An assessment of intern doctors' experiences of undergraduate education in electrocardiogram interpretation

AIM: The aim of this study is to assess the adequacy of undergraduate ECG education from the perspective of recent medical graduates.

METHODS AND METHODOLOGY: A mixed-methods survey was administered to intern doctors in a large Irish university hospital. A de novo survey was developed using established survey design principles and items adapted from validated educational tools and prior ECG education literature. It included Likert-scale items assessing perceptions of undergraduate ECG education, self-rated confidence across seven common ECG patterns, and open-ended questions exploring experiences, barriers, and recommendations. Quantitative data were analysed descriptively, while qualitative responses underwent thematic analysis using the Braun and Clarke framework.

RESULTS: 72 intern doctors participated. Quantitative findings showed variability in perceptions of ECG education quality. Educators were regarded as knowledgeable, but opportunities for active engagement, practice on authentic ECGs, and constructive feedback were limited. Confidence in interpreting common ECG patterns was moderate, with preparedness for clinical practice perceived as inconsistent. Qualitative findings reinforced these results, with participants describing ECG teaching as infrequent, inconsistently delivered, and often disconnected from clinical realities. Stress, low confidence, and limited access to feedback were frequently cited barriers to effective learning.

CONCLUSION: Although intern doctors value ECG interpretation as a core clinical skill, they feel underprepared by undergraduate teaching. Gaps are evident in the quantity and consistency of instruction, the availability of practice opportunities, and the provision of timely, constructive feedback. Participants expressed a strong preference for small-group, interactive sessions using real-world ECGs with structured feedback, highlighting clear priorities for curricular reform.