[The comparison of 4th, 5th and 6th year medical students knowledge of rules and practical skills in the interpretation of electrocardiograms at Jagiellonian University].

INTRODUCTION: The electrocardiogram (ECG) examination is one of the most frequent administered diagnostic tests. It is commonly ordered by General Practitioners, and it has became a routinely administered examination during admission to the hospital. During their studies, medical students has numerous opportunities to review and interpret the results of these tests.

AIM OF THE STUDY: The aim of our research was to statistically compare and contrast the knowledge of the rules and practical skills in the interpretation of ECGs in 4th, 5th and 6th year medical students at Jagiellonian University. We wanted to better define in which year the students acquire the most of their clinical skills and determine if 6th year students have sufficient knowledge and skills to adequately perform in their future career. We additionally wanted to understand from which source students draw their knowledge of the ECG.

MATERIAL AND METHODS: The population of 249- 4th, 5th and 6th year medical students of Jagiellonian University were asked to reply to an anonymous questionnaire. The questionnaire was comprised of three parts. The fist part contains four simple ECGs (STEMI, RBBB, PVC, normogram--sinus rhythm). The second part contained six questions regarding their theoretical knowledge. The third part contained seven questions which evaluated the students' background and approach to the problem. Students filled the questionnaire without prior preparation to avoid the short-term "examination knowledge".

RESULTS: The question that was most frequent answered correctly was question regarding the proper time (in milliseconds) of QRS complex (24.1%). Differences in the percentage of correct answers to questionnaire amongst 4th and 5th year students were statistically uncharacteristic. The percentage of correct answers of 6th year students increased by about 16% (p < 0.0001). The comparison of answers between 6th year students - who in prior semester completed a cardiology course (group A 6th year) and 6th year students who did not yet complete cardiology course (group B 6th year) showed significant improvement in group A in the percentage of correct answers for all questions about ECG. The percentage of correct answers in group A was an average 62% and in group B 45.5% (p < 0.00025). In case of 4th and 5th year students, the picture was uncharacteristic. Self study of ECG had a significant, positive influence in the percentage of correct answers amongst respondents, especially in the 6th year student population. Improvement was also seen in 4th and 5th students, but to a lesser degree. Among the 6th year students who benefited from self study, their percentage of correct answers was nearly two times then that of their fellow of 6th year students who did not self study (p < 0.0001). Only 3 of questioned students stated that they felt that their present knowledge of ECG is sufficient.

CONCLUSIONS: 4th and 5th year students have comparable knowledge of ECG. 6th year students showed a significantly improved ability to interpret the ECG, especially those who had already completed cardiology course in present term. The increase in skills of interpretation of ECG is gained primarily by self study.