Rationale: EEG interpretation is a fundamental skill for trainees, but teaching methods vary globally. In this study, we systematically reviewed EEG education practices for trainees globally focusing on baseline knowledge, teaching methodologies, and effectiveness of training.
Methods: We conducted a PRISMA protocol-based systematic review of English-language studies from PubMed using
keywords related to EEG, education, and medical trainees. Two independent reviewers evaluated the relevance of the articles, with a third reviewer acting as a tiebreaker when necessary. Data collection ended in June 2023. Studies were categorized as interventional, observational, or both. Interventional studies were defined as those which measured or surveyed trainees’ EEG-related knowledge after a prescribed educational intervention.
Results: Out of 423 articles meeting our search criteria, 27 were included. Among these, 70% were interventional studies, 26% were observational and 4% included both types. Majority (59%) of the participants were physician residents. The top fields represented among the interventional studies were neurology (37%) and anesthesiology (32%). All observational studies (100%) focused on adult neurology trainees. Most (74%) studies were based in the United States (US) and academic institutions (48%). The number of EEGs read during a typical rotation ranged from 26.8-28.1 (n=
2/27). The number of EEG weeks required for residency graduation ranged from 0-17 (n=5/27).
The focus of interventions was on abnormal findings (85%), technical aspects/basic electrophysiology (57%), EEG artifacts (76%), normal findings (67%), and normal variants (33%). No studies mentioned teaching neonatal EEG. Of the studies that employed a pre-test, most (70%) showed
improvement on post-test. Most individuals administering the interventions were neurophysiologists or epileptologists (94%). Majority (75%) of interventions included a live facilitated session, 40% included an e-learning module, and 20% included podcasts. Most didactics were interactive (85%). A minority (21%) of studies with interventions featured scrolling EEGs or EEGs with consecutive epochs rather than static images. Only in 1 study (5%), pre/post-test EEGs were
interactive. Post-test feedback was provided to participants in about a third of the studies (38%).
Conclusions: Our systematic review highlights the variability in EEG education methods among medical trainees. Gaps in current EEG education include limited standardization of EEG rotations, a lack of interactive pre- and post-test EEGs, and insufficient emphasis on neonatal EEG. Future research should prioritize developing interactive assessment tools and integrating comprehensive post-test feedback to enhance EEG learning.
Funding: None