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

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 EEG-reporting 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.