Abstract
BackgroundElectrocardiogram (ECG) is the only practical, non-invasive method of recording and analysing cardiac abnormalities. It enables a primary healthcare (PHC) clinician to detect cardiac and non-cardiac abnormalities, some potentially life-threatening. Their early detection could save a patient’s life.AimThe aim of this study was to evaluate the competence of generalist practitioners in ECG interpretation.SettingThis study was conducted at the Annual Refresher Course, Council for Scientific and Industrial Research (CSIR), Pretoria.MethodsA cross-sectional study was conducted amongst 93 generalist practitioners, using a self-administered questionnaire containing 20 ECG tracings, commonly encountered in PHC. The tracings were categorised into primary ECG parameters, ECG emergencies and common ECG abnormalities. Competence was determined by the generalist practitioner’s number of correctly interpreted ECG tracings. Data associations were computed using the Fisher’s exact test. Statistical significance was set at p ≤ 0.05.ResultsCorrect heart rate calculation was achieved by 14/83 (16.9%), ECG rhythm by 7/83 (8.4%), acute antero-septal myocardial infarction (MI) by 29/83 (34.9%), atrial fibrillation by 19/83 (22.9%) and cute inferior MI by 22/83 (26.5%) generalist practitioners. No correlation was found between the practitioners’ number of years in practice and competence in ECG interpretation (p > 0.05). The total number of correct answers achieved by all practitioners was 274/1860 (14.7%).ConclusionThe generalist practitioners had poor competency on ECG interpretation regardless of the number of years in practice. Their poor self-rating corresponded with the number of correct answers they provided. There is a need for continuous education in ECG interpretation.
Highlights
Electrocardiogram (ECG) is the only practical, non-invasive method of recording and analysing cardiac abnormalities
A study conducted by McCrea and Saltissi[17] amongst general practitioners (GPs) in Merseyside in the United Kingdom found that there was no association between practice experience and proficiency in ECG interpretation, which suggested the need for ongoing refresher training in ECG interpretation for the GPs
This study has shown that the category with the highest self-rating of ‘Poor’ was the ECG emergencies, whilst the category with the highest self-rating of ‘Good’ was the common ECG abnormalities
Summary
Electrocardiogram (ECG) is the only practical, non-invasive method of recording and analysing cardiac abnormalities It enables a primary healthcare (PHC) clinician to detect cardiac and non-cardiac abnormalities, some potentially life-threatening. Their early detection could save a patient’s life. Studies conducted in the 1990s in the United Kingdom demonstrated that doctors had a poor understanding of the ECG.[3,4] These findings raised concern as they had a direct impact on patient safety resulting from the failure to recognise potentially life-threatening medical conditions promptly and accurately. The deficiency has persisted to the 21st century, affecting both medical practitioners and medical schools.[5,6] In a recent study conducted amongst general practitioners (GPs) and cardiologists in http://www.phcfm.org
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