Evaluating the long-term retention of a multidisciplinary electroencephalography instructional model

Clinical decision making and problem solving require a core of basic factual knowledge that must be accessed sometimes months or years after it has been learned. We examined whether 10 compared with 20 total electroencephalogram (EEG) interpretations impacted scores for long-term retention with the residents in the 20 total EEG group assessed with additional examinations.

Study participants interpreted 10 (10 EEG group) or 20 (20 EEG group) EEGs during a month rotation. Using a 25-item evaluation tool, participants were assessed before any EEG interpretations and were reassessed with another 25-item assessment tool after 10 EEG interpretations with the neurophysiologist. The 20 EEG group also received unique 25-item assessments after 15 and 20 EEG interpretations. Long-term retention was assessed with a 40-item evaluation tool targeted for administration 12 months after the curriculum. The assessments were unique for the specific time points studied (baseline, after 10 EEG interpretations, after 15 EEG interpretations, after 20 EEG interpretations, and long term); all participants completed the same assessment tool for each specific time point assessed during the study. The assessment tools evaluated knowledge of EEG monitoring, anesthetic effects, and clinical EEG interpretation.

Twenty anesthesiology residents completed the study with each group consisting of 10 residents. The mean scores represent the percentage of correct items, and for the 10 EEG group, the mean scores went from 42.8% ± 14.4% at baseline to 63.2% ± 8.0% (P < 0.001) after 10 EEG interpretations; however, there was no statistically significant difference noted from baseline to long-term retention 6.9% ± 9.0% (P = 0.78). Mean scores for the 20 EEG group improved from 34.4% ± 9.7% at baseline to 63.2% ± 6.2% (P < 0.001) after 10 EEGs and 62.3% ± 9.3% (P < 0.001) for long-term retention. Using a mixed model analysis, the only difference between the 10 and 20 EEG groups involved long-term retention with a total of 20 EEG interpretations compared with 10 (P = 0.006); there were no statistical differences between the groups at baseline (P = 0.065) or after 10 EEG interpretations (P = 1.00).

Long-term retention was significantly improved after 20 compared with 10 EEG interpretations as evaluated by the assessment tools. Potential reasons for better long-term retention may relate to the total number of EEG interpretations with 2 additional spaced interval opportunities and evaluations reinforcing learning.