(P106) THE IMPACT OF COVID-19 PANDEMIC ON TRAINEES' DIAGNOSTIC PERFORMANCE IN ECG INTERPRETATION

Background: The CardioGuide virtual learning modules serve as a fundamental tool for resident trainees to refine their abilities in electrocardiogram (ECG) interpretation. Although ECG interpretation is a core component of medical training, accuracy remains disconcertingly low. The COVID-19 pandemic brought a shift towards virtual learning. It is unknown whether the pandemic has impacted trainees’ ECG interpretation performance. The aim of the study is to compare diagnostic accuracy on ECG modules completed by trainees during and post-pandemic.

METHODS AND RESULTS: We conducted a retrospective cohort study to assess diagnostic performance following completion of the learning modules during (July 2020 to July 2021) and after the pandemic (after July 2021). All trainees in postgraduate (PGY) level 1 to 3 who complete a Cardiology rotation at Western University are required to complete ECG interpretation modules, with PGY1 residents responsible for level 1 modules and PGY2 residents responsible for level 2 modules. The primary outcome is the diagnostic accuracy of trainees’ ECG interpretation during and post-pandemic. The secondary outcome is the total minutes spent on the modules between each cohort. Trainees’ diagnostic accuracy and time spent on the modules were compared with t-tests.

A total of 423 trainees (303 PGY1, 95 PGY2, 25 PGY3) completed the level 1 module. The pandemic cohort scored higher than the post-pandemic cohort (mean grade 48.4 vs 44.1%, p=.02). Based on the first attempt grade, PGY1 trainees started with a similar performance in ECG interpretation during and post-pandemic (43.8 vs 42.8%, p=0.69). Although scores increased upon multiple attempts at the ECG module, PGY1 had a lower mean grade on their last attempt during the pandemic (56.1 vs 69.5% , p= < 0.0001) and their lower performance on the module persisted in PGY2 after the pandemic compared to their peers (68.3 vs 77.8%, p=.06). The post-pandemic PGY2 cohort’s lower mean grade was associated with less time spent on the module (24.1 vs 40.9 minutes).

Conclusion: The findings suggest residents in PGY1 during the pandemic had lower baseline knowledge of ECG interpretation and lower performance on their final attempt of the ECG module. Their performance reduction on the ECG module persisted into their PGY2 training. The lower performance may be related to reduced engagement with the learning modules with the return of in-person learning on rotations. Overall, these results contribute to emerging data about the pandemic’s impact on trainees' clinical experiences and may help improve medical education to enhance trainees' diagnostic performance during their Cardiology rotations.