The Effects of Using Checklists on Electrocardiogram Interpretation: A Cross- Sectional Study on Medical Interns

Electrocardiogram (ECG), behind medical examination, is the easiest way to check the heart diseases, especially in an emergency department. Although the acquisition of Terrace from patients in the right method does not require a high level of expertise, the interpretation of this Terrace needs adequate knowledge, proficiency, and experience. The purpose of this study was to examine the effect of using the checklist in the ECG interpretation by medical interns.

The present cross-section descriptive study was carried out on medical interns of Mashhad University of Medical Sciences in 2015. 40 students who were attending a one-month emergency medicine course were randomly divided into two groups of 20. In one group, 9 standard tracings classified with equal difficulty level (easy, medium, and hard) with a standard checklist form and a questionnaire for each were completed and in the other group, the same tracings of the first group were first handed without checklists and then handed with checklists for the second time. Finally, the scores of completing the checklists and the correctness of tracing interpretations were recorded in both groups. Data analysis was done using descriptive and inferential statistical tests.

There was no statistically significant difference between the two groups in terms of baseline variables. The first group identified 41.6% of the terraces correctly using the checklist. The second group, without using the checklist, correctly identified 25.5% of the terraces; and after using the checklist, this indicator increased to 32.7% in this group. Considering at least three correct responses in the ECG interpretation as "desirable response", it was found that 50% of the subjects in the first group (using the checklist) (n=10) and only 15% (n=3) of the second group (without using the checklist) had desirable responses (p = 0.531). On the other hand, the comparison of responses before and after the use of the checklist in the second group showed a significant improvement in the number of desirable responses (15% (n=3) versus 25% (n=5), p = 0.009).

The use of a checklist for the ECG interpretation by interns of emergency medicine did not affect improving the accuracy of the interpretation than the object-oriented system, but was effective in the diagnostic review and confirmation step.