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A Novel Microlearning Asynchronous Curriculum to Improve Internal Medicine Trainees' Confidence and Skill in
Matthew Capustin1,2, Spencer Weintraub1,2, Ji-Cheng Hsieh1,3
1Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Background:
Skills in electrocardiogram (ECG) interpretation are critical in clinical decision making but remain poor among Internal Medicine residents. There remains no standardized method for teaching ECG interpretation.
Methods:
This study aimed to leverage the benefits of microlearning by assessing an asynchronous microlearning ECG curriculum for Internal Medicine residents at a single academic residency program between September 2023 and June 2024. The ECG curriculum was comprised of 30 mandatory weekly ECGs which included a clinical vignette, a 12-lead ECG, and a single multiple-choice or free response question posted on Microsoft Teams. Residents were required to submit interpretations within 1 week, after which the answer, a short description of ECG findings, and clinical pearls were posted. Data collection included pre-post surveys with a 1- to 5-Likert scale measuring self-reported confidence and a test containing 15 unique ECGs.
Results:
Of 151 total categorical and preliminary Internal Medicine residents, 38 (25.2%) completed pre-post surveys and were analyzed as matched pairs. Residents demonstrated increases in Likert ratings of confidence (mean post-pre score difference 0.44 of 5, P = <.01), overall performance (mean post-pre raw score difference 0.97 of 15, P = <.01), and performance in identifying normal variants (mean post-pre score subset difference 14.21%, P = .017). Residents had no significant change in performance in identifying tachyarrhythmias (mean post-pre score subset difference 5.9%, P = .24), ST-segment changes (0.88%, P = 0.89), or conduction disease (-0.65%, P = .92).
Conclusions:
Overall, this curriculum was effective in improving resident confidence in and knowledge of ECG interpretation, with a particular strength in identifying normal/normal variants. Next steps include targeting specific ECG pathologies in which residents show particular knowledge gaps and creation of a 3-year longitudinal curriculum to reinforce knowledge over the course of a 3-year residency.
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