Abstracts

Rationale: Nonconvulsive status epilepticus (NCSE) is a neurological emergency. Continuous EEG monitoring (cEEG) has emerged as the diagnostic modality of choice for this condition. Not all tertiary care centers have cEEG access after daytime hours and some have resorted to resident initiated EEG studies with reduced montages to aid in the detection of NCSE. Residents should therefore be knowledgeable in the ACNS critical care EEG terminology. However, it remains unknown if residents can become proficient in correctly utilizing its terms. This study aims to evaluate whether residents can acquire competency in this commonly used terminology as well as understand interrater agreements among participants.   Methods: After self-guided pre-reading and a brief 2-hour session reviewing and expanding upon the ACNS EEG terminology training slides, 16 adult neurology residents (PGY 2-4) from a Canadian institution were asked to complete the web-based ACNS certification test. This test has 37 EEG samples, each consisting of 11 questions; it has been previously described elsewhere. Residents were asked to report their comfort level using the terminology and performance scores were reported as average percent agreement (PA%) with a previously established 5-member expert panel. Data were analyzed using Microsoft Excel. Results: The overall pass rate (defined as >/=70%) for our cohort was 50% and the average score was 65.9%. The terms with the highest PA% were: seizures (90.2), main term 1 (79.1), main term 2 (78.4). Other terms with strong PA% were the +F (71.8), +R (78.9) and +S (72.8) modifiers. Figure 1 highlights the remaining terms and their PA%. The reported levels of comfort with the terminology ranged from uncomfortable (50%) and neutral (31.25%), while only 18.75% reported feeling comfortable with this terminology.  Conclusions: With minimal training, adult neurology residents at various stages in their training can learn and become proficient in the ACNS critical care EEG terminology, displaying special aptitude for identifying seizures from background rhythmic or periodic patterns. Their comfort levels however remain overall low suggesting ongoing reinforcement is needed throughout their training to improve their perception. Funding: None to declare.