APPENDIX I COMPETENCY MATRIX

NEURODIAGNOSTIC TECHNOLOGY PROGRAM GRADUATE COMPETENCIES List the course(s) and specific objective(s) that includes instruction in each competency.

CONTENT AREA COURSE # (s)

OBJECTIVE #(s)

I. ELECTROENCEPHALOGRAM (EEG) A. The graduate provides a safe recording environment by:

1. verifying identity of patient; EEG 203 #4c 2. cleaning electrodes after each procedure; EEG

202 #11a-11d

3. following universal precautions for infection control EEG 101 #1 4. attending to patient needs appropriately; EEG 203 #6a-#6e 5. recognizing/responding to life-threatening situations; EEG 101

EEG 203 #3 #7a-#7d

6. being certified to perform CPR; EEG 101 #3 7. following laboratory protocols for sedation; EEG

211a #3

8. complying with lab protocols for emergency and disaster situations; EEG 203 #8a-#8d9. complying with hazardous material handling procedures; EEG 101

EEG 201 #1 #8h

10. maintaining instrument/equipment in good working order; and, EEG 204 #8a-#8c 11. taking appropriate precautions to ensure electrical safety. EEG 204 #1a-#1h

B. The graduate establishes rapport with the patient and patient’s family by: 1. using personal communication skills to achieve patient

relaxation/cooperation; EEG 203 #4d, #4e

2. explaining all test procedures including activation procedures; EEG 207 EEG 211

#1a, #1b #4c

3. explaining the electrode application method (paste, collodion, etc.); EEG 202 #7c-#7f4. interacting on a level appropriate to patient's age and mental

capacity; and, EEG 203 #4d

5. maintaining respect and patient confidentiality. EEG 203 #4a-#4e C. The graduate evaluates the patient to:

1. determine the patient's mental age, mental state, andcomprehension level;

EEG 203 #4d, #4e

2. note the patient's overall physical condition; EEG 201 #4b 3. decide appropriate method of electrode application; EEG 202 #7a 4. ascertain the patient's capacity to cooperate with activation

procedures;EEG 207 EEG 211

#5a, #5b #4c

5. determine if hyperventilation is contraindicated; EEG 207 #5b 6. accommodate for disabilities or special needs; EEG

102a #4

7. determine the need for additional physiological monitors; EEG 208 #4a, #4b 8. document unusual or inappropriate behavior suggestive of seizure or

other event; and,EEG 203 EEG 207

#7a - #7d

9. determine the possible need for restraints or emergencyintervention.

EEG 203a EEG 209

#1 - #2

#5a - #5b D. The graduate prepares a basic data sheet (“tech sheet”) that includes:

1. patient information (name, age, ID number, doctor, etc.); EEG 203 EEG 205

#4c #8a

2. recording time, date, and graduate's name or initials; EEG 205 #8a-#8b 3. noting pertinent patient history and familial medical history; EEG 201 #4a - #4c

4. listing current medications/sedation and time of last dosage; EEG 201 EEG 205

#4b #7a-#7d, #8a

5. noting time of last meal; EEG 205 #8a 6. noting time, date, aura, and circumstances of last seizure or

symptoms; EEG 102a EEG 201 EEG 207

#3 #4a #2a-#2b

7. specifying the patient's mental, behavioral, and consciousness states;

EEG 205 #2c; #6b; #8a

8. diagramming skull defects or anomalies (if any); and, EEG 201 #4c 9. diagramming any modifications in electrode placement. EEG 202 #3d

E. The graduate’s electrode application follows method that includes; 1. measuring and marking the head following the 10/20 measurement

system; EEG 202 #1a - #1d

#2a - #2d #4a - #4c

2. adjusting electrode placement for anatomical defects or anomalies; EEG 201 EEG 202

#4c #3d

3. prepping patient's scalp prior to electrode application; EEG 202 #5a - #5e #7b

4. applying electrodes with paste or with collodion and electrolyte; and, EEG 202 #7d - #7f 5. verifying electrode impedances are balanced and below 5,000

ohms. EEG 202 #5b - #5d

#7b F. The graduate has basic knowledge of analog EEG technology. EEG

204 #2a - #3d

G. : The graduate documents the working condition of a digital EEG instrument by: 1. calibrating system amplifiers; EEG 206

EEG 207 #2a; #5a #3a, #3d, #3e

2. verifying standard filter settings; EEG 204 EEG 206

#5a; #6b #4a - #5d

3. verifying sensitivity settings; EEG 206 #6a - #6d 4. inputting a biological (bio-cal) signal to all channels; and, EEG 206 #3a; #6c; #7e 5. correcting or reporting deviations as appropriate. EEG 206 #6d

H. The graduate obtains a standard EEG that includes: 1. at least 20 minutes of technically acceptable recording (120 pages); EEG 205 #8b 2. eye opening and closing to check effects of stimuli on EEG; EEG 201 #10a 3. hyperventilation for a minimum of 3 minutes; EEG 207

EEG 211 #5a #2e; #4c

4. photic stimulation at frequencies appropriate for history & reactivity; EEG 207 #5a 5. mental stimulation/assessment procedures; EEG 207 #5a 6. periodic checks of electrode impedance; EEG 202 #5e 7. natural drowsiness and sleep, if possible; EEG 205 #3a-#3e 8. notations of montage, filters, paper speed, & sensitivity setting

changes; and, EEG 205 EEG 206

#5a - #5b #3a - #7f

9. notes on observed behavior, clinical seizure manifestations, etc. EEG 209 #2c - #2e I. The graduate customizes the recording procedure by: 1. evaluating reason for referral, history, and observed waveforms; EEG 205 #8b 2. utilizing techniques to bring out or enhance clinical symptoms; EEG 201

EEG 207 EEG 211

#10a #5a - #5b #2e, #4c

3. selecting montages appropriate for abnormalities seen and/or expected;

4. selecting appropriate instrument settings; 5. encouraging drowsiness and sleep; 6. applying additional electrodes to localize abnormal activity; EEG 205 #5a-#5b

7. monitoring respiration if appropriate; and, EEG 205 #3e 8. monitoring ECG rhythms for abnormality. EEG 208 #4b

J. The graduate understands and follows technical criteria for: 1. recording electrocerebral inactivity (brain death); EEG 202

EEG 204 EEG 206

#3e #7a #6b

2. recording neonatal EEG; EEG 211 #6a - #6j 3. recording pediatric EEG; and, EEG 211 #1a - #1c 4. recording in intensive care or cardiac care units. EEG 207 #6a

K. The graduate differentiates artiffacts from cerebral waveforms by: 1. recognizing possible artifactual waveforms; EEG 208 #7a-#7b 2. documenting (on the recording) patient movements; EEG 208 #4b 3. applying/recording leads for eye potentials or other physiological

potentials (ie. respiration, EMG);EEG 207 EEG 208

#4f #1c; #4b; #6c

4. applying/recording leads for ECG; EEG 208 #3b; #6c 5. replacing electrodes exhibiting questionable activity or contact; and, EEG 208 #5b6. troubleshooting for possible electrical interference. EEG 208 #3c; #6b

L. When the EEG recording is finished the graduate: 1. removes electrode paste/glue from the patient's scalp and hair; EEG

102a #3

2. describes clinically significant behavior; EEG 205 EEG 209

#8b #2c

3. documents sedation used, dosage, and effects (if applicable); and, EEG211a

#3

4. reviews EEG for appropriate documentation of amplifier settings &montage changes.

EEG 207 #2a - #2b

M. The graduate understands (has a working knowledge of): 1. functional neuroanatomy and neurophysiology; EEG 200 #1a - #12c 2. medication effects on the EEG background and waveforms; EEG 205 #7d 3. medical terminology and accepted abbreviations; EEG 201 #5a - #5c 4. signs, symptoms, and EEG correlates for adult neurological

disorders; EEG 210 #5a - #5j

5. signs, symptoms, and EEG correlates for pediatric neurologicaldisorders;

EEG 211 #5a - #5d

6. seizure manifestations, classifications, and EEG correlates; EEG 209 #2a - #3c 7. psychiatric and psychological disorders; and, EEG 201

EEG 209 #8a #2h

8. other knowledge as detailed in the ABRET ElectroencephalographicTechnology Practice Analysis.

EEG 203 EEG 211

#2b-#2c

N. The graduate maintains and improves knowledge and skills by: 1. reviewing EEG tracings with EEGer on a regular basis; EEG 203 #3d

Department/ABRET CE Requirements

2. reading journal articles; EEG 203 #3d Department/ABRET CE Requirements

3. studying text books related to the field; and, EEG 203 #3d Department/ABRET CE Requirements

4. attending continuing education courses in neurodiagnostics. EEG 203 #3d Department/ABRET CE REquirements

O. The EEG graduate applies the principles of electronics and mathematics to recording by: 1. knowing how differential amplifiers work; EEG 206 #2a; #5a

EEG 207 #3a 2. computing voltage and frequency of waveforms; EEG 205 #2a - #2e

#4a - #4c 3. calculating the duration of waveforms; EEG 205 #4b - #4c 4. understanding the polarity of the waveforms; EEG 207 #3a-#4f 5. understanding impedance; and, EEG 202

EEG 206 #5a - #5d; #7b #1h

6. understanding analog to digital conversion. EEG 204 #3a - #3d P. The graduate knows how waveform displays are affected by:

1. 60 Hertz filter; EEG 206 #5a-#5c 2. filter settings; EEG 206 #4a-#5 3. sensitivity settings; EEG 206 #6a-#6d 4. paper speed; EEG 205

EEG 206 #5b #7a

5. referential and bipolar montages;6. digital filters;7. electrode types and electrode material composition; and,8. malfunctioning equipment.

Q. The graduate recognizes: 1. normal and normal variant awake and asleep patterns for each age

range; EEG 205

EEG 210 EEG 211

#3a - #3e; #6a - #6c; #9a - #9b #4b #2a - #3d

2. abnormal awake and asleep patterns for each age range; EEG 209 EEG 210 EEG 211

#7b #5a - #5b #4a - #4b #5a - #5b

3. EEG patterns for levels of consciousness; and, EEG 205 #2c; #6b 4. clinical seizure patterns. EEG 209 #2c - #2d