BackgroundThe use and interpretation of electrocardiograms (ECGs) are widely accepted as an essential core skill in Emergency Medicine. It is imperative that emergency physicians are expert in ECG interpretation when they exit their training programme.AimIt is unknown whether South African Emergency Medicine trainees are getting the necessary skills in ECG interpretation during the training programme. Currently there are no clear criteria to assess emergency physicians’ competency in ECG interpretation in South Africa.MethodsA prospective cross-sectional study of Emergency Medicine residents and recently qualified emergency physicians was conducted between August 2008 and February 2009 using a focused questionnaire.ResultsAt the time of the study, there were 55 eligible trainees in South Africa. A total of 55 assessments were distributed; 50 were returned (91%) and 49 were fully completed (89%). In this study, we found the overall average score of ECG interpretation was 46.4% [95% confidence interval (CI) 41.5–51.2%]. The junior group had an overall average of 42.2% (95% CI 36.9–47.5%), whereas the senior group managed 52.5% (95% CI 43.4–61.5%).ConclusionIn this prospective cross-sectional study of Emergency Medicine residents and recently qualified emergency physicians, we found that there was improvement in the interpretation of ECGs with increased seniority. There exists, however, a low level of accuracy for many of the critical ECG diagnoses. The average score of 46.4% obtained in this study is lower than the scores obtained by other international studies from countries where Emergency Medicine is a well-established speciality.

No abstract

BackgroundEmergency medicine is a rapidly developing field in South Africa (SA) and other developing nations. There is a need to develop performance indicators that are relevant and easy to measure. This will allow identification of areas for improvement, create standards of care and allow inter-institutional comparisons to be made. There is evidence from the international literature that performance measures do lead to performance improvements.AimsTo develop a broad-based consensus document detailing quality measures for use in SA Emergency Centres (ECs).MethodsA three-round modified Delphi study was conducted over e-mail. A panel of experts representing the emergency medicine field in SA was formed. Participants were asked to provide potential performance indicators for use in SA, under subheaders of the various disciplines that are seen in emergency patients. These statements were collated and sent out to the panel for scoring on a 9-point Lickert scale. Statements that did not reach a predefined consensus were sent back to the panellist for reconsideration.ResultsConsensus was reached on 99 out of 153 (65%) of the performance indicators proposed. These were further refined, and a synopsis of the statements is presented, classified as to whether the statements were thought to be feasible or not in the current circumstances.ConclusionsA synopsis of the useful and feasible performance indicators is presented. The majority are structural and performance-based indicators appropriate to the development of the field in SA. Further refinement and research is needed to implement these indicators.Electronic supplementary materialThe online version of this article (doi:10.1007/s12245-010-0240-6) contains supplementary material, which is available to authorized users.