Competency in electrocardiogram interpretation among graduating medical students.

BACKGROUND: The ability to accurately interpret electrocardiogram (ECG) abnormalities is a core competency for graduating medical students (GMS). Incorrect interpretation of ECG findings can result in adverse patient outcomes. To our knowledge, there has been no published study evaluating the level of competency in ECG interpretation in GMS. PURPOSES: To evaluate the ability of graduating medical students to interpret abnormal and critical ECGs and to correlate student performance with self-reported confidence and adequacy of ECG training. METHODS: A list of 22 ECGs which GMS are expected to identify was developed. Classic examples of each ECG were identified and verified by two board-certified cardiologists. The 22 ECGs along with 11 questions related to confidence and degree of ECG training were administered to (a) 168 4th-year George Washington University School of Medicine (GWUSOM) students, (b) 63 incoming housestaff to GWUSOM, and (c) 22 graduating internal medicine housestaff. RESULTS: Given the lack of statistical differences, GW medical students and incoming housestaff were combined into a single group (GMS, n=231). Mean number of correct answers on the 22 ECG examination for GMS was 8.2 (SE=0.529) and 13.9 (SE=1.312) for graduating residents (p<.0001). On the 6 life-threatening ECGs, GMS scored lower than graduating residents (3.4 SE=0.191 vs. 4.6 SE=0.541; p<.0002). Mean score in the GMS group was associated with increasing levels of reported confidence and degree of ECG experience. CONCLUSIONS: A 22-item ECG examination was developed, piloted, and demonstrated to have construct validity. GMS had a limited level of competency in ECG interpretation which was correlated with reported self-confidence and degree of ECG exposure in Years 3-4.

Assessment of competency in electrocardiogram interpretation of graduating physician assistant students.

PURPOSE: This study assessed the competency in electrocardiogram (ECG) interpretation of the 2011 physician assistant (PA) class at George Washington University School of Medicine and Health Sciences. METHODS: A survey and 22-item ECG examination were completed by 51 students prior to graduation. Six strips were critical ECGs. RESULTS: The students scored 50.7% on the 22 ECGs and 68.0% on the six critical ECGs. Students who were more confident regarding their ability to accurately interpret ECGs and those who took a cardiology elective performed statistically significantly better on the 22 ECG examination (P = .005 and P = .032 respectively) but not on the six critical ECGs (P = .130 and P = .132 respectively). There were no significant associations between scores on either the 22 ECGs or six critical ECGs and students' perceived sufficiency of ECG training and desire for more ECG training. CONCLUSION: The students' overall scores indicate the need for improved training in ECG interpretation skills.