Virtual tools for teaching electrocardiographic rhythm analysis

Electrocardiographic (ECG) rhythm analysis is inadequately taught in training programs, resulting in undertrained physicians reading a large percentage of the 40 million ECGs recorded annually. The effective use of simple tools (calipers, ruler, and magnifier) required for crucial measurements and comparisons of intervals requires considerable time for interactive instruction and is difficult to teach in the classroom. The ECGViewer (Blaufuss Medical Multimedia Laboratories, Palo Alto, Calif) program was developed using virtual tools easily manipulated by computer mouse that can be used to analyze archived scanned ECGs on computer screens and classroom projection. Trainees manipulate the on-screen tools from their seats by wireless mouse while the instructor makes corrections with a second mouse, in clear view of the trainees. An on-screen ladder diagram may be constructed by the trainee and critiqued by the instructor. The ECGViewer program has been successfully used and well received by trainees at medical school, residence, and subspecialty fellow level.