EP Education

Making the Transition from the EP Lab to EKG Instructor: My Journey in Electrophysiology

Regina Kiefer, RT(R)(CV), RCES

Warner Robins, Georgia

Regina Kiefer, RT(R)(CV), RCES

Warner Robins, Georgia

Working in the medical field for 30 years has been an adventure. I’ve worked at several hospitals and a radiology office assisting with diagnostic x-rays, arteriograms, and surgeries. However, once I discovered the EP lab, I knew I was home. After years of study, I passed the Registered Cardiac Electrophysiology Specialist (RCES) exam in 2011.

As time went on, though, I wanted to become more of a contributor. Pace mapping a stubborn VT ablation was no longer the exciting learning event it was when I started. I began experiencing backaches from wearing a heavy lead apron. It had been several years since I had been assigned to precept. I also just turned 49, and wondered whether a career change was a good idea.

A nurse I worked with told me one day that Central Georgia Technical College (CGTC) in Macon, Georgia, was hiring an EKG adjunct instructor. I interviewed for the position, and began my first semester as an instructor in January 2019.

Then it was time to get to work! The Electrocardiography Technology Technical Certificate program at CGTC admits 10 students for a one-semester program. It's a fast paced program, which I loved. Working with my program chairperson and a thumb drive, I learned the material and computer system. Many of the students had no medical background, but found EKG to be a good starting point. We incorporated a lot of informal discussion about medical etiquette, and used a lot of dry erase board diagrams. There were also a lot of questions about P waves and elevated ST segments.

During the certificate program at CGTC, students spend the first seven weeks of the semester in a classroom setting learning basic cardiovascular anatomy and physiology, ECG techniques and recognition, and EP. Their clinical hours are completed after this at one of three local clinical sites. Over the next seven weeks, they are oriented to the department, taught the routine workflow, and begin to perform independently as their skills develop. Students work a total of 40 hours per week in hospitals, during which time they are able to demonstrate their knowledge of lecture material in the real world.

The requirement to pass the class is 225 hours of clinical experience. Students are assigned to the monitor room or to a clinical site’s 12-lead EKG roaming team; this decision is made based on where the site needs extra help and where the student is most likely to be successful. The clinical sites also test the students using their institutional basic rhythms course and exam. This ensures that each student has a full understanding of 12-lead interpretation.

During this time, I also began using social media in an effort to post about what I was studying, teaching, or practicing in the EP lab. In March 2019, I began an Instagram account called Baseline Intervals that solely focused on EP, EKG, and cardiology. Twitter and Facebook accounts, as well as a blog, followed shortly after. What started as a simple creative outlet has now grown into much more. Since then, I have made many connections on social media with like-minded professionals and have learned from their posts as well.

After the final exam at the end of the semester, most of my students had already accepted jobs and were inspired to continue in the cardiology field. Others felt that completing the Electrocardiography Technology Technical Certificate program was a good way to get their foot in the door for the Cardiovascular Technology and Echocardiography Associate Degrees at CGTC. I believe this certificate program is also a great precursor to the Nursing and Paramedicine programs at CGTC.

Cardiac electrophysiology is uniquely suited to accommodate and even thrive on a diverse technical staff. We have found that a mixture of radiologic technologists, CVTs, paramedics, surgical scrub techs, and respiratory therapists makes for a great team. EP is a team sport, meant for people who can sustain the long hours and still respond dynamically in a critical complication. While EP teams will continue to be comprised of personnel from multiple specialties, I believe the RCES credential will become the gold standard in EP labs in the future.

The EP lab is not a place to land and say, “Whew, I made it!” It is more like a runway for the ever curious and driven allied professional to takeoff. There is no shame in having ambition at any stage of life, especially in terms of personal growth and education. Some people might think less of certificate programs versus other four-year degree programs; however, technical colleges across the U.S. are demonstrating that they can supply skilled, quality employees in every field, especially in health sciences. Technical colleges also offer decreased tuition costs, immediate return on investment, and direct networking during clinical rotations. I hope more high school students will take the time to research dual enrollment or early entry to technical colleges. With the changing landscape of education in America, cardiovascular technology programs should be accompanied by RCES programs to prepare technologists for EP labs by providing the unique skillset required. 

Disclosure: The author has no conflicts of interest to report regarding the content herein.   

For more information, please visit: