Quantifying the medical student learning curve for ECG rhythm strip interpretation using deliberate practice

Waechter, Jason; Reading, David; Lee, Chel Hee; Walker, Mathieu

doi:10.3205/zma001248

Cited by 11 publications

(5 citation statements)

References 48 publications

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“…A study in human medicine among more than 300 first‐year medical students showed that a diagnostic accuracy of 85% could only be achieved after 73 cases and >200 minutes training. 11 Thus, the question arises as to whether it was realistic to expect our respondents to feel comfortable in ECG interpretation with less than the above‐mentioned training.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and management of arrhythmias in dogs: A cross‐sectional online survey among Flemish veterinary practitioners

Hellemans

Schittekatte

Covents

et al. 2022

Veterinary Record Open

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Background Diagnosis as well as management of arrhythmias in dogs can be challenging for veterinary practitioners. The aim was to describe ECG availability and use, as well as the diagnostic and therapeutic experiences and preferences of Flemish veterinarians regarding cardiac arrhythmias in dogs. Methods Cross‐sectional online survey among veterinarians in Flanders (Belgium). Results An ECG device was available for 55 out of 102 respondents (54%) and 41 (43%) claimed to use it in case of arrhythmia suspicion. Insufficient knowledge about ECG interpretation and immediate patient referral upon detection of an abnormal heart rhythm were the most important reasons for not having, or not using, an ECG. About half of the respondents (56%) had never used anti‐arrhythmic drugs in dogs, although only a few reported having had a negative experience. Frequently provided reasons for not using anti‐arrhythmic drugs included insufficient knowledge and a low number of dogs with arrhythmias. Conclusion Most veterinarians reported having little or no expertise with arrhythmias in dogs. Electrocardiogram availability and use among respondents was moderate and too often restricted by insufficient ECG interpretation skills. Continued efforts are needed to increase the confidence and knowledge of veterinarians about arrhythmias in dogs.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and management of arrhythmias in dogs: A cross‐sectional online survey among Flemish veterinary practitioners

Hellemans

Schittekatte

Covents

et al. 2022

Veterinary Record Open

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“…It could prove vital to identify these gaps in ECG competency and address them. As the level of competency in ECG interpretation was previously found to be correlated with the degree of ECG exposure 7 , 23 it is expected that low competency will be observed in ECG patterns that are less encountered by students, and vice versa. For example, the highest competency was observed in the STEMI ECG - a frequently encountered and taught abnormality.…”

Section: Discussionmentioning

confidence: 99%

“…It is known that the amount of practice time and the number of ECG cases practiced are correlated with diagnostic accuracy. 23 …”

Section: Discussionmentioning

confidence: 99%

Competency and confidence in ECG interpretation among medical students

Vishnevsky¹,

Cohen²,

Elitzur

et al. 2022

Int J Med Educ

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Objectives: To assess competency and confidence in ECG interpretation in medical students across years of medical school and evaluate the associations of various factors, a curriculum change, and student confidence with ECG competency. Methods: Four hundred and fourteen (414) third-to sixthyear medical students participated in this cross-sectional study conducted in 2019 in the Hebrew University of Jerusalem, Israel. A voluntary response sample of participants answered a validated, web-based questionnaire, composed of eight ECG strips. Participants were also asked about confidence and sources for ECG education and exposure. Competency and confidence across medical school years were compared using the ANOVA and chi-square tests. Results: Competency was low overall (mean score, SD (standard deviation) 3.23±1.81 out of 8), and higher in sixthyear students compared to third-, fourth-and fifth-year students (4.37±1.69 vs. 2.90±1.82, 2.90±1.54, 2.50±1.56, respectively, F(3,337)=24.425, p<0.0001). There was no difference between students before and after the curriculum change. Work experience in medicine was associated with competency (odds ratio (OR), 7.97; 95% confidence interval (CI), 4.03-15.77, p<0.0001). The reported confidence level was low (median 2 out of 5) and was found to be correlated with the total score achieved (r(332)=0.5, p<0.0001). Conclusions: Student competency was shown to be insufficient throughout medical school. Competency and confidence in ECG interpretation seem to be significantly improved by increased and repetitive exposure to ECG. Thus, strategies to facilitate better ECG skills should involve an extended focus on ECG in the undergraduate and graduate curricula and include competency-based educational programs.

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“…Teaching ECG interpretation has been described in the literature as challenging [ 6 , 14 ]. Didactic lectures and teaching rounds are most often used to teach students how to interpret ECGs [ 15 ] but other methods have been investigated, including concept maps [ 16 ], deliberate practice [ 17 ], puzzle-based methods [ 18 ], and near-peer teaching [ 19 ], all with mixed results. ECG interpretation is a technical skill that needs to be practiced often to master [ 20 , 21 ], therefore some level of self-directed learning (SDL) and practice is needed to maintain skill level.…”

Section: Introductionmentioning

confidence: 99%

Comparing the effectiveness of asynchronous e-modules and didactic lectures to teach electrocardiogram interpretation to first year US medical students

Olvet,

Sadigh

2023

BMC Med Educ

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Background Medical students are expected to be competent in interpreting electrocardiograms (ECGs) by the time they graduate, but many are unable to master this skill. Studies suggest that e-modules are an effective way to teach ECG interpretation, however they are typically evaluated for use during clinical clerkships. We sought to determine if an e-module could replace a didactic lecture to teach ECG interpretation during a preclinical cardiology course. Methods We developed an asynchronous, interactive e-module that consisted of narrated videos, pop-up questions and quizzes with feedback. Participants were first year medical students who were either taught ECG interpretation during a 2-hour didactic lecture (control group) or were given unlimited access to the e-module (e-module group). First-year internal medicine residents (PGY1 group) were included to benchmark where ECG interpretation skills should be at graduation. At three time-points (pre-course, post-course, and 1-year follow-up), participants were evaluated for ECG knowledge and confidence. A mixed-ANOVA was used to compare groups over time. Students were also asked to describe what additional resources they used to learn ECG interpretation throughout the study. Results Data was available for 73 (54%) students in the control group, 112 (81%) in the e-module group and 47 (71%) in the PGY1 group. Pre-course scores did not differ between the control and e-module groups (39% vs. 38%, respectively). However, the e-module group performed significantly better than the control group on the post-course test (78% vs. 66%). In a subsample with 1-year follow-up data, the e-module group’s performance decreased, and the control group remained the same. The PGY1 groups’ knowledge scores were stable over time. Confidence in both medical student groups increased by the end of the course, however only pre-course knowledge and confidence were significantly correlated. Most students relied on textbooks and course materials for learning ECG, however online resources were also utilized. Conclusions An asynchronous, interactive e-module was more effective than a didactic lecture for teaching ECG interpretation, however continued practice is needed regardless of how students learn to interpret ECGs. Various ECG resources are available to students to support their self-regulated learning.

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Quantifying the medical student learning curve for ECG rhythm strip interpretation using deliberate practice

Cited by 11 publications

References 48 publications

Diagnosis and management of arrhythmias in dogs: A cross‐sectional online survey among Flemish veterinary practitioners

Diagnosis and management of arrhythmias in dogs: A cross‐sectional online survey among Flemish veterinary practitioners

Competency and confidence in ECG interpretation among medical students

Comparing the effectiveness of asynchronous e-modules and didactic lectures to teach electrocardiogram interpretation to first year US medical students

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