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Improving ECG Competence in Medical Trainees in a UK District General Hospital
Christopher McAloon1, Helen Leach1, Simrat Gill1
1Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, WR5 1DD, UK.
Background:
Competency in electrocardiogram (ECG) interpretation is central to undergraduate and postgraduate clinical training. Studies have demonstrated ECGs are interpreted sub-optimally. Our study compares the effectiveness of two learning strategies to improve competence and confidence.
Method:
A 1-month prospective randomized study compared the strategies in two cohorts: undergraduate third year medical students and postgraduate foundation year one (FY1) doctors. Both had blinded randomization to one of these learning strategies: focused teaching program (FTP) and self-directed learning (SDL). All volunteers completed a confidence questionnaire before and after allocation learning strategy and an ECG recognition multiple choice question (MCQ) paper at the end of the learning period.
Results:
The FTP group of undergraduates demonstrated a significant difference in successfully interpreting "ventricular tachycardia" (P = 0.046) and "narrow complex tachycardia" (P = 0.009) than the SDL group. Participant confidence increased in both learning strategies. FTP confidence demonstrated a greater improvement than SDL for both cohorts.
Conclusion:
A dedicated teaching program can improve trainee confidence and competence in ECG interpretation. A larger benefit is observed in undergraduates and those undertaking a FTP.