Electrocardiography interpretation competency among pediatric and child health residents at Addis Ababa University, Ethiopia.

backgroundElectrocardiography (ECG) interpretation competency is vital to ensure the timely initiation of life-saving treatment for emergent ECG conditions. This competency has not been well-studied among pediatric and child health residents. Hence, the study aimed to determine the competency in ECG interpretation and its predictors among residents at the National University of Ethiopia.

methodsThis cross-sectional study employed standard ECG Wave-Maven strips, a web-based ECG self-assessment tool. The association between dependent and independent variables was tested using a chi-square test and Fisher's exact test.

resultsThe study included 95 residents with male dominance, 61.1%. The median age of study participants was 29 years (IQR: 28-30). The median service years before residency enrollment was 2 years (IQR:1-3). More than half, 51.6%, received 1-3 hours of ECG lectures. ECG training insufficiency was reported by 75.8% of participants. Residents were not confident in their ECG readings,65.3%. The majority,67.3%, partially or totally relied on computer-generated ECG (C-ECG) reports during ECG interpretation. The majority ordered up to 5 ECGs per month, 75.8% and sought consultation for ECG reading most of the time, 58.9%. Common emergent ECG conditions were rarely diagnosed correctly: long QTC syndrome, 42.1%; Complete heart block (CHB), 10.5%; supraventricular tachycardia (SVT), 9.5%; ventricular tachycardia, 8.4% and hyperkalemia, 4.2%. Young residents, 29 years or less, diagnosed sinus rhythm correctly, p = 0.017. Year I and II residents correctly diagnosed sinus arrhythmia, p = 0.001. CHB diagnosis was associated with the use of C-ECG reports, p = 0.011. SVT diagnosis was associated resident's juniority, p = 0.018 and the number of monthly ECG orders, p = 0.018. Atrial fibrillation diagnosis was associated with the service years before residency enrollment, p = 0.046. The diagnosis of acute pericarditis was associated with monthly resident's ECG orders, p = 0.034.

conclusionIn this study, three-fourths of pediatric and child health residents reported insufficient ECG training during their residency. They were not confident in their ECG readings. ECG diagnosis of common life-threatening conditions was missed. Resident's age, year of residency, monthly ECG orders, service years before residency enrollment and reliance on C-ECG reports predicted the correct diagnosis of an ECG abnormality or rhythm. Well-designed and structured urgent ECG training sessions are required to fill this gap among the residents.