To evaluate the effectiveness of a novel educational method in teaching neurology residents to identify interictal epileptiform discharges (IEDs).

Reading EEGs is a skill that every neurologist is expected to learn before completing residency. Nonetheless, it has been repeatedly shown that neurology trainees do not feel confident interpreting EEGs despite in-residency training. Given the paramount importance of accurately interpreting EEG in clinical care, improving EEG education at a trainee level is crucial.

This is a prospective randomized controlled educational trial investigating the effectiveness of a novel teaching method consisting of two pre-recorded video-based didactics and testing with instant feedback. All participants completed a pre-Spike Test with 500 EEGs with marked candidate IEDs and a survey before randomization to one of the three arms: control (no intervention), intervention#1, and intervention#2. The intervention arms consisted of two pre-recorded lectures and a “Spike Test” with instant feedback: hosted on our MGH server (intervention#1) or an iOS app - DiagnosUs (intervention#2). All participants completed a post-Spike Test and perception survey at the end of the study. Answers to marked IEDs were determined by expert consensus.

Twenty-one residents (19 adult neurology and 2 pediatric neurology, at MGH or Yale; all but one were PGY1-2s) completed the entire program: controls (n=8), intervention#1 (n=6), and intervention#2 (n=7). The average completion time was 40 days. All but two (intervention#2) participants had no prior EEG experience. Intervention#1 and intervention#2 pre- and post-intervention Spike Test mean scores±SEM were 67±2% and 76±2% (p=0.03) and 72±2% and 77±1% (p=0.06), respectively. Control pre- and post-intervention Spike Test scores were 67±3% and 67±4% (p=0.88).

A series of two short pre-recorded video-based lectures in addition to practicing with instant feedback seem to be an effective method to teach adult and pediatric neurology trainees with none to minimal prior EEG experience how to identify IEDs.