{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T21:11:43Z","timestamp":1789506703033,"version":"build-2803163510"},"reference-count":49,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Med Educ"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Accurate interpretation of high-risk acute coronary syndrome (ACS) electrocardiograms (ECGs) is essential for early diagnosis and timely reperfusion, yet substantial deficits persist across health care professions. Digital self-learning formats such as FOAMed (Free Open Access Medical Education) are widely used, but their effectiveness has rarely been evaluated for complex, high-risk ACS ECG patterns. Existing ECG education studies often focus on students or single professional groups and established ST-segment elevation myocardial infarction (STEMI) criteria, leaving newer guideline-recognized STEMI equivalents, selected emerging occlusion myocardial infarction (OMI)\u2013related patterns, and interprofessional emergency care underrepresented.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to compare the effectiveness of FOAMed podcast and videos versus traditional print-based materials for teaching high-risk ACS ECG patterns and related clinical decision-making in emergency providers.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a prospective, interprofessional, controlled mixed methods trial across 5 training sites in Germany. Paramedics, prehospital emergency physicians, and emergency department clinicians received either a FOAMed multimedia module or print-based materials through concealed allocation; deviations from the intended 1:1 ratio resulted from participant no-shows. The intervention consisted of a 30-minute supervised self-learning session. In total, 103 participants were allocated to FOAMed (n=45) or print-based materials (n=58). Two coprimary outcomes were assessed: ECG interpretation accuracy and text-based ACS clinical decision-making. Secondary outcomes included subjective confidence, learning experience, and exploratory qualitative free-text responses. Outcome assessment was automated and blinded; mixed ANOVA was the primary analysis. The study was not prospectively registered because it assessed educational outcomes in health care professionals rather than patient health outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n All 103 participants completed the study. Both groups improved, with greater gains in the FOAMed group: ECG interpretation increased from 55% to 65.5% and text-based ACS clinical decision-making from 45% to 68%, versus 57% to 60% and from 47% to 63%, respectively, in the print-based group. Effect sizes were \u03b7\u00b2=0.055 for ECG interpretation and \u03b7\u00b2=0.044 for clinical decision-making. Exploratory subgroup analyses provided no evidence of differential effects across age, gender, or professional background and were likely underpowered. Qualitative responses (46 and 37 entries) provided contextual insights into perceived clarity, engagement, and practical relevance supporting the quantitative findings.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study is innovative in directly comparing a curated FOAMed multimedia module with selected print-based materials in an interprofessional emergency care population. It differs from existing research by focusing on subtle, emerging ischemic patterns and evaluating realistic, time-limited self-learning formats. The findings provide evidence that curated FOAMed resources can produce greater short-term improvements in ECG interpretation and text-based ACS clinical decision-making than traditional print-based materials in this setting. Although implications for clinical performance remain hypothetical, concise, high-quality digital modules may represent a practical supplement to structured continuing education in emergency care.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/87587","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T10:50:05Z","timestamp":1786704605000},"page":"e87587-e87587","source":"Crossref","is-referenced-by-count":0,"title":["Teaching Acute Coronary Syndrome High-Risk ECG Interpretation and Clinical Decision-Making Through FOAMed Videos and Podcast Versus Print-Based Materials Among Emergency Care Providers: Randomized Controlled Mixed Methods Trial"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7638-579X","authenticated-orcid":false,"given":"Wiebke","family":"Turner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9287-6209","authenticated-orcid":false,"given":"Klaus","family":"Fessele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2854-6201","authenticated-orcid":false,"given":"Martin","family":"Fandler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6306-4173","authenticated-orcid":false,"given":"Jan P","family":"Ehlers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3443-6649","authenticated-orcid":false,"given":"Julia","family":"Nitsche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"issue":"38","key":"R1","doi-asserted-by":"publisher","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC Guidelines for the management of acute coronary syndromes","volume":"44","author":"Byrne","journal-title":"Eur Heart J"},{"issue":"2","key":"R2","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)","volume":"39","author":"Ibanez","journal-title":"Eur Heart J"},{"issue":"7","key":"R3","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/j.ajem.2007.02.005","article-title":"Hyperacute T wave, the early sign of myocardial infarction","volume":"25","author":"Sovari","journal-title":"Am J Emerg Med"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.jelectrocard.2015.10.005","article-title":"Precordial junctional ST-segment depression with tall symmetric T-waves signifying proximal LAD occlusion, case reports of STEMI equivalence","volume":"49","author":"de Winter","journal-title":"J Electrocardiol"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1016\/0002-8703(89)90742-4","article-title":"Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery","volume":"117","author":"de Zwaan","journal-title":"Am Heart J"},{"issue":"6","key":"R6","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.15989","article-title":"Shark fin electrocardiogram: a deadly electrocardiogram pattern in ST-Elevation Myocardial Infarction (STEMI)","volume":"13","author":"Jaiswal","journal-title":"Cureus"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2020.04.008","article-title":"A new electrocardiographic pattern indicating inferior myocardial infarction","volume":"61","author":"Aslanger","journal-title":"J Electrocardiol"},{"issue":"6","key":"R8","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1016\/j.ahj.2010.08.011","article-title":"Appropriate cardiac cath lab activation: optimizing electrocardiogram interpretation and clinical decision-making for acute ST-elevation myocardial infarction","volume":"160","author":"Rokos","journal-title":"Am Heart J"},{"issue":"4","key":"R9","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.annemergmed.2024.11.019","article-title":"ECG patterns of occlusion myocardial infarction: a narrative review","volume":"85","author":"Ricci","journal-title":"Ann Emerg Med"},{"issue":"Supplement_3","key":"R10","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartjsupp\/suag056.033","article-title":"The new occlusive\/non-occlusive MI paradigm to remedy the failure of high risk non-ST elevation MI criteria in the real world - 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