Background: Effective interpretation of electrocardiogram (ECG) data is a critical skill for primary health care physicians and part of the Family Medicine residency program curriculum. However, there is a lack of data regarding the competency of Primary Health Care Physicians in ECG interpretation in Saudi Arabia. To evaluate the competence of primary healthcare physicians in Saudi Arabia in interpreting common ECG abnormalities. Additionally, it seeks to understand participants’ perspectives on the facilitators and barriers to effective ECG learning. Methods: A cross-sectional study was conducted from 28 September 2023 to 1 November 2024. A validated questionnaire was used to assess the knowledge of primary health care physicians. Results: A total of 257 physicians participated in the study. Nearly half of the participants (51.8%) attended cardiology rotations and completed the Advanced Cardiac Life Support (ACLS) course. Findings revealed that 74.3% of participants demonstrated poor knowledge of ECG interpretation. Factors significantly contributing to ECG competence included completion of the ACLS course (p-value = 0.035), teaching during clinical rotations as a knowledge source (p-value = 0.020), and participation in ECG courses (p-value = 0.031). Barriers identified encompassed inadequate training programs and inconsistent exposure to ECGs. Conclusion: Primary health care physicians demonstrated unsatisfactory performance in ECG interpretation. Completion of ACLS and dedicated ECG courses, as well as exposure to structured teaching during clinical rotations, were significantly associated with higher competency. Therefore, integrating them into core medical curricula is recommended to enhance ECG interpretation skills among primary health care physicians. Further research is warranted to identify the most effective educational strategies for improving competency in this essential clinical skill.
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