Arrhythmias education-current considerations with a focus on ECG teaching

In order to achieve favorable learning outcomes in medical students and residents, the development of educational interventions should be guided by specific principles. This article presents readers with a short summary of Kern's six-step approach to curriculum development before discussing results of medical education research with a focus on ECG teaching. A number of consecutive studies concluded that the choice of instructional format is less important for student learning outcome than examination consequences. Thus, if the final examination is summative (i.e., graded), students achieve higher scores regardless of the instructional method employed-even in the absence of formal teaching. Formative examinations are associated with considerably worse learning outcomes; however, they facilitate the detection of differences in effectiveness between various instructional formats. Follow-up data indicate that the loss of ECG interpretation skills is greater following a summative exam compared with a formative exam. In summary, while summative exams result in a short-term performance increase as they create a strong incentive to learn, they do not guarantee superior long-term retention. This begs the question which learning objectives can and should actually be covered in undergraduate and continuing medical education. The article concludes with a set of recommendations for the development of teaching interventions on heart rhythm disorders.