EKGaction Demo: The Teaching Method of EKGaction

EKGaction starts with an EKG Review that presents an organized approach to EKG interpretation. Here, each of the 89 ABIM-style answer choices is underlined, defined and serves as a means to retrieve tracings that demonstrate every EKG diagnosis. Reading EKG Review first reinforces skills and allows the user to find the right answer choice without delay.

EKGaction is then organized by Learning Cases, Supplemental Cases, Practice Test and Quick Quizzes.

There are 66 Learning Cases. The patient’s age and a brief clinical history are presented with the 12-lead EKG and rhythm strip(s). An electronic calipers is available for use as needed. The user interprets the EKG and submits the appropriate answer(s) from the ABIM-style answer sheet. The correct answers that are chosen, the correct answers that are not chosen, incorrect answers, contradictory answers and the user’s total score and available points are instantly reported. A tally of the user’s scores is kept for the last 5 interpretations of that case and for each sequential case. A summary of total score/available points for all of the completed Learning Cases is updated as the user progresses from beginning to end. To facilitate return to a case of special interest, any case can be flagged. Learning Points follow each Learning Case and elaborate on key findings which include physical examination associations and literature references. Collateral EKGs are often provided that emphasize what distinguishes this key finding from tracings that mimic it.

There are 135 Supplemental Cases. The case presentation, calipers, ABIM-style answer choices, scoring system, reporting, archive of previous attempts, summary of all Supplemental Cases and flagging are just like the Learning Cases. There are Learning Points for every Supplemental Case, but they are fewer and generally more concise.

The Practice Test includes 60 case-based EKGs that are presented in a timed format using the same ABIM-style answer sheet, scoring system and available calipers. This can be good preparation for certification exams.

There are 45 Quick Quiz cases. These cases are intended for review in small groups and thus are not interactive.

The Learning Cases, Supplemental Cases and Quick Quizzes are each indexed by Numbered Diagnoses and Unnumbered Diagnoses. These indexes allow users to find cases that demonstrate every one of the ABIM-style answer choices, related details and bring to life the definitions presented in EKG Review.

This Teaching Method has been shown to improve trainees’ EKG interpretation skills and their scores on board certification examinations. It can also reinforce skills of those who read EKGs in their daily practice and play a role in Quality Assurance (QA).

Scoring system used in EKGaction

  1. Each correct answer that is chosen is worth +1 or +2 point(s).
  2. Each correct answer that is unchosen is worth 0 (a mistake of omission).
  3. Each incorrect answer is worth -0.2 point (a mistake of commission), except in d. below.
  4. If a key correct answer is chosen and another contradictory answer is also chosen, the contradictory answer will nullify the key correct answer point(s).
  5. Total score achieved for each case is the sum of positive and negative points.
  6. Highest score for any case is the total number of available points for that case.
  7. Lowest score for any case will never be lower than 0, even if the sum of positive and negative points is negative.

Using the EKGaction Calipers

To activate the calipers for an EKG click on the calipers icon in the upper left corner. The calipers icon will become shaded to indicate the calipers are active. Click on any two locations in the EKG to measure the distance between them. The result will be reported to the right of the icon. To make a new measurement, simply click on any two new locations on the EKG. When you are finished, click the calipers icon again to deactivate the calipers.

The sweep speed is 25 mm/s for every EKG presented.
Thus, on the X-axis 1 mm is reported as 40 ms and 25 mm is reported as 1000 ms.

Voltage is measured and reported in mm on the Y-axis, regardless of voltage standardization.
Thus, to determine voltage, it is important to make note of the standardization marker on every EKG.