Pilot study of massive open online course (MOOC) implementation in electrocardiography (ECG) learning: perspectives from general practitioners

Background: Cardiovascular disease (CVD) is Indonesia's primary cause of morbidity and mortality. Rapid detection and appropriate treatment of CVD cases are needed to reduce mortality. Electrocardiography (ECG) is a simple examination modality that can detect many cardiac abnormalities. General practitioners are expected to master the interpretation of basic ECG. Massive open online course (MOOC) is a breakthrough that can facilitate profound learning without temporal and physical barriers and support continuing medical education. This pilot study aimed to evaluate the implementation of MOOC in ECG learning among a limited number of general practitioners. Methods: Consecutive sampling was used to recruit the subjects. Subjects were given ten weeks to finish all modules and quizzes. Pre-test and post-test were taken. User satisfaction was evaluated using a questionnaire. A focused group discussion (FGD) was conducted to explore subjects' learning experiences and perspectives toward the learning system using MOOC. Results: 17 general practitioners participated in the study, but only seven could finish all the modules and quizzes. All subjects were aged under 30 years old. Those who could complete the course took 10-39 days. Post-test scores were significantly higher than pre-test scores (p=0.038). Although subjects agreed that MOOC was convenient, attractive, and suitable for general practitioners in clinical practice, they demanded an explanation of the quiz answers. They suggested that some modules should be optional. Conclusion: MOOC learning was suitable for general practitioners to improve their ECG interpretation skills. Some features should be added to increase user satisfaction. A study with extensive subjects is needed to analyze the effectiveness of this ECG course.