Electrocardiogram interpreting technician: Training and role in a contemporary electrocardiogram practice

Abstract

In 1974, the annual electrocardiogram (ECG) volume at Mayo Clinic had exceeded 100000 ECGs; and Dr Ralph E Smith, ECG Laboratory Director, introduced the concept of the ECG Interpreting Technician (EIT) to assist the cardiologist. The first 2 technicians started in 1975, and one continues working as the Lead EIT. In 2007, there were 10 EITs interpreting 180670 ECGs, 10397 Holter recordings, and 4220 event recordings. This review presents the training of and experience with EITs to assist with ECG interpretation in the Mayo Clinic ECG Laboratory. The EITs are typically selected from the ECG technician group, although on occasion individuals have had other cardiovascular backgrounds including technicians experienced with hospital bedside monitoring. The ECG technicians participate in regularly scheduled ECG interpreting classes presented by the ECG Laboratory Supervisor or Education Coordinator before becoming EITs and are chosen to be EITs based on their skills and interest displayed in the classes and as ECG technicians. Once selected, the EITs undergo an intensive training program that allows development of skills for ECG interpretation (Table 1). The EITs begin their training by spending 2 weeks working one-on-one with the Lead EIT learning ECG basic findings including rhythm, conduction, hypertrophy, and myocardial infarction. After this 2-week orientation, the new EITs will review with the Lead EIT 12-lead ECGs that have been finalized by the cardiologist. This aspect of EIT training takes on average 1 month but can range between 2 weeks and 3 months depending on how quickly the new EITs learn ECG interpretation. During this portion of the training, the new EITs will evaluate 150 to 200 ECGs daily. After this one-on-one training with the Lead EIT, the new EITs then read ECGs by themselves, overreading the initial