Curriculum Innovation: Neurocritical Care EEG Rounds: A Model to Improve Neurology Resident EEG Interpretation

Continuous EEG (cEEG) has emerged as an important monitoring tool in the intensive care unit (ICU). Traditional EEG curricula for neurology residents mainly consist of didactic lectures, which often yield limited exposure to ICU EEG concepts and are insufficient to develop proficiency. The aim of this study was to develop a curriculum to enhance neurology resident ICU EEG education. The objectives included: (1) improving residents' ICU EEG knowledge by providing exposure to real ICU EEG cases and (2) facilitating discussion of EEG findings and monitoring plans within the multidisciplinary team.

We developed and implemented Neurocritical Care (NCC)-EEG rounds, a daily 30-minute virtual conference targeting neurology residents during their NCC rotation, to review cEEG studies of patients under NCC care. Residents' comfort and knowledge toward ICU EEG interpretation were assessed before and after 4-week NCC rotation using self-designed questionnaires. An acceptability survey was distributed to residents and the neurophysiology team at the conclusion of the study reporting period to gather feedback. The paired t test was used to analyze the pretest and posttest data.

Data from 20 residents showed significant improvement in subjective comfort (5-point Likert) with overall EEG interpretation (+0.6, [95% CI 0.22-0.98], p = 0.0040), identifying epileptic seizures (+0.45, [0.09-0.81], p = 0.0158), identifying artifacts (+0.45, [0.03-0.87], p = 0.0351), classifying EEG backgrounds (+0.45, [0.09-0.81], p = 0.0158), and mean total objective knowledge scores (6.00 ± 2.43 vs 4.65 ± 2.6, [mean ± SD, maximum score 10], p = 0.0226) after their NCC rotation. The acceptability survey (5-point Likert, mean ± SD) showed that both neurology residents (N = 7) and neurophysiology attendings/fellows (N = 6) found the model to be effective as a teaching (4.3 ± 0.7 and 4.3 ± 0.7, respectively) and communication (4.7 ± 0.5 and 4.5 ± 0.8, respectively) tool.

Our model of daily NCC-EEG rounds integrates case-based EEG review into neurology residents' daily clinical care. It is shown to be an effective strategy in improving neurology residents' ICU EEG education and strengthening interteam communication at our institution. Further work is needed to assess the model's long-term effectiveness and generalizability.