Legriel Stephane, Jacq Gwenaëlle, Lalloz Amandine, Geri Guillaume, Mahaux Pedro, Bruel Cedric, Brochon Sandie, Zuber Benjamin, André Cécile, Dervin Krystel, Holleville Mathilde, Cariou Alain
Medical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.
IctalGroup, Le Chesnay, France.
Neurocrit Care. 2021 Feb;34(1):144-153. doi: 10.1007/s12028-020-01010-5.
Continuous electroencephalography (cEEG) is commonly recommended for neurocritical care patients. Routine implementation of such monitoring requires the specific training of professionals. The aim of this research was to evaluate the effectiveness of a training program on initiation of the basic interpretation of cEEG for critical care staff in a prospective multicenter study.
After completion of a pretest, participants (senior physicians, fellows, residents, medical students, and nurses) recruited in six French ICUs participated in a face-to-face electroencephalogram (EEG) training program followed by additional e-learning sessions at day 1 (post-course), day 15, day 30, and day 90, based on training tests followed by illustrated and commented answers. Each test was designed to evaluate knowledge and skills through correct recognition of ten predefined EEG sequences covering the most common normal and abnormal patterns. The primary objective was to achieve a success rate > 80% correct answers at day 90 by at least 75% of the participants.
Among 250 participants, 77/108 (71.3%) who completed the full training program achieved at least 80% correct answers at day 90. Paired comparisons between the scores obtained at each evaluation showed an increase over time. The rate of correct answers at day 90 was > 80% for all common predefined EEG sequences, except for the recognition of periodic and burst-suppression patterns and reactivity, which were identified in only 42.6% (95% CI 36.4-48.8), 60.2% (54.1-66.3), and 70.4% (64.7-76.1) of the tests, respectively.
A training strategy for the basic interpretation of EEG in ICUs, consisting of a face-to-face EEG course supplemented with reinforcement of knowledge by e-learning, was associated with significant resignation and an effectiveness of training allowing 71% of learners to accurately recognize important basic EEG patterns encountered in critically ill patients.
ClinicalTrials.gov number: NCT03545776.
连续脑电图（cEEG）通常被推荐用于神经重症监护患者。常规实施这种监测需要对专业人员进行特定培训。本研究的目的是在一项前瞻性多中心研究中评估一项培训计划对重症监护人员开始进行cEEG基本解读的有效性。
在完成预测试后，招募自六个法国重症监护病房的参与者（高级医师、研究员、住院医师、医学生和护士）参加了面对面的脑电图（EEG）培训计划，随后在第1天（课程结束后）、第15天、第30天和第90天进行额外的电子学习课程，这些课程基于培训测试并附有图示和注释答案。每个测试旨在通过正确识别十个预定义的EEG序列来评估知识和技能，这些序列涵盖了最常见的正常和异常模式。主要目标是在第90天至少75%的参与者的正确答案成功率>80%。
在250名参与者中，完成完整培训计划的108名参与者中有77名（71.3%）在第90天达到了至少80%的正确答案。每次评估获得的分数之间的配对比较显示，随着时间的推移分数有所增加。除了周期性和爆发抑制模式以及反应性的识别外，所有常见预定义EEG序列在第90天的正确答案率均>80%，在测试中分别只有42.6%（95%CI 36.4 - 48.8）、60.2%（54.1 - 66.3）和70.4%（64.7 - 76.1）的测试能识别出这些模式。
一种针对重症监护病房EEG基本解读的培训策略，包括面对面的EEG课程并辅以电子学习强化知识，与显著的效果相关，该培训有效性使71%的学习者能够准确识别重症患者中遇到的重要基本EEG模式。
ClinicalTrials.gov编号：NCT03545776。
