Training doctors in basic EEG: analysis of a learning tool relevant to resource‐limited settings

Abstract

Aim. Clinicians trained to interpret EEG in Africa are scarce. The region is challenged by inadequate access to healthcare professionals and a significant burden of disease, with the result that trained neurophysiologists and epileptologists may not be viewed as an immediate priority. However, approaches, specific to the African context, could be adopted to enable safe practice of basic EEG interpretation. Educational guidelines for the interpretation of paediatric studies, relevant to the region, are lacking. As a result, a handbook targeting this training need was developed and a pilot study undertaken to assess the efficacy of this tool to improve EEGreporting skills for clinicians at a basic level. Methods. Eleven health practitioners, who manage children with epilepsy, from various African countries, were recruited. The group analysed selected EEGs before and after reading a training manual (the handbook). A survey was conducted on how useful the participants found the handbook.Results. There was a trend (p<0.06) supporting improvement in the ability to analyse EEGs following reading of the handbook. The doctors who had one-on-one tutoring, in addition to access to the handbook, did significantly better in most EEG-reporting variables (p<0.01). Conclusions. The handbook was found to be a viable tool to promote EEG interpretation in the African setting, where foundation skills are needed. However, optimal outcomes were evident with additional individual tutoring, as well as on-going support to maintain skills. This curriculum will be adapted into a post-graduate qualification intended to generate clinicians with key basic EEG skills, but not fully trained electrophysiologists. Currently, in the African setting, for maximum impact on patient care, this approach is considered the most likely to have the furthest reach.

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

“…Many online courses [18, 28, 31, 41] are yet to be critiqued. Collaboration is essential to fill the gap by working together in educating the African continent and other LMICs in safe EEG practice [42].…”

“…Only one study was undertaken solely with paediatric residents who originated from LMICs [18]. Of the 15 studies, only two studies were performed in LMICs whilst the remaining 13 were in HICs [11,18]. Of the four studies which critiqued neurology practitioners' skills, three were performed in HICs and one on clinicians from LMICs [11,[31][32][33].…”

Processed Electroencephalogram-Based Monitoring to Guide Sedation in Critically Ill Adult Patients: Recommendations from an International Expert Panel-Based Consensus

“…In this area, experiments have already been reported, concerning, on the one hand, doctors in general (including, but not exclusively, emergency doctors, intensivists, and anesthesiologists) [ 87 ], and on the other hand, anesthesiology residents. One of the most interesting aspects of this last investigation is that the investigators have really managed to score the provided training [ 88 ]. This quantitative aspect appears to be a key point.…”

“…Literature is divided regarding the balance between support and continuing education and regular recertification [ 35 ]. It is also not clear which authority should be responsible for certification: the academic, regional, or even national level or professional or scientific society [ 86 – 88 ]. The quality of the practice of using any technology to improve patient care and outcomes must be guaranteed.…”

Electroencephalographic Findings, Antiepileptic Drugs and Risk Factors of 433 Individuals Referred to a Tertiary Care Hospital in Ethiopia

“…Epilepsy diagnosis is clinical, but EEG helps to establish the diagnosis, classify seizure types, and prognosticate the patient ( 2 , 3 , 6 – 11 ). One of the challenges of epilepsy care in resource limited areas is limited access to EEG especially in sub Saharan Africa (SSA) there is a lack of access to EEG service ( 6 , 7 ). Furthermore, in SSA access to a quality EEG service is very limited; due to limited trained EEG technicians and neurologists ( 6 , 7 ).…”