Competencies in Ecg Interpretation Among Newly Graduated Medical Students at the University of Nairobi School of Medicine

Abstract

Introduction: ECG is vital in screening, diagnosis and monitoring treatment of cardiovascular diseases. ECG interpretation accuracy influences the sensitivity and specificity of ECG utility in clinical practice. ECG interpretation competency has been studied in residents, physicians and cardiologists with varied results reported for each group. However, no study has evaluated ECG interpretation competency among newly graduated medical students in Africa. Objective: The study determined ECG interpretation competency among newly graduated medical students at the University of Nairobi. Methodology: Graduate medical students from the University of Nairobi were requested to participate in a web-based ECG survey containing 22 ECG strips. Initial survey questions concerned confidence in ECG interpretation and ECG training adequacy. The 22 ECG strips were derived from ECG Wave Maven – an ECG reference resource. A Participant could access the web-survey only once. 22 ECG strips were displayed successively for 90 seconds without any chance for revising a previous response. Data analysis was restricted to determining the proportion of participants who correctly interpreted 11 or more ECG tracings. This was reported as summative competency. Proportion of correct responses for each ECG tracing was determined and reported as Individual ECG Competency. The average for all Individual ECG Competencies calculated and reported as the Mean Competency Score. A multivariate analysis was done to correlate competency with self-reported confidence and self-reported adequacy of ECG training. Results: 2.8% of participants were considered competent for correctly interpreting 50% or more of the 22 ECG strips used in survey. ECG tracing for Hyperkalemia was the most correctly interpreted at 61% while ECG tracing LAFB was the least correctly interpreted at 5.1%. The mean competency score was 4.24 (19.27%). Correlations between ECG Competency and self-reported Confidence and self-reported adequacy of ECG training couldn’t be determined statistically because only 5 participants were found competent. Further, data on adequacy of training was insufficient. Conclusions: Graduate medical students at the University of Nairobi have limited ECG interpretation competency. Further studies are necessary to determine effective ECG interpretation teaching methods.