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医疗保健专业人员的心电图解读能力。

ECG Interpretation Proficiency of Healthcare Professionals.

作者信息

Kashou Anthony H, Noseworthy Peter A, Beckman Thomas J, Anavekar Nandan S, Cullen Michael W, Angstman Kurt B, Sandefur Benjamin J, Shapiro Brian P, Wiley Brandon W, Kates Andrew M, Huneycutt David, Braisted Andrew, Smith Stephen W, Baranchuk Adrian, Grauer Ken, O'Brien Kevin, Kaul Viren, Gambhir Harvir S, Knohl Stephen J, Albert David, Kligfield Paul D, Macfarlane Peter W, Drew Barbara J, May Adam M

机构信息

Mayo Clinic, Rochester, Minnesota.

Mayo Clinic, Rochester, Minnesota.

出版信息

Curr Probl Cardiol. 2023 Oct;48(10):101924. doi: 10.1016/j.cpcardiol.2023.101924. Epub 2023 Jul 1.

Abstract

ECG interpretation is essential in modern medicine, yet achieving and maintaining competency can be challenging for healthcare professionals. Quantifying proficiency gaps can inform educational interventions for addressing these challenges. Medical professionals from diverse disciplines and training levels interpreted 30 12-lead ECGs with common urgent and nonurgent findings. Average accuracy (percentage of correctly identified findings), interpretation time per ECG, and self-reported confidence (rated on a scale of 0 [not confident], 1 [somewhat confident], or 2 [confident]) were evaluated. Among the 1206 participants, there were 72 (6%) primary care physicians (PCPs), 146 (12%) cardiology fellows-in-training (FITs), 353 (29%) resident physicians, 182 (15%) medical students, 84 (7%) advanced practice providers (APPs), 120 (10%) nurses, and 249 (21%) allied health professionals (AHPs). Overall, participants achieved an average overall accuracy of 56.4% ± 17.2%, interpretation time of 142 ± 67 seconds, and confidence of 0.83 ± 0.53. Cardiology FITs demonstrated superior performance across all metrics. PCPs had a higher accuracy compared to nurses and APPs (58.1% vs 46.8% and 50.6%; P < 0.01), but a lower accuracy than resident physicians (58.1% vs 59.7%; P < 0.01). AHPs outperformed nurses and APPs in every metric and showed comparable performance to resident physicians and PCPs. Our findings highlight significant gaps in the ECG interpretation proficiency among healthcare professionals.

摘要

心电图解读在现代医学中至关重要,然而,对医疗保健专业人员来说,要达到并维持相应能力可能具有挑战性。量化能力差距可为应对这些挑战的教育干预提供依据。来自不同学科和培训水平的医学专业人员解读了30份具有常见紧急和非紧急发现的12导联心电图。评估了平均准确率(正确识别发现的百分比)、每份心电图的解读时间以及自我报告的信心(按0分[不自信]、1分[有些自信]或2分[自信]的量表评分)。在1206名参与者中,有72名(6%)初级保健医生(PCP)、146名(12%)心内科住院医师(FIT)、353名(29%)住院医生、182名(15%)医学生、84名(7%)高级执业提供者(APP)、120名(10%)护士和249名(21%)专职医疗人员(AHP)。总体而言,参与者的平均总体准确率为56.4%±17.2%,解读时间为142±67秒,信心评分为0.83±0.53。心内科FIT在所有指标上均表现出色。与护士和APP相比,PCP的准确率更高(分别为58.1%、46.8%和50.6%;P<0.01),但低于住院医生(58.1%对59.7%;P<0.01)。AHP在各项指标上均优于护士和APP,其表现与住院医生和PCP相当。我们的研究结果凸显了医疗保健专业人员在心电图解读能力方面存在的显著差距。

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