Piloting a brief online ECG test based on NICE clinical guideline 109

Measuring how UK paramedics respond to pathological ECG patterns for patients who present with a recent transient loss of consciousness (TLoC) is relevant to both National Health Service (NHS) auditors and healthcare educators (see NICE Clinical Guideline 109 (CG109)). We piloted an online multiple-choice test with 20 ECG patterns (and a median duration to complete of 1215 s) to assess ECG interpretations in the context of TLoC. In a sub-cohort of 207 UK year 2 and 3 paramedic students who fulfilled our inclusion criteria, we found that year 3 students (versus year 2) performed better at identifying the ECG patterns, but not at dichotomous decisions to refer onward or not. As expected, year 3 students were somewhat more confident than year 2 students that their ECG interpretations were correct. In a subset of questions showing proarrhythmic ECG patterns, both year 3 and year 2 students performed disappointingly. Thus, this pilot study with student participants buttresses the use of this test and method to do a larger audit of professionals in this field, and it suggests that there may be a mismatch between the professional guidelines and current educational practices, which should be harmonized.