APDIM: New web-based tool could help docs correctly read ECGs

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A team of physicians has developed a web-based training and examination program for reading ECGs—an interactive computer program to teach and assess the competence of doctors in training, according to research presented on Oct. 31 during the annual meeting of the Association of Program Directors in Internal Medicine in Orlando.

Researchers said that there is no current, uniform way to teach doctors in training how to interpret an ECG or assess their competence in the interpretation.

“There is no mechanism now for establishing competency among internists or family physicians or for an interim analysis of how a trainee is performing,” said team leader R. Michael Benitez, MD, associate professor of medicine at the University of Maryland School of Medicine in Baltimore and director of the Cardiovascular Fellowship Training Program.

The web-based computer module, called ACCIS (American College of Cardiology In-Service), includes both an assessment section and a teaching materials section, according to the researchers. The test-taker is presented with 50 ECGs that focus on 12 key categories of ECG interpretation. Test-takers and training program directors receive the test results. In the case of an incorrect diagnosis, the test-taker is referred to more than 100 case studies with additional teaching materials for self-directed learning. The results will be followed over time to determine if the training program actually improves ECG knowledge and will be used to set benchmarks of competency in ECG interpretation.

Two major medical accrediting bodies, the Accreditation Council for Graduate Medical Education's Residency Review Committee for Internal Medicine and the American College of Physicians, recognize the importance of establishing competent ECG interpretation during internal medicine residency. However, they noted that there is no consensus on how competence should be achieved, documented or even defined.

Physicians who will practice general internal medicine do not have to pass an ECG interpretation section in order to pass their board examination, according to Benitez.

General practitioners are often the first to detect a person with an underlying cardiac disease during a general screening evaluation. "They need to correctly identify and diagnose problems that can significantly and imminently affect the health of their patients,” Benitez said.