A Spaced Learning, Small–Group Course in Electrocardiogram Interpretation: A Peer–Led Pilot Study in Graduate Internal Medicine Education

Abstract Background Electrocardiogram (ECG) interpretation remains a perennial challenge for trainees, however a superior method of instruction for ECG analysis has yet to be determined. Many physicians struggle with a lack of confidence in ECG analysis, leading to medical errors. A body of current literature supports the benefits of small-group sessions, spaced learning, and peer-led endeavors in medical education. The authors’ aim was to develop a pilot ECG interpretation course, utilizing peer-led teaching in a spaced learning format, that was deliverable in the graduate medical education context. Methods As the trend of the “resident as teacher” model continues to blossom, the authors implemented a resident–led, small–group, spaced learning course in ECG interpretation. The course was conducted with participation of first–year Internal Medicine residents during busy inpatient rotations at a major academic medical center in February 2022, and used surveys to gauge learner confidence, competence, and subjective experience. Results This course was designed and conducted by residents, for residents, and increased learner competence and comfort in interpreting ischemic ECG patterns, conduction system pathology, supraventricular arrhythmias and ventricular rhythms. Scores reflecting confidence in ECG interpretation showed a trend towards improvement following this course, trainees preferred this course to traditional ECG didactic courses, and participants indicated that they would recommend it to others at their training level. Conclusions Given the feasibility and scalability of this intervention, the authors’ next steps will be to incorporate this course into the annual incoming resident orientation, and directly compare the perceived and measurable learning outcomes against traditional didactic methods on a larger scale.