Key result
Self-directed learning for ECG interpretation resulted in significantly lower test scores (mean 10.7) compared to workshop or lecture-based formats (mean 12.4; p=0.003 and p=0.002, respectively).
Why the study?
Do workshop or lecture-based teaching formats improve ECG interpretation test scores compared to self-directed learning in medical students?
RCT (n=223)
Randomized to workshop, lecture, or self-directed learning
Do workshop or lecture-based teaching formats improve ECG interpretation test scores compared to self-directed learning in medical students?
Absolute Event Rate: 12.4% vs 10.7%
p-value: p=0.003 (vs workshop), 0.002 (vs lecture)
For teaching ECG interpretation to medical students, workshop and lecture formats are equally effective and both are superior to self-directed learning.
Workshop or lecture formats should be prioritized over self-directed learning for ECG training in medical students; confirms structured teaching superiority in skill acquisition.
CONTEXT: Teaching 12-lead electrocardiogram (ECG) interpretation to students and residents is a challenge for medical educators. To date, few studies have compared the effectiveness of different techniques used for ECG teaching. OBJECTIVES: This study aimed to determine if common teaching techniques, such as those involving workshops, lectures and self-directed learning (SDL), increase medical students' ability to correctly interpret ECGs. It also aimed to compare the effectiveness of these formats. METHODS: This was a prospective randomised study conducted over a 28-month period. Year 4 medical students were randomised to receive teaching in ECG interpretation using one of three teaching formats: workshop, lecture or SDL. All three formats covered the same content. Students were administered three tests: a pre-test (before teaching); a post-test (immediately after teaching), and a retention test (1 week after teaching). Each tested the same content using 25 questions worth 1 point each. A mixed-model repeated-measures analysis of variance (anova) with least squares post hoc analysis was conducted to determine if differences in test scores between the formats were statistically significant. RESULTS: Of the 223 students for whom data were analysed, 79 were randomised to a workshop, 82 to a lecture-based format and 62 to SDL. All three teaching formats resulted in a statistically significant improvement in individual test scores (p < 0.001). Comparison of the lecture- and workshop-based formats demonstrated no difference in test scores (marginal mean [MM] for both formats = 12.4, 95% confidence interval [95% CI] 11.7-13.2]; p = 0.99). Test scores of students using SDL (MM = 10.7, 95% CI 9.8-11.5) were lower than those of students in the workshop (p = 0.003) and lecture (p = 0.002) groups. CONCLUSIONS: Compared with those taught using workshop- and lecture-based formats, medical students learning ECG interpretation by SDL had lower test scores.
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Mahler et al. (2011) conducted an RCT in ECG interpretation (Medical education) (n=223). Workshop or lecture-based teaching vs. Self-directed learning (SDL) was evaluated on Test scores on a 25-question ECG interpretation test (p=0.003 (vs workshop), 0.002 (vs lecture)). Self-directed learning for ECG interpretation resulted in significantly lower test scores (mean 10.7) compared to workshop or lecture-based formats (mean 12.4; p=0.003 and p=0.002, respectively).
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