Foundational ECG Education for Physician Assistant Students: Outcomes of an Active Learning Intervention

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Physician Assistant Students (n=42). Intervention: Active learning ECG session vs. Pre-intervention baseline. Primary outcome: Mean item-level performance on ECG knowledge assessment.

Q: What does this research mean for the field?

A 90-minute active learning ECG session improves first-year physician assistant students' knowledge of ECG acquisition and electrophysiology by 10.3 percentage points and substantially increases their clinical confidence. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Nicholas H. Jasion; Elizabeth K. Randolph

doi:10.18131/zbt3c-ds835

April 29, 2026Open Access

Foundational ECG Education for Physician Assistant Students: Outcomes of an Active Learning Intervention

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Key result

A 90-minute active learning ECG session is linked to a ~10-point increase in PA student knowledge.

n=42

Why the study?

ECG acquisition and cardiac electrophysiology are frequently undertaught in physician assistant cardiology curricula, with greater emphasis placed on pattern recognition than foundational ECG principles.

Does a single active learning ECG session improve knowledge and confidence in ECG acquisition and electrophysiology in first-year PA students?

Key Points

To examine whether a single 90-minute active learning session improves first-year physician assistant students' knowledge and confidence in ECG acquisition and cardiac electrophysiology.
Forty-two first-year physician assistant students participated in a 90-minute active learning session combining instruction and a hands-on electrode placement activity.
Knowledge and self-reported confidence were evaluated via voluntary pre-assessment (n=39, 93% response rate) and post-assessment (n=24, 62% response rate) surveys containing 16 item-level questions.
Pre- and post-assessments revealed a 10.3 percentage point improvement in item-level performance, improving from a pre-assessment mean difficulty of 70.9% (SD = 20.8%).
The largest gains occurred in cardiac plane orientation (e.g., identifying anterior leads increased from 38% to 83%, Cohen's h = 0.963) and lead reversal recall (49% to 92%, Cohen's h = 1.011).
During the baseline in-class activity (n=36), students scored an overall combined accuracy of 31% (mean 6.2 out of 20 points), with higher accuracy on limb electrodes (40%) than precordial electrodes (24%).

Study Design

Type

Observational (n=42)

Multicenter

No

Structured PICO

Does a single active learning ECG session improve knowledge and confidence in ECG acquisition and electrophysiology in first-year PA students?

P

Population

n=42 first-year physician assistant (PA) students

I

Intervention

Single 90-minute active learning ECG session focusing on ECG acquisition and foundational ECG principles

C

Comparator

Pre-intervention baseline (pre- and post-assessment design)

O

Outcome

Knowledge and confidence in ECG acquisition and electrophysiology

Main Result

Absolute Event Rate: 81.2% vs 70.9%

Limitations

Decline in response rate from pre-assessment (93%) to post-assessment (62%) due to voluntary survey participation
Inability to link individual student scores across time points due to anonymous data collection, preventing matched-pairs statistical testing
Potential fatigue effect on post-assessment scores as it was administered immediately following the 90-minute lecture without a break

Implication

A dedicated 90-minute active learning session improved PA students' foundational ECG knowledge and confidence in performing a 12-lead ECG.

Abstract

ECG acquisition and cardiac electrophysiology are frequently undertaught in physician assistantcardiology curricula, with greater emphasis placed on pattern recognition than foundational ECGprinciples. This study examined whether a single active learning ECG session improved first-year PAstudents’ knowledge and confidence in ECG acquisition and electrophysiology. Forty-two studentsparticipated in a 90-minute session; pre- and post-assessments revealed a 10.3 percentage pointimprovement in item-level performance, with the greatest gains in cardiac plane orientation andfoundational recall. Student confidence in performing a 12-lead ECG increased substantially. Thesefindings support integrating dedicated ECG acquisition instruction and hands-on skills training into PAcardiology curricula.

Discussion

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Cite This Study

Jasion et al. (2026) conducted an observational in Physician Assistant Students (n=42). Active learning ECG session vs. Pre-intervention baseline was evaluated on Mean item-level performance on ECG knowledge assessment. A 90-minute active learning ECG session improved first-year PA students' mean item-level performance on ECG acquisition and electrophysiology knowledge by 10.3 percentage points.

synapsesocial.com/papers/69f594fc71405d493affff1d https://doi.org/10.18131/zbt3c-ds835

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Foundational ECG Education for Physician Assistant Students: Outcomes of an Active Learning Intervention

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Foundational ECG Education for Physician Assistant Students: Outcomes of an Active Learning Intervention

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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