Clinical aptitude in the interpretation of electrocardiogram in a sample of medical interns

Abstract

Introduction: Cardiovascular diseases are the leading cause of death in Mexico. The education in the electrocardiogram (ECG) interpretation is deficient in students and residents.

Objective: To assess the student’s skills on ECG interpretation.

Methods and materials: Comparative survey of 98 students, 70 in medical internship and 28 residents of three specialties and a group of others, in four general hospitals. Dependent variable: Calculated medians in instrument conformed to 72 items, with the next indicators: rhythm (15), measurements (20), morphology (20) and diagnostic (17), in five clinical cases (auricular fibrillation, acute infarct, left ventricular hypertrophy, left bundle branch block and normality). Theorical, content and construct validity by three cardiologist, three internist`s, and one family physician (Delphi technique) was performed. Pre-test pilot in 20 students was obtained. Reliability 0.86 (Kuder-Richardson). Statistics: U Mann-Whitney and Kruskal-Wallis (intergroup comparisons), Spearman and ANOVA tests were used.
Results: The highest rates were obtained (44) by residents, with half of the expected (72), the interns obtained a less rate (39). There was difference between the interns groups (p<0.05), but not between the ones that started six months earlier. Internal medicine residents showed better rates median (48) vs. pediatricians (p<0.03, median 31).
Discussion: the results show the low knowledge in the interpretation of ECG’S. There is no difference between groups of interns who had one semester; this translates to a clinical disengagement confirmed by the low rates of the residents who had completed 8 months of their first year.

Conclusions: It’s important to link the learning of ECG with the clinic activity while internship and residence.