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Retention of Baseline Electrocardiographic Knowledge After a Blended-Learning Course
Carol Ann Brooks1, Nancy Kanyok2, Colin O'Rourke2
1Carol Ann Brooks is a clinical instructor and Nancy Kanyok is an education nurse specialist, Office of Nursing Education and Professional Practice Development, Nursing Institute; Nancy M. Albert is associate chief nursing officer, Office of Research and Innovation, Nursing Institute; and Colin O'Rourke is a biostatistician, Quantitative Health Science, Cleveland Clinic Health System, Cleveland, Ohio. brooksc2@ccf.org.
Background:
Among nurses, skill retention after an electrocardiography blended-learning course is unknown.
Objectives:
To compare 3- and 8-week electrocardiography test scores, compare scores by nurse and work characteristics and self-assessed electrocardiographic competence, and compare 1-year work retention with 3- and 8-week scores and change in scores from week 3 to week 8.
Methods:
Data were collected on demographics, comfort with electrocardiography expectations, electrocardiography competence levels, and 1-year work retention. Correlational and comparative statistics were used in analyses.
Results:
Of 69 nurses, 58% were somewhat comfortable with interventions for abnormal rhythms. Test scores were higher at 3 weeks than at 8 weeks: mean difference, 26%; P < .001. Scores at 8 weeks reflected intermediate skill retention and were not associated with nurse characteristics, electrocardiography background, comfort with rhythms and measurements, or 1-year work retention. Nurses with greater comfort for intervening when rhythm abnormalities occurred had higher median 8-week scores (P = .01) than did nurses with less comfort, and perceptions of electrocardiographic competence were associated with 8-week scores (r = 0.28; P = .02). Reduction in scores at 8 weeks was less severe in nurses with greater comfort at 3 weeks in measuring electrocardiographic intervals (P = .008) and applying therapeutic interventions (P = .009).
Conclusions:
Skill retention and competence in electrocardiographic interpretation were intermediate and correlated with baseline self-assessment. Electrocardiographic interpretation, measurement, and interventions should be reinforced at the bedside.
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