Abstract Details

Title An online competency-based examination of routine EEG interpretation accurately differentiates novices and experienced EEG readers

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S30 - Epilepsy/Clinical Neurophysiology (EEG): Technology (4:30 PM-4:42 PM)

Poster/Presentation
Number 006

Background

We recently published common curricular objectives for teaching and assessing rEEG interpretation. Here, we used this curriculum framework to develop and evaluate a multiple-choice examination for adult and child neurology trainees.

Objective

To develop an assessment tool for evaluation of competence in routine electroencephalography (rEEG) interpretation.

Design/Methods

An online, anonymous rEEG examination was developed. A previously published curriculum map was used to design 30 single-best-answer multiple choice questions covering four EEG domains: normal, abnormal, normal variants, and artifacts. Each question contained an EEG image displayed in two montages (bipolar and average). Questions were pre-reviewed, modified, and correct answers adjudicated by EEG experts (FAN/RF/SR/WT/SB). Respondents reported their level of confidence (LOC, 5-point scale) with answering questions in each domain. Accuracy and item discrimination were calculated for each question, and LOC for each domain. The test was disseminated by the ILAE and shared on social media.

Results

Of 2,076 responses, 922 were complete. Respondents comprised medical students, neurology residents, EEG/epilepsy fellows, neurology and non-neurology attending physicians, neurophysiologists/epileptologists (experts), technologists, and others. Mean accuracy [95%CI] was 74.4% [73.4-74.4]. Accuracy and LOC correlated with level of experience: experts had highest mean accuracy and LOC; neurology residents performed significantly lower than experts (p=0.002) and fellows (p<0.001), and were significantly less confident than experts and fellows in all 4 domains (all p<0.001). Accuracy was similar for fellows and experts, fellows had lower overall LOC. Among neurology residents, accuracy and LOC correlated with the number of prior weeks of EEG rotation. Accuracy increased progressively from 64% (0 prior EEG weeks) to 75% (>12 prior weeks). All but 3 questions had discrimination index of >0.25.

Conclusions

This competency-based rEEG examination maps to a published EEG curriculum, stratified performance by level of prior training, and had excellent overall psychometrics. This examination could support competency-based assessment of EEG interpretation.

Authors/Disclosures
Fabio Nascimento, MD (Washington University Medical School) PRESENTER	Dr. Nascimento has received publishing royalties from a publication relating to health care. Dr. Nascimento has a non-compensated relationship as a Editorial Team Member with Neurology RFS that is relevant to AAN interests or activities. Dr. Nascimento has a non-compensated relationship as a Production Team with Neurology Podcast that is relevant to AAN interests or activities.
Hong Gao	No disclosure on file
Roohi Katyal, MD (Louisiana State University Health Sciences Center)	Dr. Katyal has nothing to disclose.
Rebecca E. Matthews, MD (Emory University)	Dr. Matthews has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurelis. Dr. Matthews has received personal compensation in the range of $10,000-$49,999 for serving as a Speaker with Penry Epilepsy Programs.
Stefan Rampp (University Hospital Erlangen, Department of Neurosurgery)	No disclosure on file
William O. Tatum IV, DO, FAAN (Mayo Clinic)	Dr. Tatum has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bioserenity. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Natus. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Defense Law Firm on behalf of a patient with epilepsy with funds donated to the Epilepsy Foundation of America. The institution of Dr. Tatum has received research support from Esai. The institution of Dr. Tatum has received research support from Mayo Clinic. The institution of Dr. Tatum has received research support from Liva Nova. The institution of Dr. Tatum has received research support from Engage Pharmaceuticals. The institution of Dr. Tatum has received research support from Xenon. Dr. Tatum has received intellectual property interests from a discovery or technology relating to health care. Dr. Tatum has received publishing royalties from a publication relating to health care. Dr. Tatum has received publishing royalties from a publication relating to health care. Dr. Tatum has received publishing royalties from a publication relating to health care. Dr. Tatum has a non-compensated relationship as a AAN Section Chair of Clinical Neurophysiology with AAN that is relevant to AAN interests or activities.
Roy E. Strowd III, MD, FAAN (Wake Forest School Of Medicine)	Dr. Strowd has received personal compensation for serving as an employee of Kaplan. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical, Inc. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. Dr. Strowd has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology. The institution of Dr. Strowd has received research support from Southeastern Brain Tumor Foundation. The institution of Dr. Strowd has received research support from Jazz Pharmaceuticals. The institution of Dr. Strowd has received research support from National Institutes of Health. The institution of Dr. Strowd has received research support from Alpha Omega Alpha. The institution of Dr. Strowd has received research support from American Board of Psychiatry and Neurology. Dr. Strowd has received publishing royalties from a publication relating to health care. Dr. Strowd has received publishing royalties from a publication relating to health care.
Sandor Beniczky, MD, PhD (Aarhus University & Danish Epilepsy Center)	Prof. Beniczky has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eisai. Prof. Beniczky has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB. Prof. Beniczky has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lundbeck. Prof. Beniczky has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for GW. The institution of Prof. Beniczky has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ILAE.