298 - Use of a Survey-Based Consensus Method in the Development of a Novel Longitudinal Resident Pediatric ECG Curriculum

Poster Number: 298
Publication Number: 298.421

Christopher Teng, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Nicholas J. Santaniello, Childrens Hospital of Philadelphia, Staten Island, NY, United States; Dorene F. Balmer, University of Pennsylvania, Philadelphia, PA, United States; Mary E. Teresczuk, CHOP, Philadelphia, PA, United States; Erin H. Sieke, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Gia Yannekis, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Katherine Donches, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Rebecca Tenney-Soeiro, Childrens Hospital of Philadelphia, Swarthmore, PA, United States; Jeanine Ronan, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Beth Rezet, CHOP, Havertown, PA, United States; Christopher M. Janson, Childrens Hospital of Philadelphia, Philadelphia, PA, United States

Background: Residents are frequently expected to order and review electrocardiograms (ECGs) in the course of routine patient care. However, expectations for resident ECG interpretation are unclear, and formal training in pediatric ECG interpretation varies widely.

Objective: This study assessed baseline resident exposure to and perceptions on ECG interpretation training. We also aimed to develop a set of core learning topics in pediatric ECG to form the basis of a longitudinal pediatric ECG interpretation curriculum.

Design/Methods: Pediatric residents were invited to complete a needs assessment on perceptions and prior experiences regarding ECG interpretation. 15 attendings representing subspecialties with frequent resident ECG exposure (cardiology, general pediatrics, emergency medicine, critical care, and adolescent medicine) were invited to participate in an iterative survey-based consensus method to refine a set of core ECG findings for curricular inclusion, with proposed training levels for each item. Between surveys, summarized results were shared for review. A pilot PL2 didactic session was designed based on the core PL2-specific findings identified. Participants were invited to fill out pre- and post-surveys, assessing perceived confidence and testing interpretation of 6 representative sample ECGs. Change in point performance on test questions was assessed with a paired t-test.

Results: 60% of residents (n=97) completed the needs assessment, reporting low clarity regarding ECG interpretation expectations and relatively low confidence in both interpretation skills and current training (Figure 1). The consensus method included 52 initial findings, of which 16 were excluded. 4 were added for a final list of 40 findings (Table). Based on participant input, findings were sorted into PL1, PL2, and PL3 curricula. The final list was approved by 15/15 participants. 11 PL2s participated in the pilot session; of 7 survey respondents, there were trends in increased confidence with ECG identification and clarity regarding ECG interpretation expectations (Figure 2). Performance on interpretation of sample ECGs improved by an average of 2.7/14 total points (p < 0.01).Conclusion(s): At baseline, residents report a need for clearer expectations and formal training regarding pediatric ECG interpretation. An expert-based consensus method drawing from a broad range of subspecialties generated an actionable list of training level-specific core ECG interpretation topics. Didactic sessions based on such a framework are promising in improving both subjective perception and objective performance of ECG interpretation skills.
Teng_CV_2022.pdf
Table. Final list of ECG findings based on consensus method.