Among nurses, skill retention after an electrocardiography blended-learning course is unknown.


To compare 3- and 8-week electrocardiography test scores, compare scores by nurse and work characteristics and self-assessed electrocardiographic competence, and compare 1-year work retention with 3- and 8-week scores and change in scores from week 3 to week 8.


Data were collected on demographics, comfort with electrocardiography expectations, electrocardiography competence levels, and 1-year work retention. Correlational and comparative statistics were used in analyses.


Of 69 nurses, 58% were somewhat comfortable with interventions for abnormal rhythms. Test scores were higher at 3 weeks than at 8 weeks: mean difference, 26%; P < .001. Scores at 8 weeks reflected intermediate skill retention and were not associated with nurse characteristics, electrocardiography background, comfort with rhythms and measurements, or 1-year work retention. Nurses with greater comfort for intervening when rhythm abnormalities occurred had higher median 8-week scores (P = .01) than did nurses with less comfort, and perceptions of electrocardiographic competence were associated with 8-week scores (r = 0.28; P = .02). Reduction in scores at 8 weeks was less severe in nurses with greater comfort at 3 weeks in measuring electrocardiographic intervals (P = .008) and applying therapeutic interventions (P = .009).


Skill retention and competence in electrocardiographic interpretation were intermediate and correlated with baseline self-assessment. Electrocardiographic interpretation, measurement, and interventions should be reinforced at the bedside.

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