INTRODUCTION    Interpretation of the electrocardiogram (ECG) is an essential skill in most medical specialties; however, the best method of teaching how to read ECGs has not been determined. OBJECTIVES    The aim of the study was to compare the effectiveness of collaborative (C‑eL) and self (S‑eL) e‑learning of ECG reading among medical students. PATIENTS AND METHODS    A total of 60 fifth‑year medical students were randomly assigned to the C‑eL and S‑eL groups. S‑eL students received 15 ECG recordings with a comprehensive description by email (one every 48 hours), while C‑eL students received the same ECG recordings without description. C‑eL students were expected to analyze each ECG together within the subgroups using an internet platform and to submit the interpretation within 48 hours. Afterwards, they received a description of each ECG. C‑eL students' activity was assessed based on the number of words written on the internet platform during discussion. A final test consisted of 10 theoretical questions and 10 ECG recordings. The final score was a sum of points obtained for the interpretation of ECG recordings. The main endpoint of the study was the number of students whose final score was 56% or higher. RESULTS    The final test was completed by 53 students (88.3%). The main endpoint was achieved in 20 C‑eL students (77%) and in 13 S‑eL students (48.1%), P = 0.03. The final score was 6.4 (interquartile range [IQR], 5.8-7.6) in the C‑eL group and 5.6 (IQR, 4.2-7.2) in the S‑eL group, P = 0.04. It correlated with the results of the theoretical test and students' activity during C‑eL (r = 0.42, P = 0.002 and r = 0.4, P = 0.04, respectively). CONCLUSIONS    C‑eL of ECG reading among fifth‑year medical students is superior to S‑eL.

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