EEG/epilepsy clinical fellow, Massachusetts General Hospital

Fabio Nascimento, MD

"General pediatricians, general neurologists, and primary care physicians, even though they don’t take care of patients with epilepsy, they should be well-versed. They should make it a point every visit to tell someone who’s at high risk but may not have refractory seizures and say, ‘hey, this is a risk you should know about.’"

, evaluated baseline sudden death in epilepsy (SUDEP) knowledge and counseling practices among national and international adult neurology trainees. Among 161 respondents in the US and 171 respondents outside the US, the data showed alarming gaps of SUDEP knowledge, including familiarity with its risk factors and potential mitigation strategies.

While the study highlighted these issues, there were limitations to the research, including the relatively small number of trainees which may not be a reliable representation of the worldwide trainee education. Nascimento, a clinical fellow at Massachusetts General Hospital, said that while they did not ask trainees to specify their clinical focus, there could be differences within different neurology subspecialties.

Nascimento provided background on specific inconsistencies on SUDEP knowledge between neurologists, as well as evaluating other specialties outside of neurology that should be versed on SUDEP.

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The clinical fellow at Massachusetts General Hospital discussed whether SUDEP knowledge is at an appropriate level for neurologists and those in other neurology subspecialties. 

Increasing SUDEP Knowledge Across Clinical Care: Fabio Nascimento, MD

"Hopefully this will lead to other centers, researchers, clinicians, and educators to create curriculums to improve this. Then we’ll see it pop up in different places until we have a nicer structure of how to educate trainees about this.”

demonstrated an alarming lack of sudden death in epilepsy (SUDEP) knowledge for both national and international adult neurology trainees, raising questions about the training education targeted at this group. While a large majority of US residents reported being familiar with the term SUDEP (97%) and its definition (93%), familiarity with its risk factors was reported by 61% of respondents and potential mitigation SUDEP strategies by 63%.

The data also showed that about half of national (49%) and international trainees rarely or never counseled patients on SUDEP, despite the majority reporting having seen at least 45 patients with the condition during their training. Lead author 

, has taken this analytical approach to medical education before, with previous research showing inconsistencies in teaching and evaluating residents on electroencephalogram (EEG).

Nascimento, a clinical fellow at Massachusetts General Hospital, hopes that his studies will open the eyes of some program directors and entice them to take a deeper look into the practices currently in place. He sat down with 

to provide background on the reasons for taking this type of approach and why implementing more requirements or milestones may improve overall SUDEP knowledge among adult neurology trainees.

Nascimento FA, Laze J, Friedman D, Lam A, Devinsky O. SUDEP education among US and international neurology trainees. 

Published online June 7, 2021. doi: 10.1016/j.yebeh.2021.108098

The clinical fellow at Massachusetts General Hospital discussed his approach to highlighting flaws within the medical education system and the need to do so for certain areas in epilepsy. 

Improving the Medical Education System via an Analytical Approach: Fabio Nascimento, MD

"I felt like although we talk—and I hear people talk about SUDEP all the time—we don’t usually talk to patients about it in real day-to-day life. I rarely did at the beginning of residency. I did maybe a little more than my peers did just because I had that interest, but it still wasn’t enough.”

A recently conducted study using an emailed survey found that less than half of adult neurology trainees, both national and international, were educated about sudden death in epilepsy (SUDEP), raising questions about the training and education currently in place for these individuals. Although most respondents were familiar with the term, a substantially smaller number were familiar with its risk factors, and even fewer had any formal education about SUDEP.

, is no stranger to taking an analytical approach to addressing gaps within epilepsy education. In December 2020, he published a study identifying a lack of consistency in teaching and evaluating residents on electroencephalogram (EEG) during residency, while also presenting EEG education barriers and possible solutions.

Nascimento, a clinical fellow at Massachusetts General Hospital, sat down with 

to discuss the motivation behind the study, and the importance behind identifying these gaps in epilepsy education. He shared his insight into the findings and his concerns about these education and communication gaps.

The clinical fellow at Massachusetts General Hospital discussed the basis of his study evaluating adult neurology trainees and their familiarity with SUDEP and its risks. 

Identifying Gaps in Trainee SUDEP Knowledge: Fabio Nascimento, MD

"How do we make this change? Well, groups have to come together and gain an understanding that there need to be newer ways of teaching, and that we need to take advantage of the technology. There are online courses, assessments, and virtual videos that can all be used.”

Recently published findings from Fabio Nascimento, MD and Jay Gavvala, MD, MSCI, identified inconsistencies across electroencephalogram (EEG) 

. Nascimento, an EEG/epilepsy clinical fellow at Massachusetts General Hospital, claims the issues within the education system are well known by residents themselves. In total, the average number of EEGs read during a typical EEG rotation varied from more than 40, in about one-third of programs, to 0–10, in about 14% of programs.

In addition to main findings, the 2 also provided possible solutions to the most commonly reported barriers to EEG education. Their suggestions for optimizing teaching and learning included increase in supervision, reading time with faculty, and an up-tick in the responsibility and accountability to read EEGs during rotation, among others.

To better understand how these inconsistencies can be resolved, we turned to Nascimento for his insight. In an interview with 

, he provided his thoughts on where the change comes from, and why culture needs to be the highest priority to ensure better results.

Nascimento FA, Gavvala JR. Education research: neurology resident EEG education: a survey of US neurology residency program directors. Neurology. Published online December 11, 2020. doi: 10.1212/WNL.0000000000011354.

The clinical fellow at Massachusetts General Hospital gives his call to action on how what needs to change to improve EEG education among residency programs.

Fabio Nascimento, MD

Articles

Increasing SUDEP Knowledge Across Clinical Care: Fabio Nascimento, MD

Improving the Medical Education System via an Analytical Approach: Fabio Nascimento, MD

Identifying Gaps in Trainee SUDEP Knowledge: Fabio Nascimento, MD

Institutionalizing Change for EEG Education in Residency Programs: Fabio Nascimento, MD