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Evaluation of a web-based ECG-interpretation programme for undergraduate medical students

Mikael Nilsson1*, Gunilla Bolinder1, Claes Held2, Bo-Lennart Johansson3, Uno Fors4 and Jan Östergren1

Author Affiliations

1 Department of Medicine, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden

2 Department of Cardiology, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden

3 Department of Clinical Physiology, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden

4 Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden

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BMC Medical Education 2008, 8:25  doi:10.1186/1472-6920-8-25

Published: 23 April 2008



Most clinicians and teachers agree that knowledge about ECG is of importance in the medical curriculum. Students at Karolinska Institutet have asked for more training in ECG-interpretation during their undergraduate studies. Clinical tutors, however, have difficulties in meeting these demands due to shortage of time. Thus, alternative ways to learn and practice ECG-interpretation are needed. Education offered via the Internet is readily available, geographically independent and flexible. Furthermore, the quality of education may increase and become more effective through a superior educational approach, improved visualization and interactivity.


A Web-based comprehensive ECG-interpretation programme has been evaluated. Medical students from the sixth semester were given an optional opportunity to access the programme from the start of their course. Usage logs and an initial evaluation survey were obtained from each student. A diagnostic test was performed in order to assess the effect on skills in ECG interpretation. Students from the corresponding course, at another teaching hospital and without access to the ECG-programme but with conventional teaching of ECG served as a control group.


20 of the 32 students in the intervention group had tested the programme after 2 months. On a five-graded scale (1- bad to 5 – very good) they ranked the utility of a web-based programme for this purpose as 4.1 and the quality of the programme software as 3.9. At the diagnostic test (maximal points 16) by the end of the 5-month course at the 6th semester the mean result for the students in the intervention group was 9.7 compared with 8.1 for the control group (p = 0.03).


Students ranked the Web-based ECG-interpretation programme as a useful instrument to learn ECG. Furthermore, Internet-delivered education may be more effective than traditional teaching methods due to greater immediacy, improved visualisation and interactivity.