Evaluation of EEG training curricula for non‐specialist clinicians: a systematic qualitative review

Abstract

Objective. Neurologists and epileptologists are scarce in sub-Saharan Africa (SSA). Whilst electroencephalograms (EEGs) are becoming more available in the region, interpretation is typically undertaken by non-specialist clinicians with limited or no training. This is a systematic review of the peer-reviewed literature on EEG training of non-specialist clinicians worldwide, assessing the efficacy of the training methodology and the curricula content. Methods. The published literature was searched for papers relating to EEG training of non-specialist clinicians worldwide (1/01/1989-30/06/2020). All regions of the world were included and assessed for content on efficacy of curricula and potential adaptability or applicability to resource-poor settings. The grey literature was searched using ProQuest and Primo databases and references from review articles. The websites of the International League Against Epilepsy, International Federation of Clinical Neurophysiologist, American Academy of Neurology and World Federation of Neurology were reviewed for reports (non-peer reviewed) which described roll-out and impact of novel EEG training curricula. Results. There was limited data. From 2,613 articles, 15 complied with the study question. Ten studies were performed on cross-speciality clinicians, four on neurology registrars and one on a combination of healthcare workers. There was diversity of curricula models used. The studies themselves lacked consistency and directness. A few training programs were trialled in low-middle-income countries (LMICs) and paediatric training was included in only two. An ideal training curriculum was not evident nor evaluated for resource-poor settings. However, diverse teaching models were reported and set the foundations for further development of EEG training curricula for non-specialist clinicians. Significance. There is a lack of access to education in EEG training and interpretation for non-specialist clinicians in LMICs. Existing models need to be expanded or adapted and evaluated for this population group.

The Value of Concurrent Electrocardiography When Performing an Electroencephalograph

“…The reason for this inaction is unclear and may pertain to a cognitive bias or lack of awareness, from the ordering practitioner, to analyse the report in sufficient detail. 15 It may also represent a lack of understanding of the current approach to the treatment of AF, in patients being investigated for altered consciousness, which was one of the principle reasons for ordering the EEG. 16 No long term follow up was available for these patients to determine if any adverse events resulted.…”

Neonatal Seizures in Low- and Middle-Income Countries: A Review of the Literature and Recommendations for the Management

“…More training needs to be provided to nonspecialist clinicians in order to improve access to safe and accurate EEG interpretation in LMIC. 49 Some learning initiatives have already been launched in LMIC to improve pediatric EEG training. For instance, the Global Organization of Health Education 50 offers face-to-face teaching and online teaching resources in sub-Saharan African countries, such as Ethiopia and Nigeria.…”

Clinical practice applicability and relevance to non-specialists of a paediatric EEG online learning tool

“…In 2021, a systematic review was performed on EEG tools for the non-specialist and found that whilst available, they are rarely critiqued for quality of impact [ 4 ]. The study found similarities with key concepts taught and that paediatric EEG training was not adequately addressed in some EEG training programs.…”