A Novel Tool for Assessment of Emergency Medicine Resident Skill in Determining Diagnosis and Management for Emergent Electrocardiograms: A Multicenter Study

Nicholas D. Hartman*, Natasha B. Wheaton, Kelly Williamson, Erin N. Quattromani, Jeremy B. Branzetti, Amer Z. Aldeen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background Reading emergent electrocardiograms (ECGs) is one of the emergency physician's most crucial tasks, yet no well-validated tool exists to measure resident competence in this skill. Objectives To assess validity of a novel tool measuring emergency medicine resident competency for interpreting, and responding to, critical ECGs. In addition, we aim to observe trends in this skill for resident physicians at different levels of training. Methods This is a multi-center, prospective study of postgraduate year (PGY) 1–4 residents at five emergency medicine (EM) residency programs in the United States. An assessment tool was created that asks the physician to identify either the ECG diagnosis or the best immediate management. Results One hundred thirteen EM residents from five EM residency programs submitted completed assessment surveys, including 43 PGY-1s, 33 PGY-2s, and 37 PGY-3/4s. PGY-3/4s averaged 74.6% correct (95% confidence interval [CI] 70.9–78.4) and performed significantly better than PGY-1s, who averaged 63.2% correct (95% CI 58.0–68.3). PGY-2s averaged 69.0% (95% CI 62.2–73.7). Year-to-year differences were more pronounced in management than in diagnosis. Conclusions Residency training in EM seems to be associated with improved ability to interpret “critical” ECGs as measured by our assessment tool. This lends validity evidence for the tool by correlating with a previously observed association between residency training and improved ECG interpretation. Resident skill in ECG interpretation remains less than ideal. Creation of this sort of tool may allow programs to assess resident performance as well as evaluate interventions designed to improve competency.

Original languageEnglish (US)
Pages (from-to)697-704
Number of pages8
JournalJournal of Emergency Medicine
Volume51
Issue number6
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Keywords

  • educational assessments
  • emergency electrocardiography
  • residency education

ASJC Scopus subject areas

  • Emergency Medicine

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