The ECG Quiz categorizes users into three ECG Interpretation Skill Levels to ensure appropriate grading difficulty and to help learners choose a level that matches their experience. These levels—Beginning, Intermediate, and Advanced—play a central role in the scoring and feedback system (see The Scoring Algorithm for details).

Registered Users, Subscribers, and Organization Members may select their preferred skill level at any time using The ECG Quiz User Preferences menu.

Each skill level represents a different stage of ECG interpretation proficiency.

Users at this level:

• Have a basic understanding of ECG interpretation
• Can identify normal rhythms and simple abnormalities
• Recognize foundational elements such as bradycardia, tachycardia, and pauses
• Are building confidence in rhythm recognition and early pattern identification

This level is recommended for learners with limited experience or those beginning a structured ECG study.

Users at this level:

• Have a solid grasp of basic ECG interpretation
• Can identify more complex arrhythmias and conduction abnormalities
• Recognize atrial fibrillation, heart blocks, ischemic patterns, ventricular arrhythmias, and more
• Are developing the ability to integrate subtle ECG features with clinical context

This level represents a learner who is progressing toward advanced diagnostic skill.

Users at this level:

• Demonstrate advanced expertise in ECG interpretation
• Confidently identify complex arrhythmias and high-risk diagnoses
• Accurately interpret acute MI, ischemia, bradyarrhythmias, tachyarrhythmias, and pacemaker/device malfunctions
• Make rapid and reliable clinical decisions using ECG data

This level is suited for clinicians and learners with substantial experience who already interpret ECGs independently.

You may update your Skill Level using either of the following methods:

• The ECG Quiz → Manage Preferences (upper-left navigation)
• My Account → The ECG Quiz Preferences (upper-right menu)

Changing your Skill Level can alter how your ECG results are graded, including how differential diagnoses and multiple interpretations are handled.

You should archive your current results when making any Skill Level change. The system will automatically prompt you to archive your current results when you attempt to switch levels.