Improving ECG Competence in Medical Trainees in a UK District General Hospital

McAloon, Christopher; Leach, Helen; Gill, Simrat; Aluwalia, Arun; Trevelyan, Jasper

doi:10.14740/cr333e

Cited by 23 publications

(59 citation statements)

References 6 publications

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“…The ECG is an indispensable diagnostic modality in cardiac disease 1 2. Although knowledge of, and skills in ECG analysis and interpretation, hereafter referred to as ECG competence, are desired learning outcomes of undergraduate and postgraduate medical training programmes, there is ongoing concern that graduating medical trainees lack adequate ECG competence 3–12. Many reasons account for this observation.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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ObjectivesIt remains unclear whether computer-assisted instruction (CAI) is more effective than other teaching methods in acquiring and retaining ECG competence among medical students and residents.DesignThis systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesElectronic literature searches of PubMed, databases via EBSCOhost, Scopus, Web of Science, Google Scholar and grey literature were conducted on 28 November 2017. We subsequently reviewed the citation indexes for articles identified by the search.Eligibility criteriaStudies were included if a comparative research design was used to evaluate the efficacy of CAI versus other methods of ECG instruction, as determined by the acquisition and/or retention of ECG competence of medical students and/or residents.Data extraction and synthesisTwo reviewers independently extracted data from all eligible studies and assessed the risk of bias. After duplicates were removed, 559 papers were screened. Thirteen studies met the eligibility criteria. Eight studies reported sufficient data to be included in the meta-analysis.ResultsIn all studies, CAI was compared with face-to-face ECG instruction. There was a wide range of computer-assisted and face-to-face teaching methods. Overall, the meta-analysis found no significant difference in acquired ECG competence between those who received computer-assisted or face-to-face instruction. However, subanalyses showed that CAI in a blended learning context was better than face-to-face teaching alone, especially if trainees had unlimited access to teaching materials and/or deliberate practice with feedback. There was no conclusive evidence that CAI was better than face-to-face teaching for longer-term retention of ECG competence.ConclusionCAI was not better than face-to-face ECG teaching. However, this meta-analysis was constrained by significant heterogeneity amongst studies. Nevertheless, the finding that blended learning is more effective than face-to-face ECG teaching is important in the era of increased implementation of e-learning.PROSPERO registration numberCRD42017067054.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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“…In addition to the lack of ECG competence, undergraduate and postgraduate students also lack con dence in ECG analysis and interpretation, which improves with training. 14 In this study we observed that students exposed to blended learning were more con dent in ECG analysis and interpretation at the end of their Clinical Clerkship. This con dence matched their competence in basic ECG analysis and the interpretation of abnormal rhythms and waveforms.…”

Section: Discussionmentioning

confidence: 62%

Effectiveness of Blended Learning versus Lectures alone on ECG Analysis and Interpretation by Medical Students

Viljoen

Millar

Manning

et al. 2020

Preprint

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Background Most medical students lack confidence and are unable to accurately interpret ECGs. Better methods of ECG instruction are therefore being sought. Current literature indicates that the use of e-learning for ECG analysis and interpretation skills (ECG competence) is not superior to lecture-based teaching. We aimed to assess whether blended learning (lectures supplemented with the use of a web application) resulted in better acquisition and retention of ECG competence in medical students, than with conventional teaching (lectures alone). Methods Two cohorts of fourth-year medical students were studied prospectively. The conventional teaching cohort (n=67) attended four hours of interactive lectures, covering the basic principles of Electrocardiography, waveform abnormalities and arrhythmias. In addition to attending the same lectures, the blended learning cohort (n=64) used a web application that facilitated deliberate practice of ECG analysis and interpretation, with structured feedback. All participants completed three tests: pre-intervention (assessing baseline ECG competence at start of clinical clerkship), immediately post-intervention (assessing acquisition of ECG competence at end of six-week clinical clerkship) and delayed post-intervention (assessing retention of ECG competence six months after clinical clerkship, without any further ECG training). Diagnostic accuracy and uncertainty were assessed in each test. Results The pre-intervention test scores were similar for blended learning and conventional teaching cohorts (mean 31.02±13.19% versus 31.23±11.52% respectively, p=0.917). While all students demonstrated meaningful improvement in ECG competence after teaching, blended learning was associated with significantly better scores, compared to conventional teaching, in immediate (75.27±16.22% vs 50.27±17.1%, p<0.001; Cohen’s d =1.58), and delayed post-intervention tests (57.70±18.54% vs 37.63±16.35%, p<0.001; Cohen’s d =1.25). Although diagnostic uncertainty decreased after ECG training in both cohorts, blended learning was associated with better confidence in ECG analysis and interpretation. Conclusion Blended learning was superior in teaching ECG analysis and interpretation skills to medical students and achieved better levels of ECG competence and confidence than conventional lectures. Although medical students undergo a significant attrition of ECG competence without ongoing training, blended learning also resulted in better retention of ECG competence than conventional teaching. Web applications enabling deliberate practice with structured feedback may therefore be a useful adjunct to lectures for teaching Electrocardiography.

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“…A larger significant benefit was seen in those were in the teaching program. 26 On the contrary, Kopeć et al showed that competency in interpretation of the ECG is gained mainly by self-learning, whereas attendance at regular ECG classes failed to improve the skill of ECG reading. 19 Our results show a moderately level of ECG misreading among sixth-year medical students and interns at Taif University.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiography misreading among sixth-year medical students and interns in Taif University

AlGhamdi

Almuntashiri

Aljuaeed

2018

Int J Community Med Public Health

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Background: The electrocardiogram (ECG) is the most important procedure to examine the cardiac rhythm and conduction system abnormalities. The common problem of ECG misinterpretation can lead to inappropriate diagnoses and clinical decisions. There is a limited number of studies identifying the size of the problem in Saudi Arabia. We aimed to assess the frequency of ECG misreading, address the nature of errors, and analyze the determinants of ECG interpretation accuracy among sixth-year medical students and interns of Taif University, Taif, Saudi Arabia.Methods: Participants were given a quiz of 10 multiple-choice questions of commonly encountered ECG interpretations. Each correct answer was given a 1-point score. The overall score for each participant was calculated out of 10 points.Results: A total of 297 participants took part in this study and achieved a median (IQR) overall score of 6.0 (4). The most frequent score was 9 (13.5%), followed by 8 (12.8%) and 4 (12.5%). Second degree AV block, type II was misread by 60.6% of the participants, 2nd-degree AV block, type I was misread by 50.2% while other abnormalities were less frequently misread. Academic year and gender showed no significant influence on ECG interpretation. On the other hand, interest in ECG reading and previous participation in ECG courses were associated with significantly better performance (p<0.001 and p=0.001, respectively).Conclusions: Overall performance of medical students and interns was moderate. Self-learning and providing organized educational courses on ECG can positively improve ECG interpretation and allow adequate diagnosis and management of heart diseases.

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Improving ECG Competence in Medical Trainees in a UK District General Hospital

Cited by 23 publications

References 6 publications

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

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

Effectiveness of Blended Learning versus Lectures alone on ECG Analysis and Interpretation by Medical Students

Electrocardiography misreading among sixth-year medical students and interns in Taif University

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