Techniques for teaching electrocardiogram interpretation: self-directed learning is less effective than a workshop or lecture.

CONTEXT: Teaching 12-lead electrocardiogram (ECG) interpretation to students and residents is a challenge for medical educators. To date, few studies have compared the effectiveness of different techniques used for ECG teaching.

OBJECTIVES: This study aimed to determine if common teaching techniques, such as those involving workshops, lectures and self-directed learning (SDL), increase medical students' ability to correctly interpret ECGs. It also aimed to compare the effectiveness of these formats.

METHODS:   This was a prospective randomised study conducted over a 28-month period. Year 4 medical students were randomised to receive teaching in ECG interpretation using one of three teaching formats: workshop, lecture or SDL. All three formats covered the same content. Students were administered three tests: a pre-test (before teaching); a post-test (immediately after teaching), and a retention test (1 week after teaching). Each tested the same content using 25 questions worth 1 point each. A mixed-model repeated-measures analysis of variance (anova) with least squares post hoc analysis was conducted to determine if differences in test scores between the formats were statistically significant.

RESULTS: Of the 223 students for whom data were analysed, 79 were randomised to a workshop, 82 to a lecture-based format and 62 to SDL. All three teaching formats resulted in a statistically significant improvement in individual test scores (p < 0.001). Comparison of the lecture- and workshop-based formats demonstrated no difference in test scores (marginal mean [MM] for both formats = 12.4, 95% confidence interval [95% CI] 11.7-13.2]; p = 0.99). Test scores of students using SDL (MM = 10.7, 95% CI 9.8-11.5) were lower than those of students in the workshop (p = 0.003) and lecture (p = 0.002) groups.

CONCLUSIONS: Compared with those taught using workshop- and lecture-based formats, medical students learning ECG interpretation by SDL had lower test scores.