Paper Title: Competency in Electrocardiogram interpretation and placement of ECG leads among final year medical students of a Nigerian University.

Authors: Alikor C.A, Onuwaje P.


Electrocardiogram (ECG) is a very common and easily assessable tool used in the assessment of cardiovascular diseases.
Accurate interpretation of ECG abnormalities remains vital in the adequate management of some cardiac emergencies. It is
therefore expected that final year medical students (FYMS) who will soon become house officers should have good knowledge of
ECG procedures and interpretation. Hence this study is aimed at determining the competency level of final year medical
students of the University of Port Harcourt in placement of ECG electrodes (leads) and interpretation of abnormal ECGs.

It was a prospective study involving FYMS who were recruited by convenience. A structured questionnaire was administered to
one hundred and sixteen (116) graduating medical students. The questions were on basic ECG training including frequency of
training and mode of training; placement of ECG leads. A list of 20 ECG tracings was also developed for the students to

One hundred and fourteen FYMS fully participated in the study with a questionnaire response rate of 98.27%. The male to
female ratio was 1.9 : 1. Most (61.4%) of the study participants were unable to correctly place any of the ECG precordial
leads while only 7.8% of study participants correctly placed all the precordial leads V1 –V6 correctly. Of the 20 ECG slides
in this study, 12 (60%) could not be interpreted by any of the study participants. Of the remaining 8(40%) ECGs, only 0.9%
of the total study participants were able to interpret them correctly. Only 24.6% of the participants were able to correctly
identify the normal ECG and none able to recognize important ECG emergency slides of ST segment elevation and ventricular
tachycardia. Competency in ECG interpretation was higher in students who reported training during classroom lectures against
other training modalities such as self training, ward-rounds or others (P -0.0001) .

The basic knowledge of ECG interpretation and placement of ECG leads amongst final year medical students in this study
was poor. Improvement in knowledge and interpretation could be achieved through revision of the medical school curriculum to
include ECG as a course and incorporation of frequent tutorials both in the classrooms and during clinical rotations.

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