Assessment of electrocardiography interpretation competency of Ethiopian medical interns: a multi-site study

Accurate electrocardiogram (ECG) interpretation is critical for early diagnosis of cardiac conditions, yet competency among medical interns in Ethiopia remains understudied. While an earlier study offered initial insights, it was limited to two institutions. This multi-site study aimed to provide a more current and comprehensive assessment of ECG interpretation skills and associated factors among Ethiopian medical interns. A multi-site cross-sectional study was conducted with 220 interns from four randomly selected institutions. Data were collected via a structured questionnaire, adapted from validated instruments, and analyzed using SPSS 25. Competency was defined as scoring ≥ 80% on a 14-item ECG interpretation test. Multivariable logistic regression was used to identify determinants of competency. A statistically significant P-value was set at less than 0.05. The overall competency rate was 19.1%, with significant institutional variation (p < 0.001), ranging from 7.1% to 32.7%. Confidence in ECG interpretation (AOR = 9.10, 95% CI: 1.22–12.67) and emergency department (ED) rotations during clinical years (AOR = 3.87, 95% CI: 1.86–8.05) and internship (AOR = 4.07, 95% CI: 1.68–9.85) were key predictors of competency. This study highlights a persistent low competency in ECG interpretation among Ethiopian medical interns. These findings highlight the importance of structured ECG training, incorporating dedicated ED rotations, and building self-confidence through practical, simulation-based learning to improve skills and patient outcomes.