Abstracts

Rationale:
The current COVID-19 pandemic disrupts EEG and epilepsy training of future neurologists because of low patient volumes and decreased in-person interactions between individuals on the care team. Like other institutions, all elective epilepsy monitoring unit (EMU) admissions were cancelled for 8 weeks [1]. Because of social distancing, the Stanford EMU service was forced to rapidly adopt a virtual platform with distance learning. In response to new educational gaps created by SARS-CoV2, a module was created to teach residents an “Approach to Analyzing Video-EEG (vEEG) Events” for added practical EEG reading instruction and build skills for self-study.
Method:
A 2-hour module was created to teach a systematic method to analyzing events (ie spikes, questionable waveforms, artifacts, seizures, psychogenic non-epileptic events) on vEEG.  The activity included practical steps on how to access the EEG virtually and locate the records of interest.  An Epilepsy Fellow or Attending (WC, SL) taught and demonstrated the approach through 5 interactive EEG records including the patient videos and raw EEG data.  Residents were encouraged to pursue further self-study by accessing a list of real previously recorded and annotated EEGs.  Annotations can be turned on and off and interpretations of EEG are accessible in the electronic health record.  A post-module feedback survey based on a 1-5 Likert scale was administered with a score of 5 being excellent.   
Results:
To date, seven residents participated in the module with 6 surveys returned. In general, confidence level among trainees of evaluating events of interests on vEEG was moderate at 3. Residents felt that the module helped fund of knowledge and they would recommend it to other residents (4.83). Residents felt the module increased confidence in practical vEEG reading skills (4.5). The session objectives were clear (4.5), overall rating of the module was (4.5), questions were appropriate for PGY level (4.83). One trainee commented that “I liked the structure. Despite doing the required EMU rotation before, I never really had a clear strategy for reviewing the events.” Feedback from trainees suggested that the module can be improved to include “more cases” and introductory definitions can be calibrated based on the level of the learner.
Conclusion:
Virtual learning resources need to be developed to ensure trainee preparedness for future practice.  This module can be curated by an Epilepsy Fellow or Attending or used as a self-directed learning activity.  The learning activity equips trainees with a systematic method to analyze vEEG events of interest and creates a foundation for EEG self-study.  The module is being used as a required part of the EEG virtual rotation, and perhaps indefinitely. References:  [1] Sethi NK, EEG during the COVID-19 pandemic: What remains the same and what is different. Clin Neurophysiol. 2020 Jul; 131(7):1462. 
Funding:
:None