Hoyle Rachel J, Walker Katherine J, Thomson Graeme, Bailey Michael
Emergency Department, Casey Hospital, Berwick, Victoria, Australia.
Emerg Med Australas. 2007 Apr;19(2):143-50. doi: 10.1111/j.1742-6723.2007.00946.x.
To assess whether electrocardiogram (ECG) interpretation accuracy improves with advancing years of emergency medicine training.
A prospective cross-sectional double-blinded study of emergency medicine trainees attending teaching sessions in ACEM accredited Victorian hospitals. Subjects completed a survey about level of training, rotations completed and ECG training. They were then asked for the 'main diagnosis' on 10 clinically significant ECG. Those in their fourth year of advanced training onwards, or in active preparation for fellowship examination (senior trainees) were compared with trainees in earlier years (other trainees).
There were 122 trainees surveyed in total. In the present study, 48/122 were senior trainees and 74/122 were other trainees. The overall accuracy of ECG interpretation was 67.5% (95% confidence interval [CI] 63.2-71.8%) for the senior trainees and 49.6% (95% CI 45.2-53.9%) for the others. Results for some of the individual ECG were: left bundle branch block: 81.3% (95% CI 69.9-92.6%) seniors and 58.1% (95% CI 46.6-69.7%) others; ventricular tachycardia: 43.8% (95% CI 29.3-58.2%) seniors and 37.8% (95% CI 26.5-49.2%) others; and ventricular fibrillation: 70.8% (95% CI 57.6-84.1%) seniors and 63.5% (95% CI 52.2-74.9%) others.
There is an improvement in ECG interpretation accuracy with advancing years of emergency medicine training in Victoria. There exists, however, a low level of accuracy for some critical ECG diagnoses. There is a call by trainees for more formalized and regular ECG education to begin earlier in their training.
评估随着急诊医学培训年限的增加，心电图（ECG）解读的准确性是否会提高。
对在澳大利亚急诊医学学院（ACEM）认可的维多利亚州医院参加教学课程的急诊医学实习生进行一项前瞻性横断面双盲研究。受试者完成了一项关于培训水平、已完成的轮转和心电图培训的调查。然后要求他们对10份具有临床意义的心电图做出“主要诊断”。将处于高级培训第四年及以后的实习生，或正在积极准备专科医师资格考试的实习生（高年级实习生）与早期的实习生（其他实习生）进行比较。
总共调查了122名实习生。在本研究中，48/122为高年级实习生，74/122为其他实习生。高年级实习生心电图解读的总体准确率为67.5%（95%置信区间[CI]63.2 - 71.8%），其他实习生为49.6%（95%CI 45.2 - 53.9%）。部分个体心电图的结果如下：左束支传导阻滞：高年级实习生为81.3%（95%CI 69.9 - 92.6%），其他实习生为58.1%（95%CI 46.6 - 69.7%）；室性心动过速：高年级实习生为43.8%（95%CI 29.3 - 58.2%），其他实习生为37.8%（95%CI 26.5 - 49.2%）；室颤：高年级实习生为70.8%（95%CI 57.6 - 84.1%），其他实习生为63.5%（95%CI 52.2 - 74.9%）。
在维多利亚州，随着急诊医学培训年限的增加，心电图解读的准确性有所提高。然而，对于一些关键的心电图诊断，准确性水平较低。实习生呼吁在培训早期开始更正规、定期的心电图教育。
