In 2016 a series of interactive lessons developed in Articulate was made available to first year DO students to help them master the skills of electrocardiogram management and interpretation. The lessons were originally commissioned in 2015 by Cheri Silverstein-Fadlon, a Cardiologist and Assistant Professor of Internal Medicine in WesternU’s College of Osteopathic Medicine.
The curriculum consists of 5 lessons, organized in a 3-tiered curriculum as shown here. The first level presents basic concepts in ECG recording and electrode placement, providing the foundation for understanding how ECGs reflect a patient’s heart activity.
The second level includes two lessons on the basic features of normal ECG waveforms and how to measure them. A tutorial on calculating heart rate is also included.
The third level includes two lessons that provide the necessary background for recognizing abnormal waveforms and understanding their clinical significance. The second of these lessons is currently under development.
The original concept called for the development of a set of virtual calipers which could be used to measure ECG waveform components in a Unity3D environment.
Following an initial beta test with students, the calipers and Unity3D approach were eventually abandoned in favor of a virtual 2D ruler which could be integrated into a more easily maintained series of Articulate lessons.
Each lesson provides a consistent navigational template to lead students from one tutorial to the next. Students are free to look ahead or return to previous tutorials to review concepts as needed. Questions are integrated in each tutorial to encourage students to apply what they’ve learned as they progress through the lesson.
Some of the questions require students to make measurements of specific waveform features using the virtual ruler. Their responses are compared to a range of correct responses which include an appropriate margin of error.
Each lesson culminates with a series of Practice Exercises that students complete to demonstrate their recall and understanding of the key concepts presented. These exercises draw on Articulate’s extensive collection of freeform question types with built in scoring and performance tracking.
The lessons are also characterized by a visually rich treatment that uses a combination of still images, line drawings, and animations. Normal and abnormal rhythms strips were created by drawing on actual patient ECGs and textbooks such as Garcia & Miller’s Arrhythmia Recognition: The Art of Interpretation and Thaler’s The Only EKG Book You’ll Ever Need.
Earlier this year, the Physician Assistant Program in the College of Allied Health Professions expressed an interest in piloting the lessons with their PA students. Cathy Chang, MS, MBA,PA-C noted that “it’s fun to have something like this [for the students] to practice with.” Plans for expanding the curriculum include completion of Lesson 3B and more advanced lessons on the Heart Axis and other concepts.
For more information on the ECG Lessons, please contact:
Miary Andriamiarisoa, Director of Instructional Technology & Distributed Learning, at firstname.lastname@example.org
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