Please pay attention to the competency of Chinese primary clinical medical workers in electrocardiogrophic interpretation skills

Abstract

Background: Improving the capacity of health care, disease diagnosis and treatment of primary medical workers was the key to hierarchical diagnosis and treatment services. Electrocardiogram (ECG) played an important role in the diagnosis of cardiac diseases and should be regarded as the most basic tool for primary clinical medical workers in China.Objectives: To investigate the competency of Chinese medical workers in electrocardiographic interpretation skills, especially in the primary care hospitals, to explore the insufficiency of electrocardiographic interpretation skills and the improvement methods.Methods: A cross-sectional questionnaire study was conducted via the internet from March to October 2019. The questionnaire consists of 6 parts: basic information, equipping with an electrocardiograph, operating electrocardiograph, receiving electrocardiographic theory, testing of electrocardiographic interpretation, and improving electrocardiographic interpretation skills.Results: The effective quantity of this questionnaire was 2307, with an effective rate of 96.57%. The overall reliability was α=0.895. There were no significant differences among primary, private and class-Ⅲ hospitals in the aspects of equipping with an electrocardiograph (χ2=3.794, 3.104, P 0.05), operating the electrocardiograph (χ2=1.857, P 0.05) and receiving electrocardiographic theoretical study (χ2=6.701, P 0.05). Medical workers in private and class-Ⅲ hospitals had a stronger interpretation competency of ECG, including common or life-threatening ECGs (P 0.01). The development of talent echelon in primary hospitals affected the electrocardiographic interpretation skills of medical workers (P 0.01). In primary hospitals, the age was mainly ≥ 40 years (79.0%), the education background was mainly bachelor and below degree (80.9%), the professional qualification was mainly physician assistant (58.6%) and primary physician (31.4%). The interpretation competency of ECG of medical workers in private or class-Ⅲ hospitals was higher than that in primary hospitals (P 0.05 or 0.01).Conclusions: In China, the examination of electrocardiograph had been popularized. Due to the unreasonable development of talent echelon in primary hospitals, the electrocardiographic interpretation skills of primary medical workers were worrying. We should improve Authors' contributions YLG, YHL, and JL contributed equally to this work, they conceived the study with YFC and STS commenting on the study design. CXW and YCL acquired the data from questionnaires and been as questionnaire online instructors. YLG, YHL, and CL conducted the statistical analysis and interpretation of the data. YY advised on the statistical analysis. YLG wrote the first draft with support from JL. All authors reviewed the manuscript and made critical changes for intellectual content. All authors read and approved the final manuscript.