1
|
Chen Y, Wen H, Huang Z, Zhang R, Peng L. Advancing arrhythmia education through the CDIO approach: a new paradigm in nursing student training. BMC Nurs 2024; 23:427. [PMID: 38918825 PMCID: PMC11197327 DOI: 10.1186/s12912-024-02118-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/20/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The accurate diagnosis and effective management of arrhythmias are crucial, with nurses playing a key role in the early detection and treatment, significantly impacting patient outcomes. Improving education on arrhythmias among nurses, especially in critical care and perioperative settings, can enhance patient safety and the quality of care. METHODS A total of 116 trainee nurses were randomly divided into two groups: one utilizing the conceive-design-implement-operate (CDIO) model and the other employing a traditional lecture-based learning (LBL) method, to undergo arrhythmia training. The studyassessed the effects of the two teaching methods and investigated the students' attitudes toward these educational practices, with all participants completing pre- and post-course tests. RESULTS The CDIO model significantly enhances nursing students' arrhythmia proficiency, yielding higher test scores and sustained improvement after 24-week compared to the traditional LBL method, alongside markedly better self-learning enthusiasm, understanding, satisfaction with the teaching approach and effectiveness, and interest in learning arrhythmia. The CDIO model in nursing arrhythmia courses boosts theoretical knowledge and application, showing potential in clinical skill enhancement. CONCLUSIONS Our study introduces the CDIO model in nursing arrhythmia courses, with improvement in knowledge and skills, and promise for broader application.
Collapse
Affiliation(s)
- Yu Chen
- Department of Cardiology, School of Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Heling Wen
- Department of Cardiology, School of Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Zheng Huang
- Department of Surgery, The Affiliated Tumor Hospital of Chengdu Medical College, Chengdu, 610021, China
| | - Rui Zhang
- Department of Surgery, The Affiliated Tumor Hospital of Chengdu Medical College, Chengdu, 610021, China.
| | - Lei Peng
- Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.
| |
Collapse
|
2
|
Belay YH, Gezahegn D, Melaku B, Adal O. Nurses' competency on electrocardiography interpretation in adult emergency room: Addis Ababa, Ethiopia, 2021. Multicenter cross-sectional study. Int Emerg Nurs 2024; 74:101453. [PMID: 38678683 DOI: 10.1016/j.ienj.2024.101453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/26/2024] [Accepted: 04/06/2024] [Indexed: 05/01/2024]
Abstract
AIM This study aimed to assess the proficiency of nurses in interpreting electrocardiogram within the adult emergency units of Addis Ababa, Ethiopia, during the year 2021. METHODS This institutional-based descriptive, cross-sectional study involved 175 nurses from five randomly selected hospitals' adult emergency units. Semi-structured, self-administered questionnaires were used for data collection. Data were entered into Epi-Data and analyzed using SPSS version 26. Fisher's exact test identified statistical significance between dependent and independent variables at a p-value < 0.05. RESULTS Out of 203 respondents, 175 participated actively, yielding a response rate of 86.2%. Among these nurses, 159 (90.9%) were deemed not competent (scoring < 65%), with a mean score of 6.82 ± 3.65 SD. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was included in this study. CONCLUSION The overall competency level in electrocardiogram interpretation among nurses is significantly poor. This indicates that most nurses in the emergency units are unable to accurately interpret ECG monitoring, potentially leading to the failure to recognize signs of arrhythmias, electrolyte disturbances, and other cardiac abnormalities. Consequently, this may result in inappropriate patient care and increased mortality rates. Education and training were identified as key factors in enhancing their competency.
Collapse
Affiliation(s)
- Yegremew Haimanot Belay
- Department of Emergency Medicine & Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Demmelash Gezahegn
- Department of Emergency Medicine & Critical Care, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Birhanu Melaku
- Department of Emergency Medicine & Critical Care, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ousman Adal
- Department of Emergency Medicine & Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| |
Collapse
|
3
|
Iqbal N, Kandasamy R, O J, R B, Jyothish K. Virtual Reality Simulation for the Acquisition and Retention of Electrocardiogram Interpretation Skills: A Randomized Controlled Trial Among Undergraduate Medical Students. Cureus 2024; 16:e62170. [PMID: 38993414 PMCID: PMC11238897 DOI: 10.7759/cureus.62170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/13/2024] Open
Abstract
Introduction The electrocardiogram (ECG) is one of the most important tools in diagnosing cardiac abnormalities, particularly arrhythmias and myocardial infarction. It is one of the certifiable competencies for final-year medical undergraduate students. We determined virtual reality's effectiveness in acquiring and retaining ECG interpretation skills among medical students compared to traditional teaching. Methods One hundred and forty students were randomized into two groups. Seventy-one students (immersion group) were trained using virtual reality simulation to acquire and retain interpretation skills of normal and abnormal ECG. Sixty-nine students (traditional group) were trained in the classroom using chalk and board. The primary outcome of change in acquiring knowledge of the interpretation of ECG was determined by comparing pre and post-test scores. The secondary outcome of retention of knowledge was determined by comparing pre-test and second post-test scores conducted after eight weeks of intervention. The p-value of <0.05 was considered significant. Results Out of 140 students, 50 (35.7%) were males and 90 (64.3%) were female. The mean age of the students was 22.1 (SD 1.1), with 69.3% of them between the ages of 21 and 22 years. Mean pre-test scores for the interpretation of normal ECG among immersion and traditional groups were 9.8 (SD 8.4) and 8.3 (SD 7.5), respectively, and post-test scores for the acquisition of knowledge were 24.3 (SD 5.5) and 24.8 (SD 6.3), respectively. The post-test scores for retention skills were 25.3 (SD 5.6) and 20.7 (SD 6.9) respectively (p<0.001). The mean pre-test scores for the interpretation of abnormal ECG of both groups were 7.0 (SD 6) and 8.3 (SD 6.6), respectively. Mean post-test scores for acquiring knowledge to interpret abnormal ECG were 23.5 (SD 6.2) and 17.7 (SD 9), respectively (p<0.001), and mean post-test scores for retention of interpretation skills of abnormal ECG were 19.2 (SD - 6.9) and 13.3 (SD 10.2) respectively (p=0.001). The pairwise comparison of the immersion group indicates that all the combinations that changed in score from the pre to post-intervention time points, from pre-to-retention time, and from the post-to-retention time were significant (p<0.001). Conclusion Virtual reality teaching had a better impact on acquiring and retaining the skill for interpreting normal and abnormal electrocardiograms.
Collapse
Affiliation(s)
- Nayyar Iqbal
- General Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, IND
| | | | - Johnson O
- General Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, IND
| | - Balasundaram R
- General Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, IND
| | - Karthika Jyothish
- Physiology, Pondicherry Institute of Medical Sciences, Pondicherry, IND
| |
Collapse
|
4
|
Heydarikhayat N, Ghanbarzehi N, Sabagh K. Strategies to prevent medical errors by nursing interns: a qualitative content analysis. BMC Nurs 2024; 23:48. [PMID: 38233901 PMCID: PMC10792785 DOI: 10.1186/s12912-024-01726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Nursing interns often face the serious challenges and stress of clinical training. Identifying effective strategies in reducing medical errors can improve student performance and decrease patient risk and injury from errors. The purpose of this study was to identify strategies to prevent medical errors by nursing interns in Medical Universities in Sistan and Baluchistan, Southeast of Iran. METHODS This is a qualitative study using a content analysis approach. Purposive sampling was used. The study was conducted in 3 medical universities. Ten nursing interns participated in this study. Open-ended, semi-structured, and face-to-face, interviews were used to explore the experience of nursing interns about strategies to prevent medical errors during their internship. RESULTS Findings include 20 subcategories, 6 categories and one theme. The main theme is "strategies to prevent medical errors during internship". Six categories included "strategies to prevent medical errors during internship". These included "Professional acceptance and support", "Revision of the implementation of the educational curriculum", "Retraining courses for challenging skills", "Creating learning opportunities" "Professionalization", and "Facilities and requirements". CONCLUSIONS Preventing medical errors requires different strategies before and during nursing internship. Error prevention strategies include retraining and preparatory courses for challenging areas, evaluation of students' performance, and accepting students as members of the health care team, respecting and supporting them and protecting their rights. Learning from medical errors, analysis and reflection on errors should be part of the curriculum during the internship.
Collapse
Affiliation(s)
- Nastaran Heydarikhayat
- Nursing Department, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Nezar Ghanbarzehi
- Nursing Department, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Kimiya Sabagh
- Department of Pediatric Nursing, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.
| |
Collapse
|
5
|
Alalwan MA, Alshammari T, Alawjan H, Alkhayat H, Alsaleh A, Alamri I, Aldubaikel A, Alqahtani J, Alrawashdeh A, Alqahtani S. Electrocardiographic interpretation by emergency medical services professionals in Saudi Arabia: A cross sectional study. PLoS One 2023; 18:e0292868. [PMID: 37856426 PMCID: PMC10586609 DOI: 10.1371/journal.pone.0292868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Management of acute myocardial infarction (AMI) and cardiac arrhythmias in prehospital settings is largely determined by providers of emergency medical services (EMS) who can proficiently interpret the electrocardiography (ECG). The aim of this study was to assess the ECG competency of EMS providers in Saudi Arabia. METHODS Between Aug and Sep 2022, we invited all EMS providers working for the Saudi Red Crescent Authority in Makkah, Riyadh, and Sharqiyah regions to complete a cross-sectional survey. The survey was used to assess the ability of EMS providers to interpret 12 ECG strips. Characteristics and ECG competency were summarized using descriptive statistics. Differences in ECG competency across paramedics with lower and higher qualifications were assessed. RESULTS During the study period, 231 participants completed the survey, and all were included. The overall mean age was 33.4, and most participants were male (94.8%). Nearly half of the participants were paramedics with an associate degree and 46.4% were paramedics with higher degrees. The average rate of correct answers to the 12 ECG strips was 43.3% (95% CI: 35.4%, 51.3%). Atrial flutter, ventricular fibrillation, atrial fibrillation, 3rd degree heart block, and ventricular tachycardia were identified by 52.8%, 60.2%, 42.0%, 40.7%, and 49.4% of the participants, respectively. The strip with an AMI was identified by 41.1%, while a pathological Q wave and ventricular extrasystole were identified by 19.1% and 24.7%, respectively. Paramedics with higher qualifications were as 28.0%-61.0% more likely to correctly interpret the 12 ECG strips compared to those with an associate degree (p-value across all variables was ≤ 0.001). CONCLUSION While the majority of participants in our region were unable to correctly answer the 12 ECG questionnaire, paramedics with higher qualifications were. Our study indicates that there is a need for evidenced-based ECG curricula targeting different levels of EMS professionals.
Collapse
Affiliation(s)
- Mohammed Abdullah Alalwan
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Talal Alshammari
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hassan Alawjan
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hassan Alkhayat
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed Alsaleh
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ibrahim Alamri
- Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alaa Aldubaikel
- Department of Academic Affairs and Training, Saudi Red Crescent Authority, Dammam, Saudi Arabia
| | - Jaber Alqahtani
- Department of Respiratory Care, Prince Sultan Military College for Health Sciences, Dhahran, Saudi Arabia
| | - Ahmad Alrawashdeh
- Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Saeed Alqahtani
- Department of Emergency Medical Services, Prince Sultan Military College for Health Sciences, Dhahran, Saudi Arabia
| |
Collapse
|
6
|
Elsheikh E, Alkhteeb N, Alamer A, Alarfaj MO, AlQarni G, Alsultan J. Medical Students' Competency and Confidence in Interpreting Electrocardiograms at King Faisal University, Al-Ahsa. Cureus 2023; 15:e46393. [PMID: 37927746 PMCID: PMC10620545 DOI: 10.7759/cureus.46393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Electrocardiography is a crucial emergency tool in the pre-hospital situation. It is a useful non-invasive diagnostic technique for quickly identifying various heart disorders. The clinical value of the electrocardiogram (ECG) depends on the clinician's ability to interpret the result of the ECG accurately. Aims This study aims to assess the competency as well as the confidence in the interpretation of ECG among medical students at King Faisal University, Al Ahsa, Saudi Arabia. Methods This cross-sectional study was conducted among medical students enrolled at King Faisal University. Four hundred and ten (410) medical students from all five years completed an electronic self-administered pre-validated questionnaire. The questionnaire includes basic demographic data and ECG strips to assess medical students' competency and confidence levels in interpreting each case. Results More than half of the medical students were considered to have low competency (56.1%) and confidence (59%) levels. Increased competency and confidence scores were associated with fifth-year medical students and those who learned more about ECG interpretation through teaching during clinical rotations. The majority of medical students correctly interpreted anterior MI (69.3%), ventricular tachycardia (65.6%), and supraventricular tachycardia (61.2%). On the other hand, most students were unable to correctly identify pacemaker ECG (19.8%), long QT (21.2%) and left bundle branch block (33.4%). Conclusion Medical students' competency and confidence in ECG interpretation seems to be lacking. Fifth-year medical students who learned more ECG skills through teaching during clinical rotations tended to be more competent and confident with their ECG interpretation skills.
Collapse
Affiliation(s)
- Eman Elsheikh
- Internal Medicine, College of Medicine, King Faisal University, Al-Ahsa, SAU
- Cardiology, College of Medicine, Tanta University, Tanta, EGY
| | | | - Aisha Alamer
- Internal Medicine, King Faisal University, Al-Ahsa, SAU
| | | | | | | |
Collapse
|
7
|
Perrichot A, Vaittinada Ayar P, Taboulet P, Choquet C, Gay M, Casalino E, Steg PG, Curac S, Vaittinada Ayar P. Assessment of real-time electrocardiogram effects on interpretation quality by emergency physicians. BMC MEDICAL EDUCATION 2023; 23:677. [PMID: 37723508 PMCID: PMC10506301 DOI: 10.1186/s12909-023-04670-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 09/12/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Electrocardiogram (ECG) is one of the most commonly performed examinations in emergency medicine. The literature suggests that one-third of ECG interpretations contain errors and can lead to clinical adverse outcomes. The purpose of this study was to assess the quality of real-time ECG interpretation by senior emergency physicians compared to cardiologists and an ECG expert. METHODS This was a prospective study in two university emergency departments and one emergency medical service. All ECGs were performed and interpreted over five weeks by a senior emergency physician (EP) and then by a cardiologist using the same questionnaire. In case of mismatch between EP and the cardiologist our expert had the final word. The ratio of agreement between both interpretations and the kappa (k) coefficient characterizing the identification of major abnormalities defined the reading ability of the emergency physicians. RESULTS A total of 905 ECGs were analyzed, of which 705 (78%) resulted in a similar interpretation between emergency physicians and cardiologists/expert. However, the interpretations of emergency physicians and cardiologists for the identification of major abnormalities coincided in only 66% (k: 0.59 (95% confidence interval (CI): 0.54-0.65); P-value = 1.64e-92). ECGs were correctly classified by emergency physicians according to their emergency level in 82% of cases (k: 0.73 (95% CI: 0.70-0.77); P-value ≈ 0). Emergency physicians correctly recognized normal ECGs (sensitivity = 0.91). CONCLUSION Our study suggested gaps in the identification of major abnormalities among emergency physicians. The initial and ongoing training of emergency physicians in ECG reading deserves to be improved.
Collapse
Affiliation(s)
- Alice Perrichot
- Emergency Department, Beaujon Hospital AP-HP, Clichy, France
| | - Pradeebane Vaittinada Ayar
- Laboratoire des Sciences du Climat et l’Environnement (LSCE-IPSL), CNRS/CEA/UVSQ, UMR8212, Université Paris-Saclay, Gif-sur-Yvette, 91190 France
| | - Pierre Taboulet
- Emergency Department, Saint Louis Hospital AP-HP, Clichy, France
| | | | - Matthieu Gay
- Emergency Department, Beaujon Hospital AP-HP, Clichy, France
| | | | | | - Sonja Curac
- Emergency Department, Beaujon Hospital AP-HP, Clichy, France
| | - Prabakar Vaittinada Ayar
- Emergency Department, Beaujon Hospital AP-HP, Clichy, France
- INSERM UMR-S942, MASCOTT, Paris, France
- University of Paris Cité, Paris, France
| |
Collapse
|
8
|
Al Mousa AM, Alhubail FM, Almulhim M, AlBeladi BA, Almulhim NA, Almulhim AA, Algouf IA, Khan AS. Electrocardiogram Interpretation Competency of Medical Interns in Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e37557. [PMID: 37193433 PMCID: PMC10183095 DOI: 10.7759/cureus.37557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/18/2023] Open
Abstract
Objective To determine the competence of medical interns in Saudi Arabia in interpreting common ECG abnormalities, explore limitations, and facilitate solutions to the development of ECG interpretation skills in Saudi Arabia. Methods This cross-sectional study was conducted from 11 June 2022 to 3 November 2022 using the convenience stratified sampling technique among 373 medical interns (54.4% male and 45.6% female) in 15 medical colleges within Saudi Arabia. Results Almost all (91.7%) of the participants recognized the basic ECG elements, as they correctly identified normal ECG patterns. The most well-understood ECG pathologies were ventricular fibrillation, atrial fibrillation, and acute myocardial infarction, which were accurately interpreted by 69.2%, 67.8%, and 61.9% of the participants, respectively. The least understood ECG result was a pathological Q wave, which only 20.9% recognized. Most (63.5%) participants attributed their challenges in ECG interpretation to their inadequate training in college, and 57.4% of them stated that practical case-based training could best facilitate the improvement of their skills in ECG interpretation. Conclusion Most of the participants showed unsatisfactory performance in ECG interpretation. Despite their completion of advanced cardiac life support courses, their overall performance did not improve significantly. Most of them believed that their colleges did not adequately train them to read ECGs. Thus, a majority think case-based training is a key strategy for improving their ECG interpretation skills.
Collapse
Affiliation(s)
- Ali M Al Mousa
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Fatimah M Alhubail
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Mohannad Almulhim
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Baneen A AlBeladi
- Clinical Pharmacy Department, College of Clinical Pharmacy, King Faisal University, Alahsa, SAU
| | - Nasser A Almulhim
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Abdullah A Almulhim
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Ibtisam A Algouf
- Internal Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| | - Abdul Sattar Khan
- Family and Community Medicine Department, College of Medicine, King Faisal University, Alahsa, SAU
| |
Collapse
|