Availability of Resources, Knowledge, Applicability and Preferred Teaching Methods regarding Electrocardiography in a Resource-Limited Clinic in Rural Thailand

Abstract

Introduction: Electrocardiography (ECG) is a rapid, non-invasive and inexpensive test requiring minimal training to perform. ECG is used ubiquitously in the developed world to assess the cardiac and metabolic status of Emergency Department (ED) patients; however, its utility in resource-limited settings has not yet been assessed. In order to shed light on ECG utility in developing areas around the world, as well as the perceptions of resources availability, knowledge, applicability and preferred teaching methods regarding ECGs were examined in a resource-limited clinic in Mae Sot, Thailand.

Methods: Focus group discussions and self-administered surveys were conducted among healthcare workers in a clinic in rural Thailand in November 2013.

Results: Five administrative staff and supervising providers participated in focus groups; twenty-nine medics and two physicians participated in the survey. Providers described limited knowledge of ECG interpretation and limited availability of treatments for diagnosed conditions. Providers reported that ECGs are useful when counseling patients and families on prognosis and when deciding when and where to transfer patients to facilities with more resources. Reported preferred training methods include hands-on training, lectures with handouts and specific ECG case examples.

Conclusion: Despite limited treatment options in low-resource settings, ECG can be an informative diagnostic and prognostic tool. Implementation of an ECG educational program at this clinic should focus on training in three areas: ECG interpretation, delivering available treatments even when the “gold standard” treatment is not available, and counseling of patients and family members.