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

Area of Science:

• Medical Education
• Cardiology Training
• Diagnostic Skills Development

Background:

• Competency in interpreting electrocardiograms (ECGs) requires consistent practice and feedback.
• Medical students often lack structured ECG practice, relying on opportunistic learning during clinical rotations.
• Developing proficiency in ECG rhythm strip diagnosis is crucial for medical trainees.

Purpose of the Study:

• To quantify deliberate practice in electrocardiogram (ECG) rhythm strip interpretation among first-year medical students.
• To define the learning curve associated with ECG rhythm strip diagnosis.
• To explore medical students' experiences with deliberate practice in ECG interpretation.

Main Methods:

• First-year medical students from two institutions engaged with online ECG rhythm strip practice cases.
• Diagnostic accuracy was tracked throughout the practice modules, with immediate feedback provided.
• The correlation between practice volume (cases and time) and diagnostic performance on an exam was analyzed.

Main Results:

• 82% of students participated, completing a mean of 59 ECGs each, totaling over 18,000 practice instances.
• Mathematical models demonstrated a significant correlation between practice time/volume and exam diagnostic accuracy (p<0.001).
• Achieving 75% accuracy on an ECG rhythm strip exam required an average of 112 minutes and 34 practice cases; students reported high satisfaction.

Conclusions:

• Deliberate practice for ECG interpretation was successfully implemented for a large student cohort.
• A quantifiable learning curve for ECG rhythm strip diagnosis was established, estimating practice needs for proficiency.
• These findings can guide the development of competency-based medical curricula for diagnostic skills.