Electrocardiographic Training in Primary Care Residency Programs

To evaluate ECG interpretation in physicians training for primary care, we tested residents in two residency programs (one internal medicine, one family medicine) for their ability to interpret ECGs produced in an ambulatory practice. An 18-item examination used abnormal tracings from a university hospital ambulatory unit, including six technical problems generated in the daily operation of the unit. Ability increased with advancing graduate level; however, performance for both internal medicine and family medicine residents fell short of the expected level. Residents completing training in both programs incorrectly interpreted many of the technical problems (eg, limb lead reversal) as well as the usual ECG diagnoses (eg, acute pericarditis). This study suggests that ECG training of primary care residents should be supplemented to meet specific needs of the ambulatory component of primary care practice. ( JAMA 1981;246:148-150)