Abstract
BackgroundAlthough electrocardiography is considered a core learning outcome for medical students, there is currently little curricular guidance for undergraduate ECG training. Owing to the absence of expert consensus on undergraduate ECG teaching, curricular content is subject to individual opinion. The aim of this modified Delphi study was to establish expert consensus amongst content and context experts on an ECG curriculum for medical students.MethodsThe Delphi technique, an established method of obtaining consensus, was used to develop an undergraduate ECG curriculum. Specialists involved in ECG teaching were invited to complete three rounds of online surveys. An undergraduate ECG curriculum was formulated from the topics of ECG instruction for which consensus (i.e. ≥75% agreement) was achieved.ResultsThe panellists (n = 131) had a wide range of expertise (42.8% Internal Medicine, 22.9% Cardiology, 16% Family Medicine, 13.7% Emergency Medicine and 4.6% Health Professions Education). Topics that reached consensus to be included in the undergraduate ECG curriculum were classified under technical aspects of performing ECGs, basic ECG analysis, recognition of the normal ECG and abnormal rhythms and waveforms and using electrocardiography as part of a clinical diagnosis. This study emphasises that ECG teaching should be framed within the clinical context. Course conveners should not overload students with complex and voluminous content, but rather focus on commonly encountered and life-threatening conditions, where accurate diagnosis impacts on patient outcome. A list of 23 “must know” ECG diagnoses is therefore proposed.ConclusionA multidisciplinary expert panel reached consensus on the ECG training priorities for medical students.
Highlights
Electrocardiography is considered a core learning outcome for medical students, there is currently little curricular guidance for undergraduate ECG training
Those of the prior rounds, an undergraduate curriculum could be formulated from the topics of ECG instruction for which consensus was established (i.e. ≥ 75% agreement) amongst the expert panel
A limitation to this Delphi study is the absence of Anaesthetists and Paediatricians on the expert panel for devising this undergraduate ECG curriculum. These groups of clinicians, and potentially others, should be involved in future Delphi studies for the development of ECG curricula tailored to their practice. This modified Delphi study established consensus for a list of conditions that we propose for the tuition of Conclusion We have identified undergraduate ECG teaching priorities by means of a modified Delphi study with an expert panel that consisted of specialists with a wide range of expertise
Summary
Electrocardiography is considered a core learning outcome for medical students, there is currently little curricular guidance for undergraduate ECG training. Owing to the absence of expert consensus on undergraduate ECG teaching, curricular content is subject to individual opinion. The first step in the development of an outcomes-based undergraduate medical curriculum is the performance of a needs assessment to ascertain what junior doctors are expected to know [1, 2]. The results of such a needs assessment serve to inform those involved with curricular design of the core knowledge and skills that medical students need to acquire during their undergraduate training [1]. It is important to consolidate ECG knowledge and skills before qualifying, as there is usually little formal training in electrocardiography once medical students graduate [10]
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