Design: Prospective controlled mixed-methods trial with concealed allocation
Population: 103 paramedics, prehospital physicians and ED clinicians, Germany
Primary outcome: ECG interpretation accuracy; text-based ACS decision-making
Effect: ECG 55→65.5% vs 57→60%; decisions 45→68% vs 47→63%

This trial at five German training sites allocated 103 paramedics, prehospital emergency physicians and ED clinicians to a 30-minute curated FOAMed video and podcast module or print materials on high-risk ACS ECG patterns, including STEMI equivalents and occlusion MI patterns. Assessment was automated and blinded. It was published in JMIR Medical Education in September.

ECG interpretation accuracy rose from 55% to 65.5% with the online module and from 57% to 60% with print. Text-based ACS decision-making rose from 45% to 68% and from 47% to 63%. Effect sizes were small to moderate (η² 0.055 and 0.044).

This measures short-term test performance, not patient outcomes. Still, one short session moved recognition of patterns that are commonly missed, and the resources are free.

Include STEMI equivalents and occlusion MI patterns in ED teaching.
Use short curated video modules alongside case review.
Retest after weeks to check retention.
Share teaching across paramedics and ED staff, since both make the first call.

Why it matters

Occlusion MI without classic ST elevation is often missed, and brief teaching improved recognition.

The statistics, in plain English

η² values around 0.05 are small to moderate effects. Groups were uneven because of no-shows, the trial was not prospectively registered, and outcomes were tested immediately afterwards, so retention is unknown.