Abstracts

Rationale: The structure and success of EEG education vary significantly between adult neurology residencies. As a result, graduating neurology residents do not uniformly meet national EEG competency milestones set by the Accreditation Council for Graduate Medical Education (ACGME). Following recent efforts to reform our residency EEG curriculum, we aimed to understand residents’ confidence in meeting ACGME EEG milestones and identify resources and barriers in resident EEG education.

Methods: The EEG curriculum for adult neurology residents (postgraduate years [PGY] 2-4) at The Mount Sinai Hospital is summarized in Figure 1. After the curriculum reform, residents gained protected time for reading EEGs and writing reports while on dedicated epilepsy monitoring unit (EMU) service blocks, as well as biweekly didactics to review instructive and interesting EEGs. We surveyed residents (all were exposed to the new didactic sessions, some were exposed to the new EMU service) to assess engagement in EEG reading and report writing, confidence regarding ACGME EEG competencies, resources used to learn EEG, and barriers to EEG education. We compared responses from EMU residents (those exposed to the new EMU service) to non-EMU residents (those who were not); statistical analysis was limited to descriptive statistics given the small sample size.

Results: Thirteen residents responded to the survey (6 PGY2, 2 PGY3, 5 PGY4; 43% response rate), 10 of whom were exposed to the new EMU service. EMU residents reported a greater number of EEGs read and reports written compared to non-EMU residents (Figure 2). A greater percentage of EMU residents (vs. non-EMU residents) felt at least moderately confident recognizing normal EEG patterns/artifact (40% vs. 33%), recognizing status epilepticus and common abnormalities (50% vs. 33%), and writing reports (33% vs. 0%). While most residents valued formal curricular components (annual didactic series, 77%; biweekly EEG didactics, 62%; EMU service time, 54%), many residents reported using external resources (online EEG lectures, 77%; EEG textbooks, 62%; educational content from national societies, 31%). Reported barriers to EEG education included lack of time for self-directed learning (85%), insufficient opportunities to read EEGs (46%), and discomfort using EEG workstations (31%). Residents reported wanting more EEG didactics (54%), exposure to surgical epilepsy cases (54%), EMU service time (46%), and flipped-classroom format learning (38%).

Conclusions: Residents who had more protected time for EEG education reported greater engagement with EEG reading and report writing, as well as increased confidence in meeting national competency milestones. Most residents desired greater protected time to develop their EEG reading abilities using a combination of formal and informal teaching resources. Our findings are valuable to guide curriculum improvements in service of improving resident EEG education.

Funding: None