1. Bailey, Donna W. RN, PhD, Reviewer

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P.R. Jeffries, C. Sternberg, and L. Meyer, Medical AudioVisual Communications Inc, Suite 240, 2315 Whirlpool St, Niagara Falls, NY 14305, Phone: 1-800-757-4868, Fax: 905-602-8720, E-mail:, Web:, Price: $229.00



EKG Basic Rhythm Analysis is a CD-ROM that provides basic information on cardiac dysrhythmia interpretation. Created for healthcare professionals (nurses, physicians, emergency medical technicians, and paramedics) who are responsible for EKG interpretation as a part of the care they provide, the instructional material provides a review of the background information necessary for interpreting common cardiac dysrhythmias. Typical treatment is included in the instructional material.


Using the Jeffries Hyperlearning Model, basic cardiovascular anatomy and physiology content related to dysrythmia interpretation is arranged across 3 learning dimensions, General Principles, Process, and Critical Thinking. Anatomy and physiology is primarily addressed in the General Principles section while the steps in dysrhythmia interpretation are covered in the Process section. The Critical Thinking section integrates the material from General Principles and Process in scenarios to facilitate understanding through the application of cardiac system knowledge via the steps in the dysrythmia interpretation process. The presentation of the content allows the learner to move through the material sequentially much like one would experience in a typical lecture class or to adapt the dimensions to their own personal learning preferences. In other words, the learners can access the dimensions in any order, perhaps, wanting to begin with process or critical thinking initially to validate their current level of understanding. Pretests and posttests are available to structure the learning experience and provide feedback on the level of learner understanding. Additional program features include a glossary and note-taking function.



Installation is not required since the CD-ROM can run from the CD drive of your computer. The instructions for running the program are consistent with typical CD-ROM use. I ran the program on an IBM ThinkPad 600X laptop using Windows 98. I also had the opportunity to run the CD-ROM on a Macintosh using Mac OS 9.1. The software ran without any difficulty on this platform.


The MUSTREAD.txt file provided straightforward instructions for problems you might encounter with screen resolution and colors. It is necessary to have QuickTime 3.0 or higher on your computer to use the CD-ROM. The program checks to see if you have the appropriate version of QuickTime and will begin the installation process if you do not have version 3.0 or higher. I needed a more recent version and had no problems with the program installation of the update.



Accessing the instructional material was accomplished by inserting the CD-ROM and selecting RUN in the Start Dialogue box on Windows. Once the credits were faded in and out, an introduction was presented outlining the primary components of the program, General Principles, Process, Critical Thinking, and Testing. Following this screen, the main menu listed the components allowing access to the next level content related to each element. Before each main section, objectives were available describing what the learner could expect to gain in the section. Additionally, the overview and objectives were read out loud, thereby providing limited support for learners with visual impairment. Clicking on General Principles took me to 2 levels of content that included cardiac anatomy and cardiac physiology. At this level, the navigational buttons at the bottom of the screen provided access to the previous screen, main menu, glossary (Vocabulary), My Notes (the note-taking function), and exit. It took me a little time to get used to the navigational screen and I found it disconcerting to have to navigate back though the layers or to go through the Main Menu to get to a previously viewed area. Once I got acclimated to the navigational structure, it was not as frustrating but it would be more useful to have an easier way to move back and forth between content areas.


In General Principles, each subcontent level provided straightforward cardiac anatomy and physiological content much like what one would find in a textbook. The advantage gained by the program over the textbook in this section seemed to be the addition of animated graphics to illustrate some of the concepts. For the most part, the animations provided additional information that could support understanding.


Moving through the content areas in General Principles was relatively quick and easy because the screens usually contained a limited amount of information. The combination of a few statements of content and a graphical representation of the content facilitated understanding the content. It took me about an hour to work through the General Principles component.


The second section, Process, addressed the process of interpreting rhythms. This section outlined briefly background material for the origin of rhythm problems and the process for interpreting rhythms. Following these presentations was an interactive section that allows the learner to select rhythms and review content related to features of the dysrhythmia, special characteristics, etiologies, nursing and medical management, and a practice test question. This section was completed in about an hour.


Multiple-choice questions were used in the Critical Thinking, section, to integrate what had been presented in General Principles and Process. I selected a response, submitted it, and received feedback on whether it was the correct response. Correct responses received a reinforcing comment containing content, while incorrect responses received a feedback message of "Incorrect" and a content message explaining the correct answer. I spent about 15 minutes working through this section.


The final section, Testing, provided pretest and posttests. Taking the pretest, I scored 63. After completing the CD-ROM, I scored 83 on the posttest.



The program is provided in a CD-ROM jewel case with documentation limited to the inside and back cover of the CD-ROM case A MUSTREAD.txt file is available in the electronic folder but information is limited to technical issues with running the program. It would have been useful to have a detailed explanation of the navigational structure and program features than was provided. I spent a little time getting used to the navigation and content layout. This initially distracted me from the content. Novice learners might have problems with these areas since they are learning both the material and the structure of the program. Experienced providers using the CD-ROM to review or reinforce their understanding of cardiac basics could be frustrated with navigating the sections without a clearer understanding of how the content is laid out. One of the more frustrating aspects of navigation was having to back out of the sections layer by layer.



I did not need to contact technical support to use this program. On visiting the Web site, I discovered that the program was available for a 14-day free preview. Shipping cost is $9.00 for a single CD and $1.00 for additional programs. The distributor provides a variety of healthcare-oriented programs.



Using an interactive approach to learning basic concepts has been proven to enhance the learning experience. This CD-ROM provides interactivity and immediate feedback to facilitate learning. This is the strength of the program. Another advantage of this program is the amount of time needed to work through the content. I did not perceive the 2 to 3 hours as excessive to review this content.


I noticed 3 areas that might be problematic for a potential user. First, I would not recommend this product for a novice who is learning about EKG interpretation for the first time. The level of content in this CD-ROM is not detailed enough to help develop effective cognitive schemes. This could be easily remedied by adding additional basic content resources such as the "Cardiovascular Anatomy and Physiology" CD-ROM by the same authors.


Second, the quality of some of the rhythm strips used as illustrations was not as good as they might have been. For examples copied from actual tracings, the small grid did not reproduce well for the screen display of some of the EKG tracings. For the more obvious rhythms such as ventricular fibrillation, this was not a problem. I did have problems with trying to interpret the atrial rhythms and blocks because of the fuzziness of some of the tracings.


Finally, selecting material to facilitate review and knowledge development is often influenced by cost. In this respect, the software is at a disadvantage because there are a wide variety of materials available for EKG interpretation that cost much less than this CD-ROM.



PC: Windows 95 or higher, 80386 processor or higher, Super VGA graphics adapter, Sound card, Speakers, 4X or faster CD-ROM


Macintosh: System 7.0 or higher; 4MB RAM; 256 Color Monitor; 4X or faster CD-ROM