ABSTRACT #15

THE BEAT DON’T STOP: A CURRICULUM TO TEACH TELEMETRY INTERPRETATION AND ARRHYTHMIA MANAGEMENT

Sarah E. Nussbaum, Aarti Rao, Brian Hsia

PURPOSE AND GOALS: Telemetry is a ubiquitous feature on the inpatient cardiology floors, yet the ability to systematically interpret telemetry data is not routinely taught. We implemented a curriculum on the cardiology floors to teach an evidence-based approach to ordering and interpreting telemetry. The goal of this educational curriculum was to teach a systematic way to review and interpret patient telemetry data and alarms. The curriculum also taught a framework for diagnosing and treating common arrhythmias seen on the inpatient floors.

METHODS: We created a series of educational videos that were sent to learners prior to the start of cardiology floors. The videos were created to target a PGY1, however students and senior residents were also able to participate. These videos taught how to review patient telemetry systematically by reviewing alarm events, monitoring patient trends, and differentiating signal from noise. They also covered an approach to rhythm interpretation and arrhythmia management, and used example images from the telemetry monitors used on the wards to help simulate a real-world experience.

Videos were interspersed with knowledge check questions to stimulate engagement. The videos were supplemented by an in-person, hands on session at the beginning of the cardiology block to reinforce skills and provide real-world experience in reviewing telemetry data.

EVALUATION PLAN: Curricular evaluation was done using pre- and post-curricular surveys. Learners were asked to identify their current training level and rate their confidence on a 1-5 LIkert scale in their ability to interpret telemetry and manage common arrythmias. The survey also consisted of knowledge-based questions of varying difficulty. After completing the curriculum, students were again asked to rate their confidence and given knowledge check questions. On the post-curricular survey, students were also invited to leave reflective comments on the curriculum, which were evaluated with qualitative methods.

SUMMARY OF RESULTS: The majority of learners reported that they had not received training in ordering and interpreting telemetry prior to this intervention. Learners reported they felt more confident in their ability to utilize and interpret telemetry after completing the curriculum. Overall, learners had positive reflections on the curriculum and felt more prepared for their rotations after completion.

REFLECTIVE CRITIQUE: While the goal of the curriculum was to invite learners to both view the videos and participate in the in-person hands-on section, many learners ultimately engaged in only the hands-on portion. This limits the amount of education that learners received, as the in-person component focused primarily on telemetry ordering and interpretation, and less on arrhythmia management. This reflects that learner motivation is key for gaining the full utility out of the intervention, as well as the importance of protected time for learners to engage in educational activities outside of regular clinical duties.