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. 2024 Dec 30;24(1):1548.
doi: 10.1186/s12909-024-06614-5.

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

Helen Mintesnot  1 , Henok Tadele  2 , Hayat Ahmed  1 , Tamirat Moges  1 , Etsegenet Gedlu  1
Affiliations

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

Helen Mintesnot et al. BMC Med Educ. .

Abstract

Background: Electrocardiography (ECG) interpretation competency is vital to ensure the timely initiation of life-saving treatment for emergent ECG conditions. This competency has not been well-studied among pediatric and child health residents. Hence, the study aimed to determine the competency in ECG interpretation and its predictors among residents at the National University of Ethiopia.

Methods: This cross-sectional study employed standard ECG Wave-Maven strips, a web-based ECG self-assessment tool. The association between dependent and independent variables was tested using a chi-square test and Fisher's exact test.

Results: The study included 95 residents with male dominance, 61.1%. The median age of study participants was 29 years (IQR: 28-30). The median service years before residency enrollment was 2 years (IQR:1-3). More than half, 51.6%, received 1-3 hours of ECG lectures. ECG training insufficiency was reported by 75.8% of participants. Residents were not confident in their ECG readings,65.3%. The majority,67.3%, partially or totally relied on computer-generated ECG (C-ECG) reports during ECG interpretation. The majority ordered up to 5 ECGs per month, 75.8% and sought consultation for ECG reading most of the time, 58.9%. Common emergent ECG conditions were rarely diagnosed correctly: long QTC syndrome, 42.1%; Complete heart block (CHB), 10.5%; supraventricular tachycardia (SVT), 9.5%; ventricular tachycardia, 8.4% and hyperkalemia, 4.2%. Young residents, 29 years or less, diagnosed sinus rhythm correctly, p = 0.017. Year I and II residents correctly diagnosed sinus arrhythmia, p = 0.001. CHB diagnosis was associated with the use of C-ECG reports, p = 0.011. SVT diagnosis was associated resident's juniority, p = 0.018 and the number of monthly ECG orders, p = 0.018. Atrial fibrillation diagnosis was associated with the service years before residency enrollment, p = 0.046. The diagnosis of acute pericarditis was associated with monthly resident's ECG orders, p = 0.034.

Conclusion: In this study, three-fourths of pediatric and child health residents reported insufficient ECG training during their residency. They were not confident in their ECG readings. ECG diagnosis of common life-threatening conditions was missed. Resident's age, year of residency, monthly ECG orders, service years before residency enrollment and reliance on C-ECG reports predicted the correct diagnosis of an ECG abnormality or rhythm. Well-designed and structured urgent ECG training sessions are required to fill this gap among the residents.

Keywords: Addis Ababa University; Africa; Electrocardiography; Ethiopia; Medical education; Pediatric residents; Postgraduate; Residency; Training.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: Ethical approval was obtained from the Research Ethics Committee of the Department of Pediatrics and Child Health, Addis Ababa University with minute number 008/14. Study participants were given information about the purpose and what is required from them. Their right to withdraw at any time of the study and non-participation was ensured. Informed consent was obtained from all study participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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