A randomized controlled educational pilot trial of interictal epileptiform discharge identification for neurology residents

This study evaluated a technology-enhanced, retrieval-based program for
teaching neurology residents to identify interictal epileptiform discharges
(IEDs). Junior residents were randomized to rate 500 candidate IEDs with
instant feedback on either a web browser (intervention 1) or an iOS app
(intervention 2), or to an inactive control group. All participants completed
pre- and post-training assessments.

Twenty-one residents completed the study (control n=8; intervention 1 n=6;
intervention 2 n=7), most without prior EEG experience. Intervention 1
produced significant improvements in AUC (.74->.85), sensitivity (.53->.75),
and confidence (1.33->2.33; all p<.05). Intervention 2 improved AUC (.81->.86)
and confidence in identifying IEDs and spike-wave discharges (2.00->3.14;
p<.05). Controls showed no meaningful change.

This program significantly improved IED identification, with web-based
training producing the greatest objective gains. It may serve as an effective
supplement to resident EEG education.