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


To determine the effectiveness of a 6-month, interactive, multimodal, Web-based EEG teaching program (EEGonline) 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 EEGonline course. Of these, 128 learners (91% African) participated in the study. Pre- and postcourse multiple choice question (MCQ) test results and EEGonline user logs were analyzed. Differences in pre- and posttest performance were correlated with quantified exposure to various EEGonline learning modalities. Participants’ impressions of EEGonline 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 (p < 0.001, Cohen d 0.974). The largest improvement was in correct identification of normal features (43.2%–59.1%; p < 0.001, Cohen d 0.664) and artifacts (43.3%–61.6%; p < 0.001, Cohen d 0.836). 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% (p < 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 EEGonline 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.

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