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A Burst-Learning Electrocardiogram Curriculum for Internal Medicine Residents: A Single-Center Quality Improvement
Theodora C Esomonye1, Alladdin Makawi1, Ridwan Azees1
1Department of Internal Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA.
Background:
Internal medicine residents frequently encounter arrhythmias on admission and telemetry, yet studies consistently demonstrate suboptimal electrocardiogram (ECG) interpretation accuracy and inadequate formal training.
Intervention:
We implemented a 14-week structured "burst-learning" ECG curriculum at a single safety-net academic internal medicine residency, comprising twelve 15- to 30-minute case-based sessions covering 20 high-acuity rhythms aligned with American College of Cardiology/American Heart Association guidelines.A 20-item knowledge quiz and scenario-linked 5-point Likert confidence survey were administered before and after the curriculum (unpaired cohorts).
Results:
Twenty-six residents completed baseline and 15 completed postcurriculum assessments. Mean confidence rose from 2.81 ± 0.94 to 3.48 ± 0.87 (P = 0.03); knowledge scores did not change meaningfully (from 7.38 ± 2.35 to 7.87 ± 1.64; P = 0.45). Postcurriculum status independently predicted higher confidence (β = 0.61; 95% CI: 0.04-1.19; P = 0.038).
Conclusions:
A brief, low-cost burst curriculum was associated with increased resident ECG confidence and was durably incorporated into the residency schedule. However, diagnostic accuracy gains will require a longer dose and paired measurement.
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