Video and CD-ROM as a training tool for performing neurologic examinations of 1-year-old children in a multicenter epidemiologic study.
In lieu of traditional training of examiners to identify cerebral palsy on a neurologic examination at age 1 year, we proposed an alternative approach using a multimedia training video and CD-ROM we developed after a two-step validation process. We hypothesized that use of CD-ROM interactive training will lead to reliable and valid performance of the neurologic examination by both pediatric neurologists and nonpediatric neurologists. All examiners were asked to take one of six interobserver variability tests found on the CD-ROM on two occasions. In the first interobserver variability evaluation, 89% (531 of 594) of the responses agreed with the gold standard responses. Following annotated feedback to the examiners about the two items that had a 60% correct rate, the correct response rate rose to 93% (114 of 123). In the second interobserver variability evaluation, 88% (493 of 560) of the responses agreed with the gold standard responses. Following annotated feedback to the examiners about the four items that had a 70% correct rate, the correct response rate rose to 96% (104 of 108). Interactive CD-ROM examination training is an efficient and cost-effective means of training both neurologists and non-neurologists to perform structured neurologic examinations in 1-year-old children. It provides an effective means to evaluate interobserver variability, offers a route for feedback, and creates an opportunity to reevaluate variability, both immediately and at periodic intervals.
Kuban
Karl C K
KC
Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center, Boston University, MA 02118, USA. Karl.Kuban@bmc.org
O'Shea
Michael
M
Allred
Elizabeth
E
Leviton
Alan
A
Gilmore
Herbert
H
DuPlessis
Adré
A
Krishnamoorthy
Kalpathy
K
Hahn
Cecil
C
Soul
Janet
J
O'Connor
Sunila E
SE
Miller
Karen
K
Church
Paige T
PT
Keller
Cecilia
C
Bream
Richard
R
Adair
Robin
R
Miller
Alice
A
Romano
Elaine
E
Bassan
Haim
H
Kerkering
Kathy
K
Engelke
Steve
S
Marshall
Diane
D
Milowic
Kristy
K
Wereszczak
Janice
J
Hubbard
Carol
C
Washburn
Lisa
L
Dillard
Robert
R
Heller
Cherrie
C
Burdo-Hartman
Wendy
W
Fagerman
Lynn
L
Sutton
Dinah
D
Karna
Padu
P
Olomu
Nick
N
Caldarelli
Leslie
L
Oca
Melisa
M
Lohr
Kim
K
Scheiner
Albert
A
D016251:CD-ROM; D002547:Cerebral Palsy / Q000473:pathology*; D003625:Data Collection; D004493:Education; D016021:Epidemiologic Studies; D006801:Humans; D007223:Infant; D009460:Neurologic Examination / Q000592:standards; D015588:Observer Variation; D011361:Professional Competence; D014741:Video Recording