Physician Training for Electrocardiogram Interpretation: A Systematic Review and Meta-Analysis

Area of Science:

• Medical Education Research
• Diagnostic Skills Training
• Cardiology Education

Background:

• Electrocardiogram (ECG) interpretation is a crucial diagnostic skill for physicians.
• Effective instructional strategies for ECG interpretation are vital for improving diagnostic accuracy.
• Current evidence on optimal teaching methods for ECG interpretation requires synthesis.

Purpose of the Study:

• To systematically review and meta-analyze research evidence on ECG interpretation instruction.
• To identify effective instructional modalities, methods, and interpretation approaches.
• To guide the improvement of diagnostic skills training and future research.

Main Methods:

• Systematic review and meta-analysis of empirical investigations.
• Searched multiple databases (PubMed/MEDLINE, Embase, etc.) through February 2020.
• Included studies on medical students, residents, and practicing physicians; appraised quality and pooled standardized mean differences (SMDs).

Main Results:

• Included 59 studies with 17,251 participants.
• Computer-assisted instruction showed a small advantage over face-to-face (SMD 0.23).
• Group training favored individual study (SMD -0.35), peer instruction over faculty-led (SMD 0.38), and systematic interpretation approaches showed large effects (SMD 0.92).

Conclusions:

• Some instructional interventions improve ECG interpretation learning, but many evidence-based strategies need further investigation.
• Findings suggest potential improvements in training design for ECG interpretation and other visual diagnostic skills.
• Further research is needed to optimize evidence-based instructional strategies for diagnostic skills.