Abstracts

Rationale: Epilepsy can present a management challenge for many clinicians as up to 40% of patients do not obtain adequate seizure control despite being placed on several different treatment regimens. To better manage these patients, it is important that neurologists are able to apply data on new treatment regimens in order to improve the care of their patients with refractory epilepsy. This study was designed to assess effects of online continuing medical education (CME) on the knowledge and competence of neurologists in the management of refractory partial-onset seizures.Methods: A pre-and post-activity online assessment was used to measure the effectiveness of an online CME program featuring a 30-minute video-based panel discussion in managing refractory partial-onset seizures. Linked participants, who served as their own controls, were assessed both before and immediately after the activity and again 30-60 days post exposure to CME. The effect of CME on 1 case-based competency question, 2 knowledge questions, and 1 self-efficacy question (e.g., degree of difficulty in making clinical decision) at these 3 time-points was analyzed with overall mean scores for answers and Cramer’s V formula for educational effect size. McNemar's Chi-squared test was used to compare linked learners' responses from the pre- to post-assessment. P<.05 was considered statistically significant.Results: Overall, the educational intervention improved selection of correct answers immediately post-CME for all 3 clinical decision questions among neurologists (n = 96, 14% to 70% increase, P <.001), with moderate educational effect size (V=0.352) compared with pre-CME answers. CME was particularly effective at improving the competence of clinical decision making around the management of a patient with refractory partial-onset seizures, with a 14% relative improvement in answering correctly after the education. Significant improvements post-activity (P <0.05) were also seen on knowledge questions pertaining to recent clinical data on therapies to improve seizure control. Follow-up 30-60 days after CME was performed on a smaller linked participant sample. Neurologists retained knowledge on all assessment questions as evidenced by a lack of statistically significant differences in the number of post-activity correct responses compared to the follow-up assessment. As a result of participating in this activity, neurologists reported that they were more confident in managing focal seizures in patients who do not respond to initial therapy (30% post-activity improvement and a 21% improvement between post-activity and follow-up).Conclusions: The CME intervention was successful in improving neurologists’ knowledge, confidence, and competence in the management of refractory partial-onset seizures, which demonstrates the effectiveness of a targeted online video panel discussion. Additional education on the findings of recent clinical trial data involving anti-seizure medications would be beneficial.