İmanli Muharrem, Şimşek Erdem, Dezhakam Afshin, Kanmaz Seda, Dokurel İpek, Serin Hepsen M, Yılmaz Sanem, Aktan Gül, Tekgül Hasan
Department of Pediatrics, Ege University Children's Hospital, İzmir, Turkey.
Division of Pediatric Neurology, Department of Pediatrics, Ege University Children's Hospital, İzmir, Turkey.
Turk Arch Pediatr. 2023 Sep;58(5):509-514. doi: 10.5152/TurkArchPediatr.2023.23063.
The aim of this study was to evaluate the adaptability of pediatric residents to the current seizure classification of the International League Against Epilepsy-2017 (ILAE-2017) using a modular education program (MEP).
The MEP design consisted of 8 modules, including 5 modules for the current version of the ILAE-2017 seizure classification and 3 modules for the older ILAE-1981 version. The MEP was implemented with a group of pediatric residents, and it comprised 50 illustrative pediatric seizure videos along with an instruction manual kit that included a seizure determinator. Following a 3-month follow-up period, a posttest was conducted using 58 new videos in the MEP.
The overall success rates of the participants were similar both ILAE-2017 (41%) and ILAE-1981 (38.5%) seizure classifications in the post-MEP test. Regarding the ILAE-2017 mod- ules, the participants demonstrated a higher proficiency in classifying focal nonmotor seizures (56.3%) compared to focal motor seizures (34.9%). However, when it came to generalized seizures, the participants had significantly lower accuracy rates for generalized nonmotor seizures (26%) compared to generalized motor seizures (46%) with the ILAE-2017 classifica- tion. The seizure types that were most commonly misclassified, with an error rate exceeding 50%, were automatisms and myoclonic seizures within the focal seizure modules and atypical absences in generalized seizure modules of ILAE-2017.
The single-day MEP yielded modest results, with a success rate of 41% in terms of the initial adaptability of pediatric residents to the ILAE-2017 seizure classification. However, to ensure successful implementation of the ILAE-2017 classification in clinical practice, additional booster applications of the MEP are required.
本研究旨在使用模块化教育计划(MEP)评估儿科住院医师对国际抗癫痫联盟2017年(ILAE - 2017)现行癫痫发作分类的适应性。
MEP设计包括8个模块,其中5个模块针对ILAE - 2017癫痫发作分类的当前版本,3个模块针对旧版的ILAE - 1981版本。MEP应用于一组儿科住院医师,包括50个儿科癫痫发作示例视频以及一套包含癫痫发作判定器的指导手册。在3个月的随访期后,使用MEP中的58个新视频进行了后测。
在MEP后的测试中,参与者在ILAE - 2017(41%)和ILAE - 1981(38.5%)癫痫发作分类中的总体成功率相似。关于ILAE - 2017模块,与局灶性运动性发作(34.9%)相比,参与者对局灶性非运动性发作的分类熟练度更高(56.3%)。然而,对于全身性发作,按照ILAE - 2017分类,参与者对全身性非运动性发作的准确率(26%)显著低于全身性运动性发作(46%)。错误率超过50%的最常被误分类的发作类型是局灶性发作模块中的自动症和肌阵挛发作,以及ILAE - 2017全身性发作模块中的非典型失神发作。
单日MEP取得了一定成果,就儿科住院医师对ILAE - 2017癫痫发作分类的初始适应性而言,成功率为41%。然而,为确保ILAE - 2017分类在临床实践中的成功实施,需要对MEP进行额外的强化应用。