ECG interpretation skills of South African Emergency Medicine residents

Abstract

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.

Retention of Baseline Electrocardiographic Knowledge After a Blended-Learning Course

“…1 When ECG competency was studied among third-year nursing students according to the method used for teaching (lecture plus interactive discussion vs a 6-stage method that involved pattern recognition followed by interactive discussion), no differences were noted in initial scores on examinations taken immediately after completion of the course or scores obtained 1 month later. 3 Although reports are available on ECG testing among physician assistants 4 and resident physicians, 5 we found no contemporary research on hospital nurses' ECG competence according to different learning environments and teaching methods.…”

Teaching the interpretation of electrocardiograms: Which method is best?

“…Ability to correctly identify potentially life-threatening conditions was 57% in a group of US graduating medical students [2] and 46.4% in a group of South African Emergency Medicine trainees [3].…”

“…Though ECG interpretation accuracy improves with time and practice, a number of studies have shown performance in ECG interpretation using ECGs independently verified by qualified cardiologists to be poor among both medical students [2] and doctors of different grades and specialties [3,4]. Ability to correctly identify potentially life-threatening conditions was 57% in a group of US graduating medical students [2] and 46.4% in a group of South African Emergency Medicine trainees [3].…”

Determination of the Level of Emergency Medicine Resident Physicians to Recognize the Electrocardiography Findings

“…De Jager et al (9) found that as the duration of residency got longer, the errors in ECG interpretation decreased in their survey with emergency physicians. Pudlo et al (10), in a survey they applied on 4 th , 5 th , and 6 th grade students in Jagiellonian University, showed that the percentage of correct answers significantly increased in grade 6 students.…”