Comparing IM Residents with EM Resident for Their Skills of ECG Interpretation and Outlining Management Plan Accordingly

Hamid Reza Karimpoor; A Arhami Dolatabadi; R Miri; MR Ra’oofi

doi:10.22037/jme.v11i1,2.1032

Journal of Medical Education for Future Demands

Former Title: Journal of Medical Education | The Official Journal of School of Medical Education and Learning Technologies

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https://doi.org/10.22037/jme.v11i1,2.1032

Comparing IM Residents with EM Resident for Their Skills of ECG Interpretation and Outlining Management Plan Accordingly

Author(s):

Hamid Reza Karimpoor^1,*,

A Arhami Dolatabadi²,

R Miri²,

MR Ra’oofi³

1Internal Medicine resident, Shahid Beheshti University of Medical Sciences and Health Services

2Assistant professor, Shahid Beheshti University of Medical Sciences and Health Services

3GP

Journal of Medical Education for Future Demands:Vol. 11, issue 1 & 2; e105324

Published online:Jun 20, 2009

Article type:Research Article

Received:Jun 20, 2009

Accepted:Jun 20, 2009

How to Cite:Hamid Reza KarimpoorA Arhami DolatabadiR MiriMR Ra’oofiComparing IM Residents with EM Resident for Their Skills of ECG Interpretation and Outlining Management Plan Accordingly.J Med Edu.11(1 & 2):e105324.https://doi.org/10.22037/jme.v11i1,2.1032.

Abstract

Background and Purpose: Electrocardiogram (ECG) is one of the most commonly performed investigations in cardiac diseases and ECG abnormalities can reveal the early manifestations of cardiac ischemia, metabolic disorders, or life-threatening disrhythmias. Misinterpretation of ECG and its consequent mistreatment or performing inessential interventions may cause life-threatening cardiac events. Since EM residents and internal medicine (IM) residents are usually the first to visit at bedside and start treatments based on patient’s ECG, we intended to evaluate the ability of EM residents to interpret ECGs and to compare it with that of IM residents using various ECG samples.Method: 63 participants including 33 IM residents and 30 EM residents from two education hospitals of Shahid Beheshti University of Medical Sciences were enrolled in our study. A diagnosis test consisting of 15 ECG samples associated with a questionnaire containing questions about gender, academic year and proficiency in ECG interpretation was taken from all participants. This study was conducted under the supervision of a cardiologist and an emergency specialist who supervised the ECG selection, answers and scoring of each ECG. The maximum score for each ECG was 6 which were given to a completely correct diagnosis and -0.25 negative point was given if the answer was wrong or any differential diagnosis was mentioned. After the test, the answer sheets were collected and wereanalyzed with SPSS program, by two of study authors who were kept blind to the real identities of participants.Results: After classification of groups, the overall mean score was 45.5/100 (38-60). The mean score of IM and EM residents was 56.0/100 (44.9-72) and 38.9/100 (31.5-45.5), respectively (p< 0.001).No significant correlation was found between the diagnosis scores and participant’s self-judgment on her/his ECG interpretation skills (p=0.897, r=0.017). Five ECGs were considered as the most important and analysis revealed the overall mean score (out of 6) of participants was 5 for MI, 4.4 for ventricular tachycardia, 1.18 for pericarditis, 5.91 for WPW, and 5.09 for pulmonary emboli.Conclusion: our study revealed that the overall scores in ECG interpretation are low and the ECG interpretation skill in IM residents was better compared to EM residents. We demonstrated that there are several weaknesses in ECG interpretation which may have an important role in treatment of patients. Therefore there is a need for more and better ECG training programs especially in cardiac emergencies.

Keywords

ECG Interpretation

Emergency Medicine Residents

Internal Medicine Residents

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Author(s):

Hamid Reza Karimpoor:[PubMed][Scholar]
A Arhami Dolatabadi:[PubMed][Scholar]
R Miri:[PubMed][Scholar]
MR Ra’oofi:[PubMed][Scholar]