Naidoo Relisha K, Havenga Duncan M, Morris David
Division of Emergency Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
J Coll Med S Afr. 2025 May 30;3(1):190. doi: 10.4102/jcmsa.v3i1.190. eCollection 2025.
Interpreting an electrocardiogram (ECG) is challenging for junior doctors, and proficiency gaps exist commonly worldwide. This study assessed interpretation accuracy and self-confidence of South African intern doctors in identifying acute myocardial ischaemia on an ECG and analysed the impact of an education strategy.
This descriptive, quantitative study included a prospective analytical component using a standardised teaching session. All participants completed an ECG interpretation test and self-confidence questionnaire both before and after the teaching session. Descriptive statistics summarised demographics; data analyses included means, medians, modes, and individualised comparisons of pre- and post-teaching test scores and self-confidence.
One hundred and sixty-four interns were analysed. At baseline, interns demonstrated above-average accuracy (mean test score 60.1%) and most declared moderate insecurity with ECG interpretation. Post-teaching, accuracy improved marginally (mean test score 65.8%) ( < 0.001), and self-confidence improved drastically with most becoming moderately confident ( < 0.001). However, while there was a significant improvement in the recognition of four ischaemic and two non-ischaemic ECG patterns, the misinterpretation of one non-ischaemic ECG significantly worsened, and there was an insignificant impact on half of the ischaemic ECGs tested.
Interns demonstrated above-average accuracy in identifying acute myocardial ischaemia on an ECG with moderate insecurity at baseline. While a teaching session improved self-confidence, its impact on accuracy was mixed. This highlights a need for ongoing training of South African intern doctors in ECG interpretation.
This study was the first to assess ECG interpretation accuracy and associated self-confidence of South African intern doctors, thereby offering a local perspective on this essential skill.
对于初级医生而言，解读心电图（ECG）颇具挑战性，全球普遍存在能力差距。本研究评估了南非实习医生在通过心电图识别急性心肌缺血方面的解读准确性和自信心，并分析了一种教育策略的影响。
这项描述性定量研究包括一个使用标准化教学课程的前瞻性分析部分。所有参与者在教学课程前后均完成了心电图解读测试和自信心问卷。描述性统计总结了人口统计学数据；数据分析包括均值、中位数、众数以及教学前和教学后测试分数与自信心的个体化比较。
对164名实习生进行了分析。在基线时，实习生表现出高于平均水平的准确性（平均测试分数60.1%），且大多数人表示对心电图解读存在中度不安全感。教学后，准确性略有提高（平均测试分数65.8%）（<0.001），自信心大幅提高，大多数人变得中度自信（<0.001）。然而，虽然在识别四种缺血性和两种非缺血性心电图模式方面有显著改善，但对一种非缺血性心电图的误判显著恶化，并且对一半的测试缺血性心电图影响不显著。
实习生在通过心电图识别急性心肌缺血方面表现出高于平均水平的准确性，基线时存在中度不安全感。虽然一次教学课程提高了自信心，但其对准确性的影响好坏参半。这凸显了对南非实习医生进行心电图解读持续培训的必要性。
本研究首次评估了南非实习医生的心电图解读准确性及相关自信心，从而为这一关键技能提供了本地视角。
