Impact of self-directed e-learning on nurses' competency in arrhythmia interpretation in cardiology

Abstract

Accurate electrocardiogram (ECG) interpretation is an essential competency for nurses, particularly in cardiology, where the timely identification of arrhythmias can be lifesaving and significantly impact patient outcomes. Nurses often serve as the first line of clinical observation, making their ability to interpret ECGs critical for early intervention and safe patient care. However, numerous studies have highlighted persistent gaps in ECG interpretation skills among nursing staff, emphasizing the urgent need for effective, accessible educational strategies. This study aimed to assess the effectiveness of a self-directed e-learning (SDL) package in improving nurses' knowledge and competency in arrhythmia interpretation within the cardiology department of Rashid Hospital, Dubai. A quasi-experimental, one-group pre-test/post-test design was utilized with a sample of 50 nurses working in Coronary Care Units. Data were collected using a validated, structured questionnaire that included demographic data and ECG interpretation tests. The SDL package covered foundational ECG knowledge, rhythm analysis, and arrhythmia management. Results showed a statistically significant 15.92% improvement in knowledge following the intervention (t = -6.668, p < .001). A notable correlation was observed with years of experience; nurses with 1-5 years of experience demonstrated the highest improvement (p = .020). No significant differences were found based on gender (p = .234) or area of practice (p = .139). This study highlights the critical need to strengthen nurses' arrhythmia interpretation skills and demonstrates that SDL is an effective, flexible, and scalable approach to bridging competency gaps in high-acuity clinical areas such as cardiology.