Overall Goals and Objectives

• Obtain accurate and sufficient histories to characterize seizures and to define risk factors for developing epilepsy
• Review AAN practice guidelines and learn to incorporate them into the evaluation and treatment of patients with neurological disease including epilepsy and neuromuscular disorders
• Demonstrate communication skills to educate patients and families regarding neurological diagnosis and treatment
• Work with health care professionals (i.e. nursing staff, neurophysiology technologists, ancillary staff) to provide patient-focused care
• Attend subspecialty clinics, admit and manage patients
• Review electrophysiological studies and apply findings to care of neurological patients
• Formulate patient management plans regarding appropriate diagnostic and therapeutic interventions

• Explain the recognition and treatment of status epilepticus, a medical emergency
• Take a personal initiative in self-education (including reading recent literature).
• Review of standard texts of neurophysiological techniques and their application to care of neurological patients, including EEG, EMG/NCS, evoked potentials, and sleep studies.
• Have a breadth of knowledge of neurophysiological technical aspects and application to pass the CNP board examination.
• Describe the importance of EEG patterns and their implications in patient care in both routine and continuous EEG.
• Describe the importance of EMG/NCS in the diagnosis and management of patients with neuromuscular disease.
• Describe the diagnostic utility and application of evoked potentials including for neurological prognosis.
• Verbalize rational approach to the management of epilepsy including choice of appropriate antiepileptic’s
• Electroencephalography
• Describe the principles of EEG generation and recording
• Achieve an orderly approach to the interpretation of EEG studies
• Identify normal and abnormal EEG patterns
• Describe the developmental features of EEG from infancy to the elderly
•  Recognize abnormal EEG findings and correlate EEG findings with clinical epilepsy syndrome and seizure types
• Achieve skills in creating and dictating neurophysiology reports
• Correlate video recordings of seizures with EEG tracing and interpret scalp EEG findings
• Interpret continuous EEG recordings from patients in the epilepsy monitoring and intensive care units and updating care teams of the record progress

• Develop techniques to obtain accurate history from patients, and gain the patients’ confidence and trust
• Create reports that accurately convey neurophysiological findings and relate these findings to the clinical setting
• Interact effectively with other members caring for patients including nursing and technical staff
• Create neurophysiology, clinic, and hospital notes that are concise and accurate

• Show respect, compassion, integrity and ongoing professional development
• Verbalize ethical principles with adherence to confidentiality, HIPAA principles, and appropriate informed consent
• Determine psychosocial issues that complicate care.
• Be punctual and appropriately attired
• Keep patient logs up-to-date

• Appraise literature to better understand neurological disorders and their etiology and clinical presentation
• Assess studies that evaluate treatment options for epilepsy, neuromuscular and other neurological disorders
• Apply and use guidelines from the American Clinical Neurophysiological Society for the practice and interpretation of neurophysiology studies

• Identify the importance for proper diagnosis and treatment of epilepsy as to the effect of diagnosis on insurability and driving privileges
• Assess efficiencies of the UW and VA systems regarding patients referred from other centers, and develop management plans that are effective and not redundant or wasteful of medical resources
• Make decisions regarding the cost considerations of choosing appropriate treatment for neurological disorders including epilepsy
• Identify advocacy programs for patients with neurological disease.

• Competence in the indications and interpretation of neurophysiology studies and there application to improve care of patients with neurological disease (Patient Care);
• A rich knowledge base in both clinical and basic neuroscience, as well as the fundamentals of clinical neurophysiology (Medical Knowledge);
• Competence in obtaining an appropriate medical history (including sensitive issues such as sexual history) in a professional and humane manner (Interpersonal and Communication Skills, Professionalism);
• Competence in communicating diagnosis and treatment plans, and competence in communicating potentially sensitive information (Interpersonal and Communication Skills, Professionalism);
• Competence in communicating succinctly and clearly with other healthcare professionals, with a proper respect for the principles of HIPAA regulations (Interpersonal and Communication Skills, Professionalism);
• Skill in self-assessment and self-improvement (Practice-Based Learning and Improvement);
• Skill in practice assessment, as well as both practice- and systems improvement, to enhance quality of care and improve patient safety (Practice-Based Learning and Improvement, Systems-Based Practice).

At the end of the training program, the fellow will have developed:

• A scholarly approach to the practice of clinical neurophysiology, including the incorporation of evidence-based medicine into clinical decision-making (Practice Based Learning and Improvement);
• Basic knowledge of clinical trial design and statistical testing, as well as the ability to utilize this knowledge for critical interpretation of medical literature (Medical Knowledge, Practice-Based Learning and Improvement);
• First-hand experience at the process of clinical research, ideally via participation in a clinical or translational research project (or even by assisting with patient enrollment into an ongoing project), or quality improvement. (Interpersonal and Communication Skills, Professionalism, Practice-Based Learning and Improvement); and
• First-hand experience at the process of data presentation and peer-review, ideally via submission of one abstract or manuscript during the course of training (Interpersonal and Communication Skills, Medical Knowledge, Professionalism).