Program Type: Acute Care Nurse Residency Program

Course Name: Cardiac Dysrhythmia and ECG Interpretation

Course Placement and Intended Environment: This will be the second

of three 15 week courses offered during a one year nurse residency program.
The residency will be conducted at a University Hospital with varying areas of
expertise available to residents. The participants in the Nurse Residency
Program are new graduates of Baccalaureate programs who have already
passed their NCLEX exam.

Course Description: Proper use, indications for and reading of

electrocardiograms and telemetry are vital for safe patient care. Nurse
Residents will familiarize themselves with the basics of cardiac electricity,
normal and abnormal rhythms, as well as review medications that could be
used for these rhythms. By the end of this course, the nurse will feel
comfortable and confident reading and interpreting ECGs and telemetry to
better patient care. This course will be a prerequisite to completing
Advanced Cardiac Life Support certification, of which the NR will have
sufficient knowledge of dysrhythmia and how to treat it.

Course Outcomes:

Upon completion of this course the learner will be able to:

1. Identify the basic use of ECG therapy and what it represents.

2. Classify telemetry and rhythm strips to provide safe patient care.
3. Predict patient outcome based on learned knowledge.
4. Advocate for patient changes and make recommendations to
providers.
5. Apply cultural considerations while applying and assessing patient ECG
therapy.
6. Observe and record patient telemetry adequately and effectively.
7. Manipulate the environment and surroundings to ensure patient
centered care.
8. Identify that responses to patient ECG and telemetry will directly
affect their care.

Topic 1 Basics of the ECG

End of class objectives or outcomes

Identify the electrical current through the heart.
 Discover what each wave on the ECG represents.
Recognize what a normal ECG looks like.

CLASSROOM TEACHING STRATEGIES PLAN

Gridding the heart - class

NAME OF LEARNING
ACTIVITY

Learning Activity A pros-cons grid will be developed of what the students are already
Summary familiar with and what they are anticipating during this class will be
developed.

Cognitive: Understanding, Remembering, Analyzing

Domain of Learning Affective: Receive, Respond, Valuing, Characterize

(Blooms Taxonomy
Revised) Psychomotor: Adaptation, Perception, Guided Response

Student-Centered At the completion of this learning activity, the learner will:

Learning Objective(s)
Identify the electrical current through the heart. (Cognitive)

Discover what each wave on the ECG represents. (Cognitive,

Affective, Psychomotor)

Recognize what a normal ECG looks like. (Cognitive,

Affective)

Preparation Required The instructor will need to prepare print outs of Pro and Con
by Teacher/Facilitator charts to be given to each resident for the use during this
and Materials Needed activity. They will also need to understand the activity in
order to properly explain it to the residents.

Time Allotted This will be during the two-hour classroom time. The activity itself
 will take approximately 20-30 minutes of that classroom time.

Learning Styles Information X Sight Sound X Text

Addressed by Activity Presentation

Modality X Visual X Verbal

Approach X Active X Reflective

Understanding Sequential Holistic

How is content connected This information should already be familiar to the nurse
to prior learning? resident, as they have completed nursing school and have
some foundation of the cardiac electricity of the heart.

Reflective Debriefing Each residents chart will be reviewed after the class. Another chart
with Learners (post- will be compiled of the general feelings of the residents to be
learning activity) How presented and discussed during the next class session.
will it be accomplished?

Evaluation of As this chart will be discussed in real-time after completion, each

Learning (How will it resident is considered to have participated and will be evaluated as
be accomplished?) such.

Teacher Reflection This activity is considered a good fit for this class as this is
introductory content. The overall understanding of ECGs and their
(justify choice of learning potential abnormalities is detrimental to proper safe patient care.
activity and good fit for
the identified learning
objectives)

End of clinical/lab objectives or outcomes

Evaluate why a patient may need an ECG
Hypothesize if ECG is normal or abnormal and why
Identify the various segments of the ECG wave

TEACHING STRATEGIES PLAN

 Basic of basics - lab
NAME OF LEARNING
ACTIVITY

Learning Activity The students will familiarize themselves with the available
Summary equipment for performing ECGs and take a tour of the
simulation lab that will be used during residency.

Cognitive: Remembering, Applying, Understanding,

Analysis
Domain of Learning
(Blooms Taxonomy Affective: Receive, Respond, Valuing
Revised)
Psychomotor: Perception, Adaption

Student-Centered At the completion of this learning activity, the learner will:

Learning Objective(s)
Evaluate why a patient would need an ECG. (Cognitive, Affective,
Psychomotor)

Hypothesize if the ECG is normal or abnormal and why. (Cognitive,

Affective, Psychomotor)

Identify the various segments of the ECG wave. (Cognitive,

Affective)

Preparation Required Preparation will require the instructor to have a working ECG
by Teacher/Facilitator machine that is fully stocked with ECG paper and ECG leads
and Materials Needed for students to become familiar with.

Time Allotted This will be during the one hour predetermined laboratory time, and
will be given the whole class time.

Learning Styles Information X Sight Sound Text

Addressed by Activity Presentation

Modality X Visual X Verbal

Approach X Active Reflective

 Understandin Sequential Holistic
g

How is content connected The students should have a previous knowledge of the
to prior learning? electrical conductivity of the heart, which will aid them in
understanding what that electrical activity produces on an
ECG.

Reflective Debriefing Time will be taken with the class to answer any questions
with Learners (post- related to ECG equipment or what the ECG represents
learning activity) How electrically.
will it be accomplished?

Evaluation of Evaluation will be done by the students each demonstrating

Learning (How will it to the instructor how to use the ECG machine. This hands-on
be accomplished?) evaluation provides the opportunity for real-time correction
and explanation of concerns or questions.

Teacher Reflection This learning activity is appropriate for this nurse residency
program because of the overwhelming amount of ECG
(justify choice of learning exposure the nurse will see. This particular activity is very
activity and good fit for basic and is used as an introductory lesson. It will prepare the
the identified learning nurse for the rest of information they will learn throughout
objectives) the Cardiac Dysrhythmia course as a whole.

Topic 2 Myocardial Infarction and Myocardial Ischemia

End of class objectives or outcomes

Identify three ECG changes that classify a myocardial infarction
Categorize which areas of the ECG indicate the infarcting area of the heart
Identify limitations to diagnosing an infarction via ECG
TEACHING STRATEGIES PLAN
 A Matching of Heart - Class
NAME OF LEARNING
ACTIVITY

Learning Activity Nurse residents will be shown an ECG lead with suspected
Summary infarction or ischemia and the resident will be responsible for
matching the lead with a picture of the area of the heart that is
infracting or experiencing ischemia. This will be done in two teams
working against each other.

Cognitive: Understanding, Remembering, Analyzing,

Applying
Domain of Learning
(Blooms Taxonomy Affective: Responding, Receive, Value
Revised)
Psychomotor: Perceive

Student-Centered At the completion of this learning activity, the learner will:

Learning Objective(s)
Identify three ECG changes that classify as a myocardial
infarction (Affective, Cognitive, Psychomotor)

Categorize which areas of the ECG indicate the infracting area

of the heart. (Affective, Cognitive, Psychomotor)

Identify limitations to diagnosing an infarction via ECG.

(Affective, Cognitive, Psychomotor)

Preparation Required The instructor will need to find infracting ECGs representing
by Teacher/Facilitator different areas of the heart. Those ECGs will then be cut
and Materials Needed apart and placed on 1 foot x 1 foot cardboard pieces so that
the nurse can easily flip it over for matching purposes.

Time Allotted This will be during the two-hour allotted classroom time with
nursing residents. The activity itself will take approximately 20-30
minutes.

Learning Styles Information X Sight Sound X Text

Addressed by Activity Presentation
 Modality X Visual X Verbal

Approach X Active X Reflective

Understandin X Sequential Holistic

g

How is content connected At this point, the resident has their previous knowledge of
to prior learning? cardiac electricity, as well as readings through their textbook.
As this is a residency program, the nurse has had patient
contact and has likely had a patient with potential cardiac
event requiring intervention.

Reflective Debriefing After the activity is finished, the residents will be given the
with Learners (post- opportunity to express whether they found it helpful or not.
learning activity) How Questions regarding the results can be asked and there will be a
will it be accomplished? short discussion with the whole class regarding these feelings.

Evaluation of The outcomes of the actual matching game will be discussed as a

Learning (How will it group. Though it is broken in to teams, there is no winner. Teams
be accomplished?) are used to promote collaboration and team work. All residents will
be asked to give their input via a one-sentence summary. These
summaries will be reviewed by the instructor after class and will be
briefly discussed during the next weeks class for follow-up.

Teacher Reflection This learning activity is very important for the nurse residents to
understand well. As nurses, chest pain and possible MI is something
(justify choice of learning that is seen very frequently. A firm understanding of how to read
activity and good fit for ECGs to rule out these potentially life threatening diagnoses is
the identified learning detrimental to patient care and needs to be at the forefront of a
objectives) nurses practice.

End of clinical/lab outcomes

Verbalize ways to reduce limitations to diagnosing infarction on ECG
Evaluate practice ECGs for infarction and identify the area of which it occurs
Identify the important medications to be administered during a suspected or confirmed
MI

TEACHING STRATEGIES PLAN

Stand for your heart - Lab

NAME OF LEARNING
ACTIVITY

Learning Activity Students will be shown an ECG representing infarction. They will
Summary be given the choice to go to the left side of the room representing
one choice for which part of the heart is infracting and the right side
of the room representing another choice of area of the heart.

Cognitive: Understanding, Remembering, Analyzing,

Applying
Domain of Learning
(Blooms Taxonomy Affective: Respond, Receive, Organize, Value
Revised)
Psychomotor: Perceive, Adapt

Student-Centered At the completion of this learning activity, the learner will:

Learning Objective(s)
Verbalize ways to reduce limitations to diagnosing infarction
on ECG. (Affective, Cognitive, Psychomotor)

Evaluate practice ECGs for infarction and identify the area of

which it occurs. (Affective, Cognitive, Psychomotor)

Identify the important medications to be administered during

a suspected or confirmed myocardial infarction. (Cognitive,
Affective, Psychomotor)

Preparation Required The teacher will need to collect ECGs of myocardial

by Teacher/Facilitator infarctions and ischemia that originate from different areas of
and Materials Needed the heart to show the difference in how the ECG will look.
There will need to be a way to project ECG clips on to the
front of the room..

Time Allotted This will be during the one hour predetermined laboratory time.
This activity will take approximately 30-45 minutes.

Learning Styles Information X Sight Sound X Text

Addressed by Activity Presentation

Modality X Visual X Verbal

 Approach X Active X Reflective

Understandin X Sequential Holistic

g

How is content connected At this point, the resident has their previous knowledge of
to prior learning? cardiac electricity, as well as readings through their textbook
to this point. As this is a residency program, the nurse has
had patient contact and has likely had a patient with potential
cardiac event requiring intervention.

Reflective Debriefing Time will be spent at the end of the lab experience and prior to
with Learners (post- evaluation for the residents to ask questions and receive
learning activity) How clarification.
will it be accomplished?

Evaluation of Students will be asked to participate in The Muddiest Point to

Learning (How will it express something they were confused about. These will be
be accomplished?) reviewed by the instructor after lab and will be discussed as a group
during the next lab experience.

Teacher Reflection This learning activity is very important for the nurse residents to
understand well. As nurses, chest pain and possible MI is something
(justify choice of learning that is seen very frequently. A firm understanding of how to read
activity and good fit for ECGs to rule out these potentially life threatening diagnoses is
the identified learning detrimental to patient care and needs to be at the forefront of a
objectives) nurses practice.