 to 2022 were reviewed, and scores were compared before and after initiation of the “check-ins.” Outcomes included the number of assessment points submitted (an indicator of how often these Milestones were recorded earlier in residency) and the proportion of graduating residents attaining the Level 4 Milestone.

Results:

Before the initiation of “check-ins,” there were missing Milestone scores for 17% (49/290) and 21% (60/290) of assessment points in EEG and EMG, respectively, mainly from PGY2 reports. Post-intervention, this significantly decreased to 1% (1/150, p<0.001) for EEG, but not for EMG (20% [30/150], p = 0.865). Pre-intervention, resident Milestone achievement of at least Level 4 by graduation was 63% (26/41) for EEG and 17% (7/41) for EMG; this increased to 81% (25/31) for EEG (p = 0.111), and 52% (16/31) for EMG (p = 0.002).

Conclusions:

A longitudinal curriculum with annual “check-ins” significantly improved ability to track EEG Milestone progress. The proportion of graduating residents achieving Milestone goals for EMG increased significantly, and there was a trend toward higher attainment levels for EEG. We propose that these “check-ins” provide residents and programs with more accurate individualized feedback to better target future learning and program improvement.