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This is a Pre-Registered Trial study.

October 2, 2025Open Access

Impact of standardized electroencephalography terminology education among early-career neurologists in Korea: a single-group pretest–posttest study

KPKyung‐Il ParkSeoul National University Hospital SHSang Bin HongSeoul National University Hospital HLH Y Lee

Key Points

Overall EEG interpretation accuracy scores improved significantly after education intervention among neurologists.
From initial scores of 88.8, the accuracy increased to 118.2 post-education, with a p-value of 0.037.
Learning modules particularly enhanced recognition of generalized periodic discharges and electrographic seizures.
Despite improvements, minor EEG features remained frequently overlooked, highlighting gaps in education.

Abstract

Purpose This study evaluated the effectiveness of implementing standardized electroencephalography (EEG) terminology and education on improving interpretation skills among non-English speakers. Methods EEGs were collected retrospectively from 16 critically ill patients and two alert epilepsy patients (30-minute sessions) and read by 10 neurologists. After initial interpretation, a learning module was provided to the neurologists. One week later, the neurologists reinterpreted the same EEGs randomly reordered. The interpretation accuracies of 144 items were scored as correct, similar, incorrect, or not recognized based on consensus answers. Results Overall scores improved significantly after learning modules were completed, increasing from 88.8 ± 23.1 to 118.2 ± 39.2 (p = 0.037). Performance improvement was also observed, regardless of years of clinical experience treating patients with epilepsy. However, more experienced raters tended to have higher inter-rater agreement. The baseline correct answer rates for rhythmic delta activity (RDA), periodic discharges (PD), sporadic epileptiform discharge (ED), and electrographic seizures (ES) were 42.5%, 50%, 60.0%, and 20.0%, respectively. After the learning modules were completed, correct answer rates increased by 21.4% for RDA (p = 0.11), 11.1% for PD (p = 0.06), and 28.1% for ES (p = 0.02), but decreased by 11.1% for sporadic ED (p = 0.02). Specifically, the accuracy for generalized PD improved significantly after learning (p = 0.04). Most minor items except location were often missed even after learning. Conclusion Education is imperative for standardizing EEG descriptions. As such, developing educational modules that emphasize minor items including prevalence, frequency, duration, and amplitude will broaden the recognition of EEG features, improving the quality of future research and patient care. Keywords: Electroencephalography, American Clinical Neurophysiology Society standardized terminology, Education

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