ECG theoretical knowledge and interpretation competency of arrhythmias in final-year students: a cross-sectional study

Electrocardiography (ECG) is the key method for diagnosing arrhythmias. Nurses' prompt recognition and early clinical decisions can greatly improve patient outcomes, making it essential to develop nursing students' ECG interpretation skills for arrhythmias. This study aims to assess the theoretical knowledge and ECG interpretation competency of nursing students and examine factors associated with their performance. This study used a cross-sectional design and was conducted in two university-affiliated hospitals in Sichuan Province. A total of 116 final-year nursing students who had received ECG training during their internship were included, along 228 registered nurses divided into two groups. Data were collected through self-administered questionnaires, comparing the differences in demographic information, arrhythmia theoretical knowledge, and ECG interpretation competency in arrhythmias across the three groups. Binary logistic regression was used to identify the factors influencing theoretical knowledge and ECG interpretation competency for arrhythmias among nursing students. Final-year nursing students who participated in ECG interpretation training reported frequent engagement in ECG interpretation practice and regular ECG-related discussions, but there were still issues with insufficient self-learning. Compared to registered nurses, nursing students demonstrated theoretical knowledge comparable to that of registered nurses working in adult cardiology, emergency, and intensive care units, and higher than that of registered nurses working in other adult departments. Regarding ECG interpretation competency, nursing students scored lower than registered nurses working in adult cardiology, emergency, and intensive care units, but higher than those working in other adult departments. ECG interpretation practice (AOR = 6.302 (1.324–29.991), p = 0.021), self-learning (AOR = 7.330 (1.651–32.551), p = 0.009), and a solid theoretical foundation (AOR = 20.075 (4.460–90.360), p < 0.001) were key factors influencing nursing students' interpretation competency for arrhythmia ECGs. Final-year nursing students demonstrated ECG interpretation competency for arrhythmias comparable to that of registered nurses in specialized adult units and superior to those in general adult wards. ECG interpretation practice, self-learning, and theoretical knowledge were associated with higher interpretation competency among nursing students.