Educational Technology Improves ECG Interpretation of Acute Myocardial Infarction among Medical Students and Emergency Medicine Residents

INTRODUCTION: Asynchronous online training has become an increasingly popular educational format in the new era of technology-based professional development. We sought to evaluate the impact of an online asynchronous training module on the ability of medical students and emergency medicine (EM) residents to detect electrocardiogram (ECG) abnormalities of an acute myocardial infarction (AMI). METHODS: We developed an online ECG training and testing module on AMI, with emphasis on recognizing ST elevation myocardial infarction (MI) and early activation of cardiac catheterization resources. Study participants included senior medical students and EM residents at all post-graduate levels rotating in our emergency department (ED). Participants were given a baseline set of ECGs for interpretation. This was followed by a brief interactive online training module on normal ECGs as well as abnormal ECGs representing an acute MI. Participants then underwent a post-test with a set of ECGs in which they had to interpret and decide appropriate intervention including catheterization lab activation. RESULTS: 148 students and 35 EM residents participated in this training in the 2012–2013 academic year. Students and EM residents showed significant improvements in recognizing ECG abnormalities after taking the asynchronous online training module. The mean score on the testing module for students improved from 5.9 (95% CI [5.7–6.1]) to 7.3 (95% CI [7.1–7.5]), with a mean difference of 1.4 (95% CI [1.12–1.68]) (p<0.0001). The mean score for residents improved significantly from 6.5 (95% CI [6.2–6.9]) to 7.8 (95% CI [7.4–8.2]) (p<0.0001). CONCLUSION: An online interactive module of training improved the ability of medical students and EM residents to correctly recognize the ECG evidence of an acute MI.