title: Video and CD-ROM as a training tool for performing neurologic examinations of 1-year-old children in a multicenter epidemiologic study.
abstract: 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.
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center, Boston University, MA 02118, USA. Karl.Kuban@bmc.org
authors.forename: Karl C K
authors.initials: KC
authors.lastname: Kuban
authors.forename: Michael
authors.initials: M
authors.lastname: O'Shea
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Allred
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
authors.forename: Herbert
authors.initials: H
authors.lastname: Gilmore
authors.forename: Adré
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authors.lastname: DuPlessis
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authors.lastname: Krishnamoorthy
authors.forename: Cecil
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authors.lastname: Hahn
authors.forename: Janet
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authors.lastname: Soul
authors.forename: Sunila E
authors.initials: SE
authors.lastname: O'Connor
authors.forename: Karen
authors.initials: K
authors.lastname: Miller
authors.forename: Paige T
authors.initials: PT
authors.lastname: Church
authors.forename: Cecilia
authors.initials: C
authors.lastname: Keller
authors.forename: Richard
authors.initials: R
authors.lastname: Bream
authors.forename: Robin
authors.initials: R
authors.lastname: Adair
authors.forename: Alice
authors.initials: A
authors.lastname: Miller
authors.forename: Elaine
authors.initials: E
authors.lastname: Romano
authors.forename: Haim
authors.initials: H
authors.lastname: Bassan
authors.forename: Kathy
authors.initials: K
authors.lastname: Kerkering
authors.forename: Steve
authors.initials: S
authors.lastname: Engelke
authors.forename: Diane
authors.initials: D
authors.lastname: Marshall
authors.forename: Kristy
authors.initials: K
authors.lastname: Milowic
authors.forename: Janice
authors.initials: J
authors.lastname: Wereszczak
authors.forename: Carol
authors.initials: C
authors.lastname: Hubbard
authors.forename: Lisa
authors.initials: L
authors.lastname: Washburn
authors.forename: Robert
authors.initials: R
authors.lastname: Dillard
authors.forename: Cherrie
authors.initials: C
authors.lastname: Heller
authors.forename: Wendy
authors.initials: W
authors.lastname: Burdo-Hartman
authors.forename: Lynn
authors.initials: L
authors.lastname: Fagerman
authors.forename: Dinah
authors.initials: D
authors.lastname: Sutton
authors.forename: Padu
authors.initials: P
authors.lastname: Karna
authors.forename: Nick
authors.initials: N
authors.lastname: Olomu
authors.forename: Leslie
authors.initials: L
authors.lastname: Caldarelli
authors.forename: Melisa
authors.initials: M
authors.lastname: Oca
authors.forename: Kim
authors.initials: K
authors.lastname: Lohr
authors.forename: Albert
authors.initials: A
authors.lastname: Scheiner
mesh_terms: 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