Resident Competency and Interrater Agreements Using the ACNS Critical Care EEG Terminology (P3.259)

Objective: This study aims to evaluate whether residents can acquire competency in the commonly used ACNS Critical Care EEG Terminology. Background: Nonconvulsive status epilepticus (NCSE) is a neurological emergency. Continuous EEG monitoring (cEEG) has emerged as the diagnostic modality of choice for this condition. Not all tertiary care centers have cEEG access after daytime hours and some have resorted to resident initiated EEG studies in the detection of NCSE. Residents should therefore be knowledgeable in the ACNS Critical Care EEG Terminology. However, it remains unknown if residents can become proficient in correctly utilizing its terms. Design/Methods: After self-guided pre-reading and a 2 hour review session of the ACNS EEG terminology training slides, 16 adult neurology residents (PGY 2–4) from a Canadian institution were asked to complete the web-based ACNS certification test. This test contains 37 EEG samples, each consisting of 11 questions. Residents were asked to report their comfort level using the terminology, and performance scores were reported as average percent agreement (PA%) with a previously established 5-member expert panel. Data were analyzed using Microsoft Excel. Results: The overall pass rate (defined as >/=70%) for our cohort was 50% and the average score was 65.9%. The terms with the highest PA% were: seizures (90.2), main term 1 (79.1), main term 2 (78.4). Other terms with strong PA% were the +F (71.8), +R (78.9) and +S (72.8) modifiers. The reported levels of comfort with the terminology ranged from uncomfortable (50%) and neutral (31.25%), while only 18.75% reported feeling comfortable with this terminology. Conclusions: With minimal training, adult neurology residents at various stages in their training can become proficient in the ACNS Critical Care EEG Terminology, displaying special aptitude for identifying seizures from background rhythmic or periodic patterns. However, their overall comfort level remains low, suggesting ongoing reinforcement is needed throughout their training to improve their perception. Disclosure: Dr. Ding has nothing to disclose. Dr. Carpentier has nothing to disclose. Dr. McBain has nothing to disclose. Dr. Gaspard has nothing to disclose. Dr. Westover has nothing to disclose. Dr. Fantaneanu has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with UCB, Eisai, Sunovion.