ECG Interpretation Skills of South African Emergency Medicine Residents

Overview

Journal Int J Emerg Med

Publisher Biomed Central

Specialty Emergency Medicine

Date 2011 Mar 5

PMID 21373298

Citations 19

Authors

Japie de Jager

Lee Wallis

David Maritz

Affiliations

Soon will be listed here.

Abstract

Background: The use and interpretation of electrocardiograms (ECGs) are widely accepted as an essential core skill in Emergency Medicine. It is imperative that emergency physicians are expert in ECG interpretation when they exit their training programme.

Aim: It is unknown whether South African Emergency Medicine trainees are getting the necessary skills in ECG interpretation during the training programme. Currently there are no clear criteria to assess emergency physicians' competency in ECG interpretation in South Africa.

Methods: A prospective cross-sectional study of Emergency Medicine residents and recently qualified emergency physicians was conducted between August 2008 and February 2009 using a focused questionnaire.

Results: At the time of the study, there were 55 eligible trainees in South Africa. A total of 55 assessments were distributed; 50 were returned (91%) and 49 were fully completed (89%). In this study, we found the overall average score of ECG interpretation was 46.4% [95% confidence interval (CI) 41.5-51.2%]. The junior group had an overall average of 42.2% (95% CI 36.9-47.5%), whereas the senior group managed 52.5% (95% CI 43.4-61.5%).

Conclusion: In this prospective cross-sectional study of Emergency Medicine residents and recently qualified emergency physicians, we found that there was improvement in the interpretation of ECGs with increased seniority. There exists, however, a low level of accuracy for many of the critical ECG diagnoses. The average score of 46.4% obtained in this study is lower than the scores obtained by other international studies from countries where Emergency Medicine is a well-established speciality.

Citing Articles

IMPROVING ECG LEARNING AND COMPETENCE AMONG MEDICAL AND POSTGRADUATE TRAINEES: SCOPING REVIEW OF AVAILABLE EVIDENCE.

Adebayo O, Anele F, Afolabi T, Inofomoh F, Ajibare A, Aje A Ann Ib Postgrad Med. 2025; 22(2):95-105.

PMID: 40007712 PMC: 11848365.

Electrocardiography interpretation competency among pediatric and child health residents at Addis Ababa University, Ethiopia.

Mintesnot H, Tadele H, Ahmed H, Moges T, Gedlu E BMC Med Educ. 2024; 24(1):1548.

PMID: 39736753 PMC: 11684311. DOI: 10.1186/s12909-024-06614-5.

Evaluating the impacts of digital ECG denoising on the interpretive capabilities of healthcare professionals.

McKenna S, McCord N, Diven J, Fitzpatrick M, Easlea H, Gibbs A Eur Heart J Digit Health. 2024; 5(5):601-610.

PMID: 39318698 PMC: 11417490. DOI: 10.1093/ehjdh/ztae063.

Electrocardiogram (EKG) knowledge and interpretation proficiency among healthcare professionals in Pakistan: a prospective cross-sectional study.

Hassan Z, Kumari U, Waseem M, Yaqoob U, Sahito M, Zehra S Ann Med Surg (Lond). 2024; 86(9):5058-5064.

PMID: 39238999 PMC: 11374200. DOI: 10.1097/MS9.0000000000002220.

The Effectiveness of Online Learning in Improving the Electrocardiogram Interpretation Skills of Junior Medical Trainees: A Mixed Methods Observational Study.

Elkammash A, Ahmed M, Alsinan M, Madi K Cureus. 2023; 15(7):e42320.

PMID: 37614256 PMC: 10443891. DOI: 10.7759/cureus.42320.

References

Hoyle R, Walker K, Thomson G, Bailey M . Accuracy of electrocardiogram interpretation improves with emergency medicine training. Emerg Med Australas. 2007; 19(2):143-50. DOI: 10.1111/j.1742-6723.2007.00946.x. View

Brady W, Perron A, Chan T . Electrocardiographic ST-segment elevation: correct identification of acute myocardial infarction (AMI) and non-AMI syndromes by emergency physicians. Acad Emerg Med. 2001; 8(4):349-60. DOI: 10.1111/j.1553-2712.2001.tb02113.x. View

Eken C, Goksu E, Eray O, Yalcinkaya S . The consistency of emergency physicians' and cardiologists' ECG interpretation and likelihood classification of chest pain patients. Int J Clin Pract. 2006; 60(10):1194-7. DOI: 10.1111/j.1742-1241.2005.00788.x. View

Salerno S, Alguire P, Waxman H . Competency in interpretation of 12-lead electrocardiograms: a summary and appraisal of published evidence. Ann Intern Med. 2003; 138(9):751-60. DOI: 10.7326/0003-4819-138-9-200305060-00013. View

Beller G, Bonow R, Fuster V . ACCF 2008 Recommendations for Training in Adult Cardiovascular Medicine Core Cardiology Training (COCATS 3) (revision of the 2002 COCATS Training Statement). J Am Coll Cardiol. 2008; 51(3):335-8. DOI: 10.1016/j.jacc.2007.11.008. View

Hatala R, Norman G, Brooks L . Impact of a clinical scenario on accuracy of electrocardiogram interpretation. J Gen Intern Med. 1999; 14(2):126-9. DOI: 10.1046/j.1525-1497.1999.00298.x. View

FISCH C . Evolution of the clinical electrocardiogram. J Am Coll Cardiol. 1989; 14(5):1127-38. DOI: 10.1016/0735-1097(89)90407-5. View

Gjorup T, Kelbaek H, Nielsen D, Kreiner S, Godtfredsen J . Interpretation of the electrocardiogram in suspected myocardial infarction: a randomized controlled study of the effect of a training programme to reduce interobserver variation. J Intern Med. 1992; 231(4):407-12. DOI: 10.1111/j.1365-2796.1992.tb00952.x. View

Loy C, Irwig L . Accuracy of diagnostic tests read with and without clinical information: a systematic review. JAMA. 2004; 292(13):1602-9. DOI: 10.1001/jama.292.13.1602. View

10.

Berger J, Eisen L, Nozad V, DAngelo J, Calderon Y, Brown D . Competency in electrocardiogram interpretation among internal medicine and emergency medicine residents. Am J Med. 2005; 118(8):873-80. DOI: 10.1016/j.amjmed.2004.12.004. View

11.

White T, Woodmansey P, Ferguson D, Channer K . Improving the interpretation of electrocardiographs in an accident and emergency department. Postgrad Med J. 1995; 71(833):132-5. PMC: 2398154. DOI: 10.1136/pgmj.71.833.132. View

12.

Madias J . How I read, and teach others to read, ECGs. J Electrocardiol. 2006; 39(1):110-1. DOI: 10.1016/j.jelectrocard.2005.07.008. View

13.

Auseon A, Schaal S, Kolibash Jr A, Nagel R, Lucey C, Lewis R . Methods of teaching and evaluating electrocardiogram interpretation skills among cardiology fellowship programs in the United States. J Electrocardiol. 2009; 42(4):339-44. DOI: 10.1016/j.jelectrocard.2009.01.004. View

14.

Boersma E, Maas A, Deckers J, Simoons M . Early thrombolytic treatment in acute myocardial infarction: reappraisal of the golden hour. Lancet. 1996; 348(9030):771-5. DOI: 10.1016/S0140-6736(96)02514-7. View

15.

. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Fibrinolytic Therapy Trialists' (FTT).... Lancet. 1994; 343(8893):311-22. View

16.

Hurst J . The interpretation of electrocardiograms: pretense or a well-developed skill?. Cardiol Clin. 2006; 24(3):305-7, vii. DOI: 10.1016/j.ccl.2006.03.001. View

17.

Wathen J, Rewers A, Yetman A, Schaffer M . Accuracy of ECG interpretation in the pediatric emergency department. Ann Emerg Med. 2005; 46(6):507-11. DOI: 10.1016/j.annemergmed.2005.03.013. View

18.

Todd K, Hoffman J, Morgan M . Effect of cardiologist ECG review on emergency department practice. Ann Emerg Med. 1996; 27(1):16-21. DOI: 10.1016/s0196-0644(96)70290-1. View