Educational Technology Improves ECG Interpretation of Acute Myocardial Infarction among Medical Students and Emergency Medicine Residents

Abstract

IntroductionAsynchronous online training has become an increasingly popular educational format in the new era of technology-based professional development. We sought to evaluate the impact of an online asynchronous training module on the ability of medical students and emergency medicine (EM) residents to detect electrocardiogram (ECG) abnormalities of an acute myocardial infarction (AMI).MethodsWe developed an online ECG training and testing module on AMI, with emphasis on recognizing ST elevation myocardial infarction (MI) and early activation of cardiac catheterization resources. Study participants included senior medical students and EM residents at all post-graduate levels rotating in our emergency department (ED). Participants were given a baseline set of ECGs for interpretation. This was followed by a brief interactive online training module on normal ECGs as well as abnormal ECGs representing an acute MI. Participants then underwent a post-test with a set of ECGs in which they had to interpret and decide appropriate intervention including catheterization lab activation.Results148 students and 35 EM residents participated in this training in the 2012–2013 academic year. Students and EM residents showed significant improvements in recognizing ECG abnormalities after taking the asynchronous online training module. The mean score on the testing module for students improved from 5.9 (95% CI [5.7–6.1]) to 7.3 (95% CI [7.1–7.5]), with a mean difference of 1.4 (95% CI [1.12–1.68]) (p<0.0001). The mean score for residents improved significantly from 6.5 (95% CI [6.2–6.9]) to 7.8 (95% CI [7.4–8.2]) (p<0.0001).ConclusionAn online interactive module of training improved the ability of medical students and EM residents to correctly recognize the ECG evidence of an acute MI.

Improving Electrocardiography Diagnostic Accuracy in Emergency Medical Services Personnel

“…[20][21][22][23] Online or web-based teaching has been shown to have comparable efficacy with more traditional lecture or workshop-based teaching in regard to ECGs. [24][25][26] It has been postulated that web-based training may, in fact, be more effective than traditional teaching methods. 27,28 Medical students appreciated a web-based program and attributed its success to greater immediacy, improved visualization, and interactivity.…”

Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis

“…It remains important to review whether these novel teaching and learning methods are effective 26. Previous studies have shown that students’ knowledge of, and skills in the analysis and interpretation of ECGs improve with computer-assisted instruction (CAI) 27–34. However, these studies did not compare CAI to other methods of instruction and thus it cannot be concluded that CAI is better than traditional methods of ECG teaching.…”

Getting to the heart of the issue: senior emergency resident electrocardiogram interpretation and its impact on quality assurance events

“…The EM literature provides little guidance with regard to the optimization of ECG interpretation curricula. [8][9][10][11] In our training program residents are exposed to ECG interpretation teaching via didactic lectures, asynchronous learning modules, one-on-one dedicated training, and textbook review. Trainees also take the annual American Board of Emergency Medicine In-Training Examination, which includes ECG interpretation and questions related to cardiac emergencies.…”