Education Research: Development of a Workplace-Based Assessment to Enhance EEG Interpretation Skills for Medical...

Electroencephalography (EEG) interpretation is a core competency in neurology residency training, yet structured EEG education for interested medical students remains limited. Workplace-based assessments (WBAs) offer structured, formative feedback within authentic clinical settings and may address gaps in EEG education. We developed a novel EEG-specific WBA for use during a 2-week medical student "Epilepsy and EEG" elective to facilitate direct observation, structured feedback, and formative assessment of students. This prospective study evaluated the feasibility and perceived educational value of the tool, examined changes in faculty-reported medical student assistance over time, and characterized EEG features reviewed during WBA encounters.

We conducted a prospective study during a 2-week Epilepsy and EEG elective at a single academic medical center (October 2024-February 2026). Students were asked to complete 4 EEG WBAs. Using a two-step model, students documented the verbal feedback and EEG features reviewed using a structured checklist before faculty completed a brief assessment using a 5-point entrustment scale. Faculty and students completed anonymous postintervention surveys assessing feasibility and educational value. Entrustment ratings were compared between Week 1 and Week 2 using the Fisher exact test.

A total of 20 medical students completed 79 EEG WBAs with 6 faculty members. The proportion of WBAs rated as requiring high levels of assistance ("I helped a lot") decreased significantly from Week 1 to Week 2 of the elective (48.7% vs 21.1%, relative risk: 0.57, 95% CI 0.37-0.87, p = 0.017, Fisher exact test). Commonly reviewed EEG features included myogenic artifact (74.7%), eye blink artifact (69.6%), posterior dominant rhythm (55.7%), and sleep spindles (49.4%). The most frequent abnormal findings were focal epileptiform discharges (34.2%) and generalized epileptiform discharges (27.8%). Survey respondents (16 students, 5 faculty) reported high feasibility and educational value; no significant differences were observed between student and faculty responses.

As a proof of concept, these findings demonstrate that WBAs can serve as an effective formative assessment tool for EEG education in a brief elective for a subset of medical students. This model may also be adapted for neurology residents and fellows. Limitations include a single-institution sample, short elective duration, and multiple potential sources of variability.