title: Can pediatric residents interpret electrocardiograms?
abstract: The purpose of this study was to assess the electrocardiogram (ECG) interpretation skills of pediatric residents in a controlled environment and determine if the level of residency training (intern vs senior) improves accuracy. A list of ECG diagnoses was provided to four pediatric residency educators with instructions to categorize each diagnosis as follows: I, all residents; II, the majority of residents, including all senior residents; III, less than the majority of residents; and IV, few residents should be able to interpret correctly. Only those categories that the entire panel believed all residents (category I) or all senior residents (category II) should be able to interpret correctly were included. The test included 17 ECGs: 14 category I and 3 category II. A total of 132 residents participated: 78 interns and 54 seniors. Both groups scored below expected levels. Mean correct score among seniors was 10.9 out of the expected 17 (p < 0.001). Mean correct score for interns was 7.7 out of the expected 14 (p < 0.00l). No difference in ECG interpretation accuracy was found between residency programs. In general, pediatric residents' ECG interpretation skills are less accurate than expected. Although there is a trend toward improvement during training, senior residents fell short of the expectations of the panel. We speculate that focused education in this area will improve resident ECG interpretation and benefit patient care by (1) facilitating referral and treatment of patients with cardiovascular disease and (2) decreasing referrals for erroneous interpretations.
authors.affiliation: Division of Pediatric Cardiology, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA. christopher.snyder@yale.edu
authors.forename: C S
authors.initials: CS
authors.lastname: Snyder
authors.forename: J T
authors.initials: JT
authors.lastname: Bricker
authors.forename: A L
authors.initials: AL
authors.lastname: Fenrich
authors.forename: R A
authors.initials: RA
authors.lastname: Friedman
authors.forename: G L
authors.initials: GL
authors.lastname: Rosenthal
authors.forename: C L
authors.initials: CL
authors.lastname: Johnsrude
authors.forename: C
authors.initials: C
authors.lastname: Kertesz
authors.forename: N J
authors.initials: NJ
authors.lastname: Kertesz
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004562:Electrocardiography; D006331:Heart Diseases / Q000175:diagnosis; D006801:Humans; D007396:Internship and Residency; D015203:Reproducibility of Results; D014481:United States