Improving ECG interpretation skills of junior doctors: Embracing the rhythm of the heart

On a daily clinical basis, it is common for healthcare professionals to encounter a large number of patients presenting with cardiovascular related issues. The ability to accurately interpret and recognise life-threatening features on an electrocardiogram (ECG) is crucial for junior doctors to make timely referrals and formulate precise care plans. Conversely, the skill of ruling out significant cardiovascular system (CVS) problems can also prevent unnecessary admissions, investigations, and inappropriate referrals to cardiology. In our experience at Queen Elizabeth Hospital, Kings Lynn, we have observed a notable gap in the ECG interpretation skills of junior doctors during post-take ward rounds and front door clerking. It is evident that there is a need to reinforce the basic ECG knowledge of junior doctors to improve the overall quality of patient care within the trust. The project took place from May 2023 to July 2023 and completed two PDSA cycles. During each cycle, junior doctors were surveyed about their confidence level in interpreting ECGs and the challenges they were facing. Based on their responses, teaching topics were developed to address the specific challenges that junior doctors encounter in their daily clinical practice. A weekly ECG teaching session was held every Sunday evening via Microsoft Team Meeting. All presenters and facilitators of these sessions received feedback from the attendees to assess the effectiveness of the teaching. At the end of the first cycle, another survey was conducted to analyse and compare the results with the previous survey. The second cycle was then planned based on the analysis of the first cycle's report, incorporating the feedback from junior doctors. As shown in Fig. 2, overall ECG interpretation skills of junior doctor improved from being 0% very confident to 28.6% very confident. 33% of survey responders were fairly confident pre teaching which improved to 64% after completing second cycle. In summary, deciphering ECGs is a fundamental clinical proficiency that poses a considerable challenge for many novice physicians. Nevertheless, with the aid of adequate knowledge reinforcement, structured theoretical education, and interactive case-based conversations, this proficiency can be approached in a manner that enables most doctors to become well-acquainted and self-assured in handling various ECG types, encompassing ischaemia, arrhythmias, and heart blocks. We take great pride in showcasing our Quality Improvement Project (QIP) as it has successfully exhibited a substantial enhancement. However, it is crucial that we uphold and cultivate our knowledge and skills through continuous learning.