Table 7 The leading themes and subthemes that emerged from the qualitative analysis
Theme | Subtheme | Number of mentions | Examples |
|---|---|---|---|
Curricular development | Need for prioritisation | 16 | “I feel we should focus on firm basics and the emergencies” “There are certain things they need to be able to recognise on their first night on call - can these issues be weighted more heavily?” “Focus should be on identifying life threatening conditions and conditions that cannot be diagnosed without an ECG.” |
Too difficult | 9 | “The more complex the curriculum, the more insecure the junior doctor.” “When making things too complicated one can overwhelm the students.” “If too much detail is taught to the undergraduate, mistakes are even more likely!” “Complex diagnoses … may be overwhelming for a large proportion and result in less learning paradoxically.” | |
Too much work | 5 | “Although it is important for junior doctors to have a good knowledge of ECG interpretation, it will be difficult for them to retain all included aspects.” “The undergraduate curriculum is extensive and needs to be reduced” “Our purpose is to empower the junior doctor, not provide a comprehensive overhaul from the outset. Knowledge is incremental over the doctor’s work lifespan. For the junior doctor, keep it simple with must know and nice to know” | |
Know when to seek advice | From an experienced colleague | 4 | “Not knowing everything is OK but their teaching must include that when they don’t know it is imperative to ask somebody who does know” |
By means of electronic support | 5 | “Expose them to the many medical apps that are available that can assist with diagnosis” “Consider the usage of phone apps to assist at the bedside. Most students use these and it might be worth including teaching the skill of looking up ECGs at the bedside” | |
Contextual learning | Clinical context | 3 | “It is vital to teach the ECG in a clinical context and to integrate it into the clinical diagnosis” |
Workplace experience | 3 | “Other … factors may have to be taken into account, such as the amount of patient exposure an undergraduate student … would have had, the … curriculum contact time that can be afforded to ECG training and the most common diagnoses that students will encounter in a particular environmental context” | |
Other strategies for making diagnosis | 2 | “… junior doctors have … access to a lab in South Africa: [diagnosing] hypokalaemia / hyperkalaemia etc. … by ECG loses importance” | |
Recognition of importance study | Positive stakeholder engagement | 11 | “Thank you for the opportunity to participate in this study.” |
Criticism of Delphi process | 4 | “The time between rounds may have influenced my responses” “The panel should not consist of too many cardiologists.” | |
Dissemination of results | 4 | “Please circulate findings as soon as available.” “The results will really polish our way to tutoring and mentoring” |