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EYE-ECG2: Addressing medical student feedback in an RCT with eye-tracking videos featuring cued retrospective reporting and modified learning sequences for ECG interpretation skills training

GMS J Med Educ. 2025 Sep 15;42(4):Doc47. doi: 10.3205/zma001771. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the effectiveness of an enhanced eye-tracking video intervention (EYE-ECG2) in improving ECG interpretation skills of medical students. Building on the foundational EYE-ECG1 study [Scherff et al. GMS J Med Educ. 2024], which tested the utility of expert eye movement modelling and retrospective think-aloud commentary for ECG skill acquisition, this follow-up study introduces modifications designed to optimise learning outcomes.

METHODS: A randomised controlled trial was conducted with medical students (N=94) allocated to either the control group (TAU) with standard ECG interpretation training, consisting of a validated set of 4 ECG cases for ECG interpretation; or the intervention group (INT) who additionally received the EYE-ECG2 video. The EYE-ECG2 video included refined ECG gaze cues and Cued Retrospective Reporting (CRR) by a senior cardiology expert. Performance was assessed pre- and post-training. Data were analysed to compare improvements in diagnostic accuracy, decision-making processes and student feedback were evaluated.

RESULTS: The results of the previous study were successfully replicated, showing an overall significant learning benefit from the cases and a moderate, yet nonsignificant tendency for INT>TAU (ΔM=0.80-2.42%; p=.79-.30). Randomised case presentation attenuated the special role of learning case 1 observed previously in EYE-ECG1. Exploration of student feedback showed a largely positive or neutral evaluation (74%), and a prior cardiological clerkship was a distinguishing factor resulting in positive (vs. neutral/negative) sentiment regarding the eyetracking videos with CRR (χ2(2)=7.57, p=.03).

CONCLUSION: The ECG training significantly improved participants’ ECG interpretation skills, with a strong start in the training session playing a key role in these improvements. Student feedback indicated that certain subgroups, particularly those with prior cardiological experience, may derive a greater self-reported benefit from the EYE-ECG2 videos.

PMID:41103394 | PMC:PMC12527390 | DOI:10.3205/zma001771