Evaluation of a web-based ECG-interpretation programme for undergraduate medical students

Mikael Nilsson, Gunilla Bolinder, Claes Held, Bo-Lennart Johansson, Uno Fors, Jan Ostergren, Mikael Nilsson, Gunilla Bolinder, Claes Held, Bo-Lennart Johansson, Uno Fors, Jan Ostergren

Abstract

Background: Most clinicians and teachers agree that knowledge about ECG is of importance in the medical curriculum. Students at Karolinska Institute have asked for more training in ECG-interpretation during their undergraduate studies. Clinical tutors, however, have difficulties in meeting these demands due to shortage of time. Thus, alternative ways to learn and practice ECG-interpretation are needed. Education offered via the Internet is readily available, geographically independent and flexible. Furthermore, the quality of education may increase and become more effective through a superior educational approach, improved visualization and interactivity.

Methods: A Web-based comprehensive ECG-interpretation programme has been evaluated. Medical students from the sixth semester were given an optional opportunity to access the programme from the start of their course. Usage logs and an initial evaluation survey were obtained from each student. A diagnostic test was performed in order to assess the effect on skills in ECG interpretation. Students from the corresponding course, at another teaching hospital and without access to the ECG-programme but with conventional teaching of ECG served as a control group.

Results: 20 of the 32 students in the intervention group had tested the programme after 2 months. On a five-graded scale (1- bad to 5 - very good) they ranked the utility of a web-based programme for this purpose as 4.1 and the quality of the programme software as 3.9. At the diagnostic test (maximal points 16) by the end of the 5-month course at the 6th semester the mean result for the students in the intervention group was 9.7 compared with 8.1 for the control group (p = 0.03).

Conclusion: Students ranked the Web-based ECG-interpretation programme as a useful instrument to learn ECG. Furthermore, Internet-delivered education may be more effective than traditional teaching methods due to greater immediacy, improved visualisation and interactivity.

Figures

Figure 1
Figure 1
The learning object explains the depolarization process in the myocardium by an animation and an explanation in text.
Figure 2
Figure 2
The learning object presents one of the ECG cases in the interactive ECG interpretation module. The cases are based on a clinical history. The student is asked to interpret the ECG. One of the tools they can use for this purpose is the special moveable ruler. The ECG can be magnified together with the ruler for measuring the components of the ECG-complex. The student's interpretation can be compared with the interpretation of an expert.
Figure 3
Figure 3
The learning object is an example of one of the theoretical questions. The students are asked to interpret the rhythm by choosing from one of 4 alternatives. Directly after answering the question feedback is given, where the right answer is enlightened.
Figure 4
Figure 4
Individual scores at the diagnostic test by the end of the sixth semester. Students in the test group are represented in red bars (n = 17) and in the control group in grey bars (n = 25). Maximal points were 16. The difference between the groups was statistically significant (p = 0.03).

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Source: PubMed

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