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已发表论文
评估住院医师心电图解读能力与信心：一项多中心试点研究
Received 30 June 2025
Accepted for publication 12 November 2025
Published 31 December 2025 Volume 2025:16 Pages 2481—2489
DOI https://doi.org/10.2147/AMEP.S550536
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Md Anwarul Azim Majumder
Shengwei Liang,* Ruihui Lai,* Tan Xu
Department of Cardiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tan Xu, Email xutan0501@163.com
Background: Electrocardiography (ECG) is a pivotal diagnostic tool. However, the accuracy of ECGs interpretation by resident varies from region to region, but overall interpretation ability is poor. The aim to assess whether the low competency described worldwide are also prevalent in the Chinese residents.
Methods: This pilot study was a cross-sectional, questionnaire-based assessment of ECG interpretation skills of residents (n=165). We selected eight 12-lead ECGs. Each ECG was provided with a brief clinical scenario, consisted of age, gender, and chief complaint.
Results: The Cronbach’s Alpha for Likert scale used item questionnaire was 0.75. In the university learning situation, only a small number of students considered they were proficient in ECG (n=3, 1.82%). More than half of residents (n=102, 61.82%) relearned the ECG knowledge during their clinical clerkships. The overall ECG interpretation ability is poor, as ECG test scores were 6(4,8). Just 17 residents (10.3%) scored more than 10 points. The non-internal medicine residents had a better performance in the interpretation of supraventricular tachycardia compared with internal medicine residents (median score 2 versus 0, p< 0.05). The highest competency was observed in the ST elevated myocardial infarction (correct rate 54.55%). The poorest ability to misread ECG was long QT and left bundle branch block (correct rate 0.61% and 0.00%). Few participants reported complete confidence about their diagnosis (less than 10%).
Conclusion: Our research reveals that residents do not appear to be prepared to interpret ECG abnormalities, including common emergencies and common abnormalities, even the normal ECG strip.
Keywords: competency, confidence, ECG, residents, questionnaire
Department of Cardiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tan Xu, Email xutan0501@163.com
Background: Electrocardiography (ECG) is a pivotal diagnostic tool. However, the accuracy of ECGs interpretation by resident varies from region to region, but overall interpretation ability is poor. The aim to assess whether the low competency described worldwide are also prevalent in the Chinese residents.
Methods: This pilot study was a cross-sectional, questionnaire-based assessment of ECG interpretation skills of residents (n=165). We selected eight 12-lead ECGs. Each ECG was provided with a brief clinical scenario, consisted of age, gender, and chief complaint.
Results: The Cronbach’s Alpha for Likert scale used item questionnaire was 0.75. In the university learning situation, only a small number of students considered they were proficient in ECG (n=3, 1.82%). More than half of residents (n=102, 61.82%) relearned the ECG knowledge during their clinical clerkships. The overall ECG interpretation ability is poor, as ECG test scores were 6(4,8). Just 17 residents (10.3%) scored more than 10 points. The non-internal medicine residents had a better performance in the interpretation of supraventricular tachycardia compared with internal medicine residents (median score 2 versus 0, p< 0.05). The highest competency was observed in the ST elevated myocardial infarction (correct rate 54.55%). The poorest ability to misread ECG was long QT and left bundle branch block (correct rate 0.61% and 0.00%). Few participants reported complete confidence about their diagnosis (less than 10%).
Conclusion: Our research reveals that residents do not appear to be prepared to interpret ECG abnormalities, including common emergencies and common abnormalities, even the normal ECG strip.
Keywords: competency, confidence, ECG, residents, questionnaire