The essential skill of ECG interpretation: How do we define and improve competency?

It is hard to imagine something more central to the practice of medicine than the performance and interpretation of the ECG. This simple, non-invasive, and ubiquitous test is essential for the diagnosis of a wide range of medical conditions, across a broad range of medical settings—the emergency room, primary care office, intensive care unit and beyond. For nearly 100 years, this test has held up as a fundamental pillar of medical practice. Unfortunately, proficiency in ECG interpretation is not a universal skill, and the barriers in achieving ECG fluency are rooted at multiple levels of medical curricula. To aid in solving the problem of declining ECG competency, clearly defined skill competencies for all healthcare professionals are needed. Once competency expectations are set, centralised educational resources may be used to achieve these benchmarks. The medical education community has been the driver to spearhead such societal initiatives and will need to be integral in the rejuvenation of proper ECG interpretation. In this context, medical educators ought to inspire the next generation as well as current providers to revisit and reinvigorate the complexities and beauty of ECG interpretation.