Evaluating the Efficacy of an Online Learning Tool for EEG Teaching: A Prospective Cohort Study.

Abstract

To determine the effectiveness of a 6-month, interactive, multimodal, Web-based EEG teaching program (EEG<i>online</i>) in improving EEG analysis and interpretation skills for neurologists, neurology residents, and technologists, particularly in resource-limited settings. Between June 2017 and November 2018, 179 learners originating from 20 African countries, Europe, and the United States were registered on the EEG<i>online</i> course. Of these, 128 learners (91% African) participated in the study. Pre- and postcourse multiple choice question (MCQ) test results and EEG<i>online</i> user logs were analyzed. Differences in pre- and posttest performance were correlated with quantified exposure to various EEG<i>online</i> learning modalities. Participants' impressions of EEG<i>online</i> efficacy and usefulness were assessed through pre- and postcourse satisfaction surveys. Ninety-one participants attempted both pre- and postcourse tests (71% response rate). Mean scores improved from 46.7% ± 17.6% to 64.1% ± 18%, respectively (<i>p</i> < 0.001, Cohen <i>d</i> 0.974). The largest improvement was in correct identification of normal features (43.2%-59.1%; <i>p</i> < 0.001, Cohen <i>d</i> 0.664) and artifacts (43.3%-61.6%; <i>p</i> < 0.001, Cohen <i>d 0.836</i>). Improvement in knowledge was associated with improved subjective confidence in EEG analysis. Overall confidence among postcourse survey respondents improved significantly from 35.9% to 81.9% (<i>p</i> < 0.001). Lecture notes, self-assessment quizzes, and discussion forums were the most utilized learning modalities. The majority of survey respondents (97.2%) concluded that EEG<i>online</i> was a useful learning tool and 93% recommended that similar courses should be included in EEG training curricula. This study demonstrated that a multimodal, online EEG teaching tool was effective in improving EEG analysis and interpretation skills and may be useful in resource-poor settings.