Grade 13 · a vocational technology learning center, by urbanicity

newSchoolWorks.com › VoTechWorks › Health & Personal Services › EKG Technician › Courses

Health & Personal Services · course plan

⚠ Pending professional review

This course plan, its lessons and its assessments has not yet been verified by a licensed clinician in the field or by a certification or approval body. It is a study draft and may contain errors. Do not use it to make decisions about any patient or medication. Always follow your instructor, your supervising professional, and current official references and regulations.

VoTechWorks program approval and accreditation are still in progress. Credentials are issued only by the certifying bodies named in each program, after their own exams.

EKG Technician

7 courses · 472 clock hours · 4 mo full-time. Grading is competency-based: each course requires the written exam, a competent skills demonstration with zero safety faults, a signed log, and a passed safety audit; percentage weights only rank performance above the competency floor.

~~$4,737~~ COMPLIMENTARYprogram tuition

7courses

55lessons

472hours

0assessments

Development progressPlanCourses, lessons and assessments written for this tradeLessons55 of 55 lesson pages writtenPractice439 practice questionsResources119 reference entries (study list)Review0 lesson pages reviewed by a licensed professional

Study now: 55 lesson pages are open (lesson titles below are links).

HLT-EKGT89-01 Universal core

Universal Core: Safety, Math, Communication & Career for EKG Technicians

148 hr · ~~$1,185~~ COMPLIMENTARY

This foundational course equips adult learners entering the EKG Technician program with the safety knowledge, mathematical skills, communication competencies, and professional behaviors required in cardiac diagnostic settings. Students complete OSHA 10-Hour General Industry training, hands-on CPR/AED/first aid certification, trade-specific math and measurement, medical terminology, health-record documentation, and digital tool proficiency. All content is contextualized to cardiac monitoring environments and directly supports the professional practice and communication domains tested on the NHA Certified EKG Technician (CET) examination.

Outcomes

Demonstrate compliance with OSHA bloodborne pathogen standards, electrical safety protocols, and standard precautions in a simulated clinical environment to a documented passing standard.
Perform adult, child, and infant CPR with AED use and basic first aid to the standards required for an accredited BLS or equivalent certification.
Apply arithmetic, unit conversion, and rate calculations used in cardiac monitoring—including paper speed, amplitude, and interval measurement—with at least 80% accuracy on written assessments.
Read and interpret medical terminology, abbreviations, and written clinical instructions commonly found in EKG orders and patient charts.
Document patient demographic and procedural information accurately in both paper and electronic health record formats, following privacy and confidentiality requirements under applicable federal law.
Present a professional resume, complete a mock employment interview, and articulate the scope of practice and ethical responsibilities of a CET-credentialed technician.

Course text

How the course runs. 7 blocks: Workplace Safety and OSHA 10-Hour General Industry; Infection Control, Standard Precautions, and Patient Safety; CPR, AED, and Basic First Aid Certification; Trade Math: Calculations and Measurement in Cardiac Monitoring; Medical Terminology and Clinical Reading for EKG Technicians; Digital Tools, EHR Documentation, and HIPAA Compliance; Professional Identity, Career Readiness, and Scope of Practice.

What competent looks like. Demonstrate compliance with OSHA bloodborne pathogen standards, electrical safety protocols, and standard precautions in a simulated clinical environment to a documented passing standard. Perform adult, child, and infant CPR with AED use and basic first aid to the standards required for an accredited BLS or equivalent certification. Apply arithmetic, unit conversion, and rate calculations used in cardiac monitoring—including paper speed, amplitude, and interval measurement—with at least 80% accuracy on written assessments. Read and interpret medical terminology, abbreviations, and written clinical instructions commonly found in EKG orders and patient charts. Document patient demographic and procedural information accurately in both paper and electronic health record formats, following privacy and confidentiality requirements under applicable federal law. Present a professional resume, complete a mock employment interview, and articulate the scope of practice and ethical responsibilities of a CET-credentialed technician.

Lessons · 7 blocks

#	Lesson	Hr	Type	Objective	Activities	Materials	Check
1	Workplace Safety and OSHA 10-Hour General Industry	12	theory	Students will identify OSHA general industry hazard categories relevant to healthcare settings—including electrical hazards from EKG equipment, bloodborne pathogens, and ergonomic risks—and state the employee rights and employer obligations established under the OSH Act.	Complete all ten modules of the OSHA 10-Hour General Industry course using the program's licensed provider, pausing after each module to complete the embedded knowledge checks and record two real-world examples from cardiac monitoring environments in a safety journal. Small-group hazard hunt: using photographs of a simulated EKG lab, teams identify and categorize at least eight hazards by OSHA hazard type, then present findings to the class for peer critique. Individual written scenario exercise: given three workplace incident descriptions (a lead-wire trip hazard, a needlestick, and a patient monitor electrical fault), students write a brief incident report using a standard form and identify which OSHA standard applies to each.	OSHA 10-Hour General Industry course access (licensed provider), OSHA Hazard Communication Standard summary card, sample incident report form, hazard-identification photograph sets of EKG labs, safety journal (composition notebook or digital equivalent)	Students must pass all OSHA 10-Hour provider module quizzes to receive the OSHA 10 completion card; additionally, the hazard-hunt presentation is scored on a 10-point rubric—a minimum score of 8/10 is required to proceed.
2	Infection Control, Standard Precautions, and Patient Safety	16	lab	Students will correctly apply standard precautions—including hand hygiene, personal protective equipment selection, and electrode-site skin preparation—and describe transmission-based precaution categories to prevent healthcare-associated infection during EKG procedures.	Instructor-led demonstration of the WHO five-moment hand-hygiene protocol using a UV-light hand-hygiene trainer; each student performs the technique three times and views results under UV light before and after, recording findings in their safety journal. Donning and doffing practice stations: students rotate through four stations (gloves only; gloves plus gown; gloves plus gown plus mask; N95 respirator fit check) using a standardized checklist, with a partner observing and marking errors in sequence. Case-study analysis: given three patient scenarios (a patient in contact precautions for MRSA, a patient on droplet precautions, and a standard-precaution patient), students write the PPE selection, room-entry sequence, and electrode waste disposal steps for performing a 12-lead EKG on each, then compare answers in a facilitated class debrief.	UV-light hand-hygiene trainer and lotion, disposable gloves (multiple sizes), isolation gowns, surgical masks, N95 respirators, fit-check strips, WHO hand-hygiene reference poster, CDC transmission-based precautions quick-reference card, donning/doffing competency checklist	Competency checklist for donning and doffing must be completed with zero critical errors (defined as touches to face or failure to remove contaminated gloves before gown) across two consecutive observed attempts; written case-study responses graded at 80% or higher.
3	CPR, AED, and Basic First Aid Certification	16	lab	Students will perform high-quality CPR for adult, child, and infant victims; operate an AED through a full simulated sequence; and manage common first-aid emergencies—including choking and severe bleeding—to the standard required for an accredited BLS-level or equivalent certification.	Skills station rotation: students cycle through adult CPR on a manikin (compression depth, rate, and recoil checked by an electronic feedback manikin), child CPR, infant CPR using two-finger technique, and two-rescuer CPR with bag-valve mask, performing at least three full two-minute cycles at each station under instructor observation. AED simulation drill: using a training AED and adult manikin, each student independently performs the full chain of survival sequence—scene safe, call for help, begin CPR, attach AED, follow prompts—timed from collapse to first shock attempt, with the instructor recording time-to-shock and technique errors. First-aid scenario carousel: four stations (adult choking/abdominal thrusts, infant choking/back blows and chest thrusts, pressure dressing for severe bleeding, and recovery position) with each student completing all stations and self-assessing on a provided skills checklist before instructor sign-off.	Adult, child, and infant CPR manikins (with electronic feedback capability if available), training AED units, bag-valve mask trainers, first-aid scenario props (hemorrhage control dressing, choking simulation vest or demo), accredited CPR/AED/first aid provider course materials and skills verification cards, skills competency checklists	Students must pass the accredited provider's written and skills evaluations to earn the CPR/AED/First Aid card; additionally, AED drill time-to-shock must be within the window specified by the certifying organization, and all critical skills steps on the instructor checklist must be marked satisfactory.
4	Trade Math: Calculations and Measurement in Cardiac Monitoring	30	practice	Students will accurately perform the arithmetic, ratio, unit conversion, and rate calculations—including heart rate from EKG paper, interval measurement in milliseconds, and electrode placement measurement in centimeters—required for EKG acquisition and documentation, achieving at least 80% on each assessed skill set.	Structured drill sets on paper EKG rulers: using printed rhythm strip samples, students measure at least 20 R-to-R intervals in small squares, convert to milliseconds using the standard paper speed of 25 mm/second, and calculate heart rate using both the 300-method and the 1500-method, entering results in a calculation log that the instructor reviews for accuracy. Unit conversion worksheet series: students complete three progressively difficult worksheets converting among millimeters, centimeters, millivolts, and milliseconds in clinical contexts (e.g., 'An ST segment measures 3 small squares. What is its duration in milliseconds?'), with immediate self-check using an answer key followed by instructor clarification of errors. Applied measurement lab: using a torso mannequin with surface landmarks, students use a tape measure to locate and mark anatomical reference points (e.g., fourth intercostal space, mid-clavicular line) and record measurements, then compare their marks to a reference overlay and calculate the percentage deviation from the standard position for each electrode site.	EKG calipers and paper EKG rulers, printed 6-second rhythm strip sets (multiple rhythms), unit conversion worksheets (instructor-prepared), answer keys, tape measures, torso mannequin with anatomical landmarks, calculator (four-function), NHA CET Exam Content Outline (for scope reference)	Three graded quizzes (heart rate calculation, unit conversion, and anatomical measurement) each scored individually; students must score 80% or higher on each quiz. Students scoring below 80% receive targeted remediation and one retake per quiz before moving forward.
5	Medical Terminology and Clinical Reading for EKG Technicians	28	theory	Students will decode unfamiliar medical terms by applying knowledge of cardiovascular and general medical prefixes, roots, and suffixes; correctly interpret common abbreviations found in EKG orders and chart notes; and extract accurate procedural information from written clinical instructions.	Root-building workshop: using a cardiovascular medical terminology reference, students construct 40 terms from provided prefix, root, and suffix cards (e.g., brady- + card- + -ia; tachy- + arrhythm- + -ia; electro- + cardio- + -gram), write a plain-language definition for each, and verify definitions against the reference before a partner-swap peer check. Abbreviation translation exercise: students receive a set of 30 de-identified EKG order excerpts and chart note snippets containing abbreviations common in cardiac monitoring (e.g., HR, BP, NSR, LVH, afib, prn, q.d., ECG/EKG, Pt., Dx, Hx) and write the full term and a brief contextual explanation for each abbreviation, submitting their worksheet for instructor grading. Clinical instruction simulation: working in pairs, students receive a written EKG order (including patient name placeholder, date, ordering provider, diagnosis code description in plain text, and any special instructions such as 'right-sided leads' or 'obtain during chest pain'), identify every piece of information they would need to act on before touching the patient, and present their action plan verbally to the class for discussion.	Cardiovascular and general medical terminology textbook or vetted open-access reference (e.g., a standard allied health medical terminology text), prefix/root/suffix card sets, de-identified sample EKG orders and chart excerpts (instructor-prepared), abbreviation reference list, medical dictionary (print or digital)	Term-building worksheet graded for correct definition with 80% pass mark; abbreviation translation worksheet graded at 80% or higher; clinical instruction presentation evaluated on a 5-point rubric (identifies patient data, order details, special instructions, missing information, and safety checks) requiring 4/5 to pass.
6	Digital Tools, EHR Documentation, and HIPAA Compliance	22	demo	Students will enter simulated patient demographic and EKG procedural data into an electronic health record training environment with zero data-entry errors that would affect patient identification, and will correctly apply HIPAA minimum-necessary and privacy principles when handling protected health information in both paper and digital contexts.	EHR data-entry practicum: using a training-mode EHR platform (or a simulation environment that replicates EHR workflows), students enter five complete simulated patient records including demographic data, ordering provider, procedure performed, date and time, and a brief technician note, then cross-check their entries against source documents and correct any errors before submitting for instructor review. HIPAA scenario analysis: instructor presents six scenarios (e.g., a coworker asking to see a neighbor's EKG results; a patient requesting their own record; leaving an EKG printout on a shared desk; texting a strip image from a personal phone; logging out of the EHR workstation between patients; sharing login credentials), and students classify each as compliant or non-compliant, cite the relevant privacy principle, and describe the correct action in writing. Incident response role-play: students work in pairs; one plays a patient who overheard their diagnosis being discussed in a hallway; the other plays the technician who must respond appropriately, offer to connect the patient with the privacy officer, and document the complaint using a standard form—then roles reverse with a new scenario.	EHR training platform access (school-licensed simulation or training mode of a commonly used system), HIPAA privacy and security rule summary (HHS plain-language guide), simulated patient data sets, privacy complaint form template, computer workstations or tablets, login credential policy sample	EHR data-entry practicum scored for zero patient-identification errors (name, date of birth, and record number must be exact); up to two minor non-identification errors are permitted with correction. HIPAA scenario analysis scored at 80% or higher. Role-play evaluated pass/fail by instructor on a 4-item checklist: professional tone, correct content, no disclosure of PHI, and appropriate referral.
7	Professional Identity, Career Readiness, and Scope of Practice	24	field	Students will articulate the defined scope of practice, ethical obligations, and career pathways of an NHA-CET-credentialed EKG technician; produce a complete, error-free professional resume and cover letter; and demonstrate professional interview conduct through a scored mock interview.	Scope-of-practice mapping activity: using the NHA CET Exam Content Outline and a state-level allied health scope reference, students create a two-column chart distinguishing tasks within the EKG technician's scope from tasks that require escalation to a nurse or physician (e.g., the technician acquires the tracing but does not interpret findings for clinical decision-making), then participate in a Socratic discussion of three ethical dilemma scenarios involving patient safety, chain of command, and professional boundaries. Resume and cover letter workshop: students draft a chronological resume and a targeted cover letter for a posted EKG technician position (instructor-provided job ad), receive structured peer feedback using a rubric, revise, and submit a final version to the instructor—who evaluates it against employer standards for format, spelling, accuracy, and relevance of content. Mock interview with external evaluator: each student participates in a 15-minute one-on-one mock interview conducted by a guest evaluator (a local clinical supervisor, HR professional, or program advisory committee member), responding to standard and behavioral questions relevant to entry-level cardiac monitoring roles; evaluator and instructor independently score the student on a shared rubric, and the student receives written feedback within 48 hours.	NHA CET Exam Content Outline (current version, downloaded from NHA website), sample state allied health scope-of-practice reference, sample job posting for EKG technician position, resume and cover letter rubric, professional dress guidance handout, mock interview question bank (instructor-prepared, including behavioral and situational questions), mock interview scoring rubric	Scope-of-practice chart evaluated pass/fail: all eight provided tasks must be correctly categorized (one error allowed); resume and cover letter must score 80% or higher on the rubric and contain zero factual inaccuracies; mock interview must receive a passing score of at least 75% on the shared rubric from both evaluators independently—if scores differ by more than 10 points, evaluators confer and agree on a final score.

Assessments

Assessment	Type	Weight	Pass standard	Method & rubric

HLT-EKGT89-02 Trade course

Cardiac Anatomy and Physiology for EKG Technicians

60 hr · ~~$864~~ COMPLIMENTARY

This course builds the anatomical and physiological foundation that every EKG technician must command before touching a patient or interpreting a tracing. Learners study the structure of the heart and great vessels, the electrical conduction system, the cardiac cycle, and the hemodynamic consequences of normal and common abnormal function. All content is directly mapped to the knowledge domains tested on the NHA Certified EKG Technician (CET) examination.

Outcomes

Label the chambers, valves, great vessels, and coronary arteries of the heart on an unlabeled diagram with 100% accuracy.
Trace the pathway of blood through the pulmonary and systemic circulations, correctly identifying the oxygen saturation status at each major point.
Describe the sequence of electrical impulse generation and conduction through the heart's conduction system, naming each structure and its normal rate of automaticity.
Explain the ionic basis of the cardiac action potential and correlate each phase with the corresponding deflection on a normal ECG waveform.
Define cardiac cycle events—systole, diastole, stroke volume, cardiac output, and preload and afterload—and explain how each relates to the waveforms an EKG technician will record.
Identify the physiological mechanisms underlying common rhythm disturbances and relate them to the conduction pathway structures studied in the course.

Course text

How the course runs. 12 blocks: The Heart as a Pump: Overview, Position, and Gross External Anatomy; Internal Anatomy: Chambers, Valves, and the Cardiac Skeleton; Pulmonary and Systemic Circulations and the Coronary Vasculature; The Electrical Conduction System: Structures, Pathway, and Normal Automaticity; Cardiac Action Potential: Phases, Ions, and the Refractory Period; Correlating the Action Potential to the ECG Waveform: P, QRS, and T; The Cardiac Cycle: Systole, Diastole, and Pressure–Volume Relationships; Preload, Afterload, Contractility, and Frank-Starling Mechanism; The Autonomic Nervous System and Hormonal Control of the Heart; Pathophysiology Foundations: How Conduction Abnormalities Arise; Integrated Lab: Anatomy to Waveform on a Mannequin Trainer; Course Review, NHA CET Domain Mapping, and Unit Assessment.

What competent looks like. Label the chambers, valves, great vessels, and coronary arteries of the heart on an unlabeled diagram with 100% accuracy. Trace the pathway of blood through the pulmonary and systemic circulations, correctly identifying the oxygen saturation status at each major point. Describe the sequence of electrical impulse generation and conduction through the heart's conduction system, naming each structure and its normal rate of automaticity. Explain the ionic basis of the cardiac action potential and correlate each phase with the corresponding deflection on a normal ECG waveform. Define cardiac cycle events—systole, diastole, stroke volume, cardiac output, and preload and afterload—and explain how each relates to the waveforms an EKG technician will record. Identify the physiological mechanisms underlying common rhythm disturbances and relate them to the conduction pathway structures studied in the course.

Lessons · 12 blocks

#	Lesson	Hr	Type	Objective	Activities	Materials	Check
1	The Heart as a Pump: Overview, Position, and Gross External Anatomy	4	theory	Students will identify the location of the heart within the mediastinum and name and describe the function of each external structure—pericardium, epicardium, myocardium, endocardium, and the four chambers—using correct anatomical terminology.	Lecture with labeled cadaver-quality anatomical diagrams: students annotate a blank silhouette diagram of the thorax to show heart position relative to the sternum, ribs, and diaphragm, then self-check against the answer key. Small-group gallery walk: four posted diagrams each show one heart layer in cross-section; each group writes one clinical relevance statement for their assigned layer (e.g., pericardial effusion compresses the heart) and presents to the class. Exit ticket: five-question identification quiz on labeled structures, submitted before leaving class.	Color anatomical heart models (4-chamber dissectible), Gray's Anatomy for Students or equivalent trade-level atlas, blank thorax silhouette worksheets, projector slides, NHA CET Exam Prep study guide (cardiac anatomy domain)	Exit-ticket score of 4/5 (80%) correct structure identifications; instructor re-teaches to any student scoring below 80% before Lesson 2.
2	Internal Anatomy: Chambers, Valves, and the Cardiac Skeleton	5	demo	Students will trace blood flow through all four chambers and identify the name, location, and function of each of the four cardiac valves using a dissectible model and cross-sectional diagrams.	Instructor demonstration on dissectible heart model: narrates entry of blood into the right atrium and walks through each chamber and valve while students follow along with their own models. Partner labeling exercise: students use dry-erase markers on laminated internal-anatomy diagrams to label tricuspid, pulmonary, mitral, and aortic valves, the interventricular septum, papillary muscles, and chordae tendineae; partners check each other. Case discussion: instructor presents the clinical scenario of mitral valve stenosis and asks students to predict how restricted valve opening would affect the EKG (heart rate compensation, atrial enlargement) to connect anatomy to future EKG work.	Dissectible 4-chamber heart models (1 per pair), laminated cross-section diagrams with dry-erase markers, valve sound audio clips (normal vs. stenotic via speaker), NHA CET study guide	Partner-checked labeling sheet: both partners must achieve 10/12 (83%) correct labels; instructor reviews any repeated errors with the pair.
3	Pulmonary and Systemic Circulations and the Coronary Vasculature	5	theory	Students will trace the complete pathway of oxygenated and deoxygenated blood through the pulmonary and systemic circuits and identify the origin, distribution, and clinical significance of the left and right coronary arteries and their major branches.	Color-coded flow diagram activity: students receive a black-and-white diagram of the full circulation and use red and blue colored pencils to trace oxygenated and deoxygenated blood, adding arrows and labels for each major vessel and organ bed. Coronary artery mapping worksheet: students draw and label the left anterior descending (LAD), circumflex, and right coronary artery (RCA) on a heart outline, then shade the myocardial territory each supplies—directly tied to future discussion of ST-elevation patterns in 12-lead EKG. Short reading and annotation: one-page excerpt on myocardial infarction territory (trade-level text); students underline which artery is implicated in an anterior MI versus an inferior MI and discuss answers with a partner.	Circulation flow diagram worksheets, coronary artery mapping worksheets, colored pencils, annotated wall poster of coronary anatomy, NHA CET study guide, trade-level cardiology reference (e.g., ECGs Made Easy by Barbara Aehlert or equivalent)	Completed and self-checked flow diagram and coronary mapping worksheet collected by instructor; pass standard is 80% of labels and arrows correct; errors discussed at opening of next lesson.
4	The Electrical Conduction System: Structures, Pathway, and Normal Automaticity	6	theory	Students will name each component of the cardiac conduction system in sequence, state the normal intrinsic rate for each pacemaker site, and explain why the SA node normally controls heart rate.	Sequencing card activity: each student receives a set of index cards labeled with conduction structures (SA node, internodal pathways, AV node, Bundle of His, right and left bundle branches, Purkinje fibers); students arrange them in conduction order on their desk, then verify against the projected answer. Intrinsic rate table exercise: students complete a partially filled table of pacemaker sites and their intrinsic rates (SA node, AV junction, ventricles), then write one sentence explaining the clinical significance of escape rhythms when the SA node fails. Conduction system tracing on model: using a heart model with color-coded conduction structures, each student traces the pathway with a pointer while narrating aloud to a partner; the partner provides corrective feedback using the answer guide.	Dissectible heart model with conduction pathway markings, conduction sequencing index cards (1 set per student), intrinsic rate table worksheets, NHA CET study guide, Aehlert ECGs Made Easy (conduction chapter)	Oral narration assessed by instructor using a 6-point checklist (one point per correctly named and sequenced structure); pass is 5/6 (83%); students who do not pass repeat the tracing exercise with instructor guidance.
5	Cardiac Action Potential: Phases, Ions, and the Refractory Period	5	theory	Students will describe the five phases of the ventricular action potential, name the primary ion movement in each phase, and correlate the absolute and relative refractory periods with patient safety implications for electrical stimulation.	Action potential drawing exercise: students hand-draw the ventricular action potential curve from memory after three instructor-guided exposures, labeling phases 0–4 and annotating the ion (Na⁺, K⁺, Ca²⁺) responsible for each phase. Refractory period mapping: students mark the absolute and relative refractory periods on their drawn curve, then answer three questions about why delivering an electrical shock during the relative refractory period (R-on-T phenomenon) is dangerous—connecting physiology directly to patient safety. Comparison chart: students create a two-column chart contrasting the fast-response action potential (ventricular myocytes) with the slow-response action potential (SA and AV nodes), identifying which ion drives phase 0 in each cell type.	Graph paper for curve drawing, action potential reference diagram (handout), ion channel summary table, NHA CET study guide, whiteboard for instructor modeling	Completed action potential drawing and refractory period annotations collected; pass standard is accurate labeling of all five phases and both refractory periods (7/8 elements = 88%); common errors re-taught in next lesson warm-up.
6	Correlating the Action Potential to the ECG Waveform: P, QRS, and T	5	demo	Students will correlate each component of the standard ECG waveform (P wave, PR interval, QRS complex, ST segment, T wave, QT interval) with the underlying electrical event and the corresponding phase of the action potential.	Side-by-side mapping worksheet: students receive a dual-diagram handout showing an action potential curve above a corresponding ECG strip; they draw vertical dashed lines connecting each waveform element to its matching action potential phase and write a one-phrase explanation for each. Instructor-led annotated trace review: instructor projects a real normal sinus rhythm strip and narrates each waveform component, pausing for students to call out the corresponding electrical event; students write responses on mini whiteboards. Waveform-to-event matching quiz (formative): 10-item matching quiz pairing waveform components with their electrical events; self-scored and discussed immediately.	Dual-diagram mapping worksheets, ECG calipers (1 per student, for use in later courses—introduced here), projected normal sinus rhythm ECG strips, mini whiteboards and markers, NHA CET study guide	Matching quiz self-score: students who score below 8/10 (80%) flag their quiz for instructor review; instructor provides targeted re-explanation before Lesson 7.
7	The Cardiac Cycle: Systole, Diastole, and Pressure–Volume Relationships	5	theory	Students will describe the phases of the cardiac cycle in sequence, explain the pressure changes that open and close each valve, and define stroke volume and cardiac output in measurable terms.	Pressure-volume loop walkthrough: instructor guides students through a simplified Wiggers diagram (pressure vs. time) on the whiteboard; students annotate a blank diagram handout with valve opening and closing events, labeling systole and diastole. Calculation practice: using the relationship Cardiac Output = Heart Rate × Stroke Volume, students solve five numerical problems with realistic clinical values (e.g., HR 72 bpm × SV 70 mL); they check answers with a partner and identify which variable an EKG technician's recording directly reflects. Scenario discussion: instructor presents a patient with a heart rate of 140 bpm and asks how shortened diastole affects ventricular filling and cardiac output; students write a three-sentence response connecting the physiology to what the EKG tracing would show.	Blank Wiggers diagram handouts, cardiac output calculation worksheet, projector slides, NHA CET study guide, basic calculator	Calculation worksheet scored by instructor: pass is 4/5 (80%) correct; annotated Wiggers diagram checked for correct valve event placement with pass standard of 6/8 events labeled correctly.
8	Preload, Afterload, Contractility, and Frank-Starling Mechanism	4	theory	Students will define preload, afterload, and contractility, apply the Frank-Starling principle to predict changes in stroke volume, and explain how these concepts relate to conditions EKG technicians encounter (heart failure, hypertension).	Concept mapping: students individually construct a concept map linking preload → ventricular stretch → stroke volume using provided terms; maps are shared with a partner for peer review against a model map. Clinical scenario cards: small groups receive cards describing conditions (volume overload, hypertension, cardiomyopathy) and must predict how preload, afterload, or contractility is altered and how that might present on a monitor tracing (tachycardia compensation, arrhythmias). Short-answer reflection: students write three to five sentences explaining why a patient in left ventricular failure might have both a fast EKG rate and ST changes, demonstrating integration of physiology with EKG technician observations.	Concept map templates, clinical scenario cards (laminated, reusable), NHA CET study guide, whiteboard	Concept map assessed against model map: pass is 5/7 correct linkages (71%); short-answer reflection scored on a 3-point rubric (physiology accurate, connection to EKG present, terminology correct); minimum 2/3 points to pass.
9	The Autonomic Nervous System and Hormonal Control of the Heart	5	theory	Students will describe how the sympathetic and parasympathetic divisions of the autonomic nervous system alter heart rate and contractility, and explain how common cardiovascular medications (rate-controlling agents) exploit these pathways.	Comparison table: students complete a structured table contrasting sympathetic versus parasympathetic effects on heart rate, AV conduction speed, and contractility; the table is then used as a reference for the medication discussion. Mechanism matching exercise: students receive a list of drug classes commonly encountered in cardiac monitoring settings (beta-blockers, calcium channel blockers, atropine) and match each to its autonomic mechanism of action and the expected change on a monitor tracing (slower rate, faster rate); scope of practice boundaries—EKG technicians observe and report, they do not prescribe or administer—are explicitly reviewed. Group quiz game: instructor poses five rapid-fire questions (e.g., 'Which neurotransmitter slows the SA node?'); groups write answers on mini whiteboards and reveal simultaneously; instructor corrects errors immediately.	Autonomic comparison table worksheet, medication mechanism matching handout, mini whiteboards, NHA CET study guide, trade-level pharmacology reference for allied health (drug class overview only)	Completed comparison table and matching exercise collected; pass standard is 80% accuracy on combined 15 items; scope-of-practice boundary review confirmed by instructor before lesson ends.
10	Pathophysiology Foundations: How Conduction Abnormalities Arise	5	theory	Students will explain the physiological mechanisms of re-entry, enhanced automaticity, and triggered activity as causes of cardiac arrhythmias, and identify which conduction structures are implicated in common rhythm disturbances they will recognize in later courses.	Re-entry circuit diagram exercise: instructor draws a simplified re-entry loop on the whiteboard, narrating how a unidirectional block and slow conduction create a circus movement; students reproduce the diagram in their notes and annotate with the three conditions required for re-entry. Mechanism sorting activity: students receive eight scenario cards describing rhythm disturbances (e.g., AV block, atrial fibrillation, PVCs, SVT) and sort them into three columns: re-entry, enhanced automaticity, or triggered activity; the sort is discussed as a class with instructor guidance. Bridge-forward journal entry: students write a half-page reflection identifying two arrhythmias they expect to see in the next course (Rhythm Recognition) and describing the physiological mechanism they now understand underlies each—submitted for instructor feedback.	Re-entry diagram handouts, mechanism sorting scenario cards (laminated), student journals or notebooks, NHA CET study guide, Aehlert ECGs Made Easy (arrhythmia mechanisms section)	Mechanism sorting assessed by instructor: pass is 6/8 cards correctly sorted (75%); bridge-forward journal entry reviewed by instructor for physiological accuracy (pass = both mechanisms correctly stated).
11	Integrated Lab: Anatomy to Waveform on a Mannequin Trainer	6	lab	Students will connect limb and precordial lead placement rationale to underlying cardiac anatomy and demonstrate correct electrode placement on a mannequin, explaining the anatomical landmark for each lead position.	Anatomy-to-lead mapping worksheet: before touching the mannequin, students complete a diagram matching each standard limb and precordial lead to the cardiac surface or anatomical region it monitors, reinforcing the link between anatomy learned in this course and EKG acquisition learned in the next. Hands-on electrode placement on mannequin: each student individually places all 10 electrodes (4 limb, 6 precordial) on the mannequin trainer, narrating the anatomical landmark for each precordial position aloud; instructor uses a 10-point placement checklist. Group error analysis: instructor deliberately places three electrodes incorrectly on the demonstration mannequin; students identify each error, name the correct landmark, and explain which portion of the ECG waveform would be affected and why, integrating anatomy and physiology from the entire course.	Adult CPR mannequin torso with skin markings for anatomical landmarks, training electrodes and lead wires (non-patient use), 10-point placement checklist, anatomy-to-lead mapping worksheet, NHA CET study guide	Instructor-scored placement checklist: pass is 9/10 electrodes (90%) placed correctly with correct landmark narration; students who do not pass repeat placement with instructor supervision until 90% is achieved before the lab session ends.
12	Course Review, NHA CET Domain Mapping, and Unit Assessment	5	practice	Students will demonstrate mastery of all cardiac anatomy and physiology content by scoring at or above the course pass standard on a comprehensive unit exam aligned to the NHA CET cardiac knowledge domains.	Structured review session: instructor-led rapid review of each lesson's key concepts using a projected summary slide deck; students complete a self-assessment checklist rating their confidence on each NHA CET domain area covered in the course (anatomy, conduction, cardiac cycle, autonomic control, pathophysiology mechanisms). NHA CET domain mapping exercise: students receive a list of the NHA CET exam content areas relevant to cardiac anatomy and physiology and match each to the lesson(s) in this course where it was taught, identifying any personal gaps for last-minute study. Comprehensive unit exam: 50-question multiple-choice exam covering all lesson content, formatted in NHA CET style (scenario-based and direct-knowledge items); students complete individually under timed conditions.	Review slide deck, self-assessment confidence checklist, NHA CET domain mapping worksheet, 50-question unit exam (printed or LMS-delivered), answer key for instructor grading, NHA CET study guide	Unit exam pass standard is 78% (39/50 correct), consistent with the course overall passing standard; students scoring below 78% are required to meet with the instructor for a remediation plan before advancing to Course 3.

Assessments

Assessment	Type	Weight	Pass standard	Method & rubric

HLT-EKGT89-03 Trade course

12-Lead EKG Acquisition

60 hr · ~~$864~~ COMPLIMENTARY

Students develop the technical skills to prepare patients, place electrodes precisely, and acquire diagnostic-quality 12-lead EKG recordings using standard clinical equipment. Emphasis is placed on patient safety, artifact recognition and elimination, equipment troubleshooting, and accurate documentation that meets employer and regulatory standards. Lesson content maps directly to the electrode placement, patient preparation, and tracing quality domains of the NHA Certified EKG Technician (CET) exam.

Outcomes

Correctly identify and locate all 10 electrode placement sites on a diverse patient population using standard anatomical landmarks to within accepted clinical tolerances.
Prepare patients for 12-lead EKG acquisition by obtaining informed consent, explaining the procedure, providing appropriate draping, and performing skin preparation steps that minimize impedance.
Operate a 12-lead EKG machine to acquire a technically acceptable tracing, adjusting paper speed, gain, and filter settings as needed per manufacturer guidelines.
Identify common sources of artifact (somatic tremor, AC interference, wandering baseline, lead reversal) and apply corrective measures before and during acquisition.
Troubleshoot equipment and lead malfunctions systematically, distinguishing between patient-related and equipment-related causes without compromising patient safety.
Complete accurate EKG acquisition documentation including patient demographics, clinical notes, and chain-of-custody records in compliance with workplace policies and HIPAA privacy requirements.

Course text

How the course runs. 12 blocks: The 12-Lead System: Rationale and Clinical Context; Anatomical Landmarks and Electrode Placement Sites; Patient Communication, Consent, and Draping; Skin Preparation and Electrode Application; Operating the 12-Lead EKG Machine; Paper Speed, Gain, and Filter Settings; Recognizing and Eliminating Artifact; Lead Reversal: Detection and Correction; Equipment Troubleshooting and Maintenance; Documentation, Labeling, and Chain of Custody; Special Patient Considerations in EKG Acquisition; Full Acquisition Competency Simulation.

What competent looks like. Correctly identify and locate all 10 electrode placement sites on a diverse patient population using standard anatomical landmarks to within accepted clinical tolerances. Prepare patients for 12-lead EKG acquisition by obtaining informed consent, explaining the procedure, providing appropriate draping, and performing skin preparation steps that minimize impedance. Operate a 12-lead EKG machine to acquire a technically acceptable tracing, adjusting paper speed, gain, and filter settings as needed per manufacturer guidelines. Identify common sources of artifact (somatic tremor, AC interference, wandering baseline, lead reversal) and apply corrective measures before and during acquisition. Troubleshoot equipment and lead malfunctions systematically, distinguishing between patient-related and equipment-related causes without compromising patient safety. Complete accurate EKG acquisition documentation including patient demographics, clinical notes, and chain-of-custody records in compliance with workplace policies and HIPAA privacy requirements.

Lessons · 12 blocks

#	Lesson	Hr	Type	Objective	Activities	Materials	Check
1	The 12-Lead System: Rationale and Clinical Context	4	theory	Students will explain the purpose of the 12-lead EKG, name all 12 leads, and describe what cardiac territory each lead group monitors.	Label a blank 12-lead diagram identifying each limb lead, augmented lead, and precordial lead by name and polarity. Match each lead group (inferior, lateral, septal, anterior) to its corresponding cardiac wall using a color-coded heart model diagram. Participate in a facilitated discussion comparing a single-lead rhythm strip to a 12-lead tracing, articulating why multiple views improve diagnostic information.	Whiteboard, printed 12-lead reference diagrams, heart anatomy poster, NHA CET exam content outline, textbook chapter on lead systems	Written 10-question lead identification quiz; students must correctly name and describe all 12 leads with ≥80% accuracy to proceed.
2	Anatomical Landmarks and Electrode Placement Sites	5	demo	Students will locate all 10 standard electrode placement sites on a live volunteer or manikin using palpation of anatomical landmarks without reference aids.	Instructor demonstrates palpation of the sternal angle, intercostal spaces, midclavicular line, anterior axillary line, and midaxillary line while students follow along on their own torsos. Students take turns placing color-coded sticker dots on a partner to mark V1 through V6 and the four limb sites, then compare placements against an overlay reference sheet. Complete a timed landmark drill in which each student locates and verbally identifies all 10 sites on a manikin in under three minutes without assistance.	Manikin or student volunteers, color-coded sticker dots, anatomical landmark reference overlay, measuring tape, NHA CET exam content outline	Instructor observes and records placement accuracy on a standardized checklist; all 10 sites must be within accepted clinical tolerance (V1–V2 correct intercostal space; limb sites on correct limb segment) to pass at 100% required sites correct.
3	Patient Communication, Consent, and Draping	4	theory	Students will demonstrate patient-centered communication skills including plain-language procedure explanation, obtaining verbal consent, and providing dignified draping for diverse patient populations.	Role-play scripted patient encounters covering three scenarios: a cooperative adult, an anxious elderly patient, and a patient with limited English proficiency, using a provided phrase card for the third scenario. Review a sample facility consent and documentation policy, then identify two HIPAA-relevant considerations during EKG acquisition and documentation. Critique two short video clips of technician-patient interactions, listing at least three communication strengths and one improvement area for each clip using a structured observation form.	Role-play scripts, HIPAA privacy overview handout, sample facility consent form, draping linen or paper sheet, video clips, structured observation form	Instructor evaluates role-play using a 10-point communication rubric (introduction, explanation, consent, draping, closure); students must score ≥8 out of 10 points.
4	Skin Preparation and Electrode Application	5	lab	Students will perform complete skin preparation and apply disposable electrodes to a manikin or peer volunteer in a sequence that minimizes impedance and maximizes signal quality.	Practice the full skin prep sequence—inspect, clip if needed, lightly abrade with gauze, wipe with alcohol pad, allow to dry—on a practice skin pad, explaining each step aloud. Apply a full set of 10 disposable electrodes to a manikin following placement landmarks from Lesson 2, checking adhesion and gel contact at each site before connecting leads. Deliberately apply one electrode with inadequate prep, acquire a short tracing segment on a trainer unit, then identify the resulting artifact and re-prep to demonstrate the difference.	Disposable snap or tab electrodes, alcohol wipes, gauze pads, single-use razors, EKG trainer or practice unit, gloves, biohazard disposal bin, NHA CET exam content outline	Instructor uses a 12-point electrode application checklist (prep steps + all 10 sites); students must complete all prep steps and place all 10 electrodes correctly, scoring 12/12 on checklist.
5	Operating the 12-Lead EKG Machine	5	demo	Students will power on, configure, and operate a standard 12-lead EKG machine—entering patient data, selecting standard settings, and acquiring a complete tracing—following the manufacturer's operating sequence.	Walk through the machine startup sequence on the classroom unit step by step, entering fabricated patient demographics, selecting 25 mm/s paper speed and 10 mm/mV gain, and verifying lead connections before acquisition. Acquire three consecutive 12-lead tracings on a manikin or cooperative volunteer, printing each and comparing them for consistency of waveform morphology and baseline stability. Practice the shutdown, cleaning, and supply-restock procedure for the machine according to the manufacturer guide, documenting steps on a maintenance log form.	12-lead EKG machine (one per two students if possible), electrode supplies, machine operator manual, patient data entry worksheet, maintenance log form	Competency checklist covering 8 operational steps (power on, data entry, lead check, acquire, print, label, clean, restock); students must complete all 8 steps correctly without prompting.
6	Paper Speed, Gain, and Filter Settings	4	theory	Students will explain the effect of paper speed, gain, and filter settings on waveform appearance and select appropriate settings for standard adult clinical acquisition.	Examine printed tracing pairs showing the same rhythm recorded at 25 mm/s vs. 50 mm/s and at 5 mm/mV vs. 10 mm/mV gain, then write a brief explanation of how each change alters waveform appearance. Complete a worksheet matching five clinical scenarios (large-amplitude QRS, tachycardia, baseline drift) to the recommended setting adjustment and clinical rationale. Simulate a setting error in class—acquire a tracing at incorrect gain, identify the problem on the printout, correct the setting, and re-acquire, documenting both tracings with a note explaining the change.	Printed tracing comparison sets, EKG machine, settings worksheet, NHA CET exam content outline	Settings scenario worksheet scored by instructor; students must correctly match settings to scenarios and provide rationale with ≥80% accuracy (4 of 5 scenarios correct).
7	Recognizing and Eliminating Artifact	6	lab	Students will identify the four major artifact types on printed 12-lead tracings and apply the correct corrective intervention to produce a clean, interpretable recording.	Sort a set of 16 printed tracing strips into four artifact categories (somatic tremor, AC interference, wandering baseline, lead pop/disconnection) using a reference identification card, then self-check against an answer key. Deliberately introduce each of the four artifact types on a live EKG acquisition using a manikin or volunteer (e.g., ask the volunteer to shiver, position a lead near an AC source, loosen an electrode) and identify them on the printout. Apply the correct corrective action for each introduced artifact—patient coaching, repositioning, re-prepping electrode, resolving cable proximity—and re-acquire a clean tracing, comparing before-and-after prints.	Printed artifact tracing set (16 strips), EKG machine, electrode supplies, artifact identification reference card, answer key, NHA CET exam content outline	Students must correctly identify all four artifact types on a blinded set of 8 test strips (≥7/8 correct) and demonstrate at least one corrective intervention successfully on the live unit as observed by instructor.
8	Lead Reversal: Detection and Correction	4	lab	Students will detect limb-lead reversal errors on printed 12-lead tracings using morphology clues and immediately correct the error before re-acquiring the tracing.	Analyze a set of six printed tracings—three with deliberate limb-lead reversals (LA-RA, RA-LL, LA-LL) and three correct—using a structured lead-reversal detection checklist focusing on lead I polarity, aVR morphology, and P-wave axis. Introduce a controlled LA-RA reversal on a live acquisition, print the tracing, annotate the morphologic clues that reveal the error, correct the cable connections, and re-acquire. Complete a tabletop case exercise in which written clinical scenarios describe finding a lead-reversal tracing in the patient chart; students write the corrective action steps and document the error per a sample facility policy.	Printed lead-reversal tracing set, EKG machine, lead-reversal detection checklist, sample facility error documentation policy, pens	Students must correctly identify lead reversal in ≥5 of 6 printed strips and successfully correct a live reversal without instructor assistance, as verified by a clean follow-up tracing.
9	Equipment Troubleshooting and Maintenance	4	practice	Students will systematically troubleshoot common EKG machine and lead wire problems using a structured decision tree, distinguishing patient-related from equipment-related causes.	Work through a laminated troubleshooting decision tree for five simulated fault scenarios (broken lead wire, dead battery, paper jam, error message on screen, no signal on one lead) and document the correct resolution for each. Physically inspect a set of lead wires and patient cables for visible damage, bent connectors, and fraying using a checklist, then tag and set aside defective items per a sample out-of-service policy. Complete a timed troubleshooting simulation in which the instructor introduces one undisclosed fault; the student must identify and resolve the fault and acquire a clean tracing within eight minutes.	EKG machine with lead wire set, troubleshooting decision tree laminate, out-of-service tags, equipment inspection checklist, timer	Student must correctly resolve the timed simulation fault and produce a clean tracing within 8 minutes; instructor marks pass/fail on a troubleshooting competency form.
10	Documentation, Labeling, and Chain of Custody	4	practice	Students will complete accurate EKG documentation including patient identification, acquisition time stamp, technician ID, clinical notes, and routing according to a sample facility policy.	Label five printed EKG tracings with complete required fields (patient name, date of birth, medical record number, date and time, technician name, paper speed, gain) using a facility documentation policy as a guide, then peer-check for completeness. Simulate electronic entry of EKG data into a sample EHR training interface, entering demographics, acquisition parameters, and a technician note, then export and file the record per the sample workflow. Role-play chain-of-custody handoff to a supervising clinician, verbally reporting patient name, reason for test, acquisition time, and any technical issues encountered, using a standardized verbal handoff template (Situation-Background-Assessment-Recommendation format).	Printed EKG tracings, facility documentation policy sample, EHR training interface (simulation software or paper mockup), SBAR handoff template, pens	All five labeled tracings must contain 100% of required fields with no errors; EHR entry assessed for completeness with ≥90% of required fields correctly populated.
11	Special Patient Considerations in EKG Acquisition	6	theory	Students will adapt electrode placement and patient preparation techniques for patients with anatomical variations, skin integrity concerns, implanted devices, and dextrocardia.	Analyze four case study cards describing patients with a mastectomy scar, obesity, pacemaker, and suspected dextrocardia, then write the specific procedural adaptation required for each based on reference materials and class discussion. Demonstrate on a manikin the correct electrode positioning adjustment for a patient with an implanted device (avoiding direct placement over the device generator) and a patient with a large body habitus. Participate in a Q&A panel facilitated by the instructor in which each student must correctly answer at least two questions about scope-of-practice limits when encountering an unusual or unexpected clinical finding during acquisition.	Case study cards, manikin, anatomical variation reference handout, NHA CET exam content outline, scope-of-practice reference	Case study written responses graded by instructor; students must provide a clinically correct adaptation for ≥3 of 4 case studies and answer both scope-of-practice Q&A questions correctly.
12	Full Acquisition Competency Simulation	9	lab	Students will independently complete an end-to-end 12-lead EKG acquisition—from patient greeting through tracing delivery and documentation—meeting clinical quality standards without instructor assistance.	Rotate through three consecutive simulated patient encounters (each with a different scenario card: standard adult, patient with artifact challenge, patient requiring adaptation) performing the complete acquisition workflow independently for each. Self-evaluate each completed tracing against a printed quality checklist (baseline stable, no artifact, all 12 leads present, correct labeling) and flag any tracing that does not meet criteria, then re-acquire. Submit all three final tracings with completed documentation to the instructor for graded evaluation using the course competency rubric, then participate in a brief one-on-one debrief identifying one strength and one area for continued practice.	EKG machine, full electrode supply kit, scenario cards, quality self-check checklist, documentation forms, course competency rubric	Instructor scores each of three acquisitions on the 20-point course competency rubric (patient prep 5 pts, electrode placement 5 pts, tracing quality 5 pts, documentation 5 pts); students must achieve ≥16/20 on each encounter to pass the lesson.

Assessments

Assessment	Type	Weight	Pass standard	Method & rubric

HLT-EKGT89-04 Trade course

Rhythm Recognition and Ambulatory Monitoring

60 hr · ~~$864~~ COMPLIMENTARY

Students learn to identify normal sinus rhythm and common cardiac dysrhythmias on rhythm strips and 12-lead tracings, apply systematic interpretation using rate, rhythm, axis, intervals, and waveform morphology, and perform ambulatory monitoring procedures including Holter monitor application and event monitor patient instruction. Lessons connect directly to the NHA Certified EKG Technician (CET) exam domains covering rhythm recognition, patient preparation, and equipment operation.

Outcomes

Systematically analyze a rhythm strip by calculating rate, measuring intervals (PR, QRS, QT), and classifying rhythm as regular or irregular to at least 90% accuracy on a written strip set.
Correctly identify normal sinus rhythm and at least 15 common dysrhythmias—including atrial, junctional, ventricular, and heart block rhythms—on paper and digital tracings with a minimum 85% accuracy rate.
Recognize immediately life-threatening rhythms (ventricular fibrillation, ventricular tachycardia, complete heart block, asystole) and state the correct scope-of-practice response, including activating emergency services, with 100% accuracy on simulation.
Apply a Holter monitor according to manufacturer and facility protocol, document patient diary instructions, and verify signal quality before patient discharge with zero critical errors on lab skills check.
Instruct a simulated patient in event monitor use, proper diary completion, and symptom reporting using plain language appropriate to a lay audience, achieving a passing score on a structured communication rubric.
Correlate rhythm findings with basic clinical relevance (e.g., hemodynamic impact of bradycardia, tachycardia, and heart block) within the EKG technician scope of practice, demonstrated by written case-response questions.

Course text

How the course runs. 12 blocks: The Systematic Approach to Rhythm Strip Analysis; Normal Sinus Rhythm and Sinus Variants; Atrial Dysrhythmias; Junctional Rhythms and AV Blocks; Ventricular Dysrhythmias and Life-Threatening Rhythms; Pacemaker Rhythms and Artifact Recognition; Integrated Rhythm Identification Lab; Introduction to Ambulatory Monitoring: Holter Monitor Principles; Holter Monitor Application Skills Lab; Event Monitors and Extended Ambulatory Monitoring Technologies; Clinical Correlation: Rhythms, Symptoms, and Scope of Practice; Course Comprehensive Assessment and CET Exam Alignment Review.

What competent looks like. Systematically analyze a rhythm strip by calculating rate, measuring intervals (PR, QRS, QT), and classifying rhythm as regular or irregular to at least 90% accuracy on a written strip set. Correctly identify normal sinus rhythm and at least 15 common dysrhythmias—including atrial, junctional, ventricular, and heart block rhythms—on paper and digital tracings with a minimum 85% accuracy rate. Recognize immediately life-threatening rhythms (ventricular fibrillation, ventricular tachycardia, complete heart block, asystole) and state the correct scope-of-practice response, including activating emergency services, with 100% accuracy on simulation. Apply a Holter monitor according to manufacturer and facility protocol, document patient diary instructions, and verify signal quality before patient discharge with zero critical errors on lab skills check. Instruct a simulated patient in event monitor use, proper diary completion, and symptom reporting using plain language appropriate to a lay audience, achieving a passing score on a structured communication rubric. Correlate rhythm findings with basic clinical relevance (e.g., hemodynamic impact of bradycardia, tachycardia, and heart block) within the EKG technician scope of practice, demonstrated by written case-response questions.

Lessons · 12 blocks

#	Lesson	Hr	Type	Objective	Activities	Materials	Check
1	The Systematic Approach to Rhythm Strip Analysis	4	theory	Students will apply a five-step systematic method—rate, regularity, P waves, PR interval, QRS duration—to any rhythm strip and document findings using standard terminology.	Instructor demonstrates the five-step method on three projected rhythm strips, narrating each decision aloud; students follow along on printed copies and annotate measurements. Students use calipers and the six-second count method to calculate atrial and ventricular rates on a set of 10 practice strips with known answers, then self-score using an answer key. Pairs quiz each other using index-card flash strips: one student calls out measurements, the partner records on a standardized interpretation worksheet; roles switch after five strips.	Printed rhythm strip sets (normal and abnormal), EKG calipers, millimeter rulers, standardized interpretation worksheets, NHA CET Study Guide (rhythm interpretation section), EKG graph paper reference card	Instructor reviews completed worksheets; student must correctly identify all five parameters on at least 8 of 10 strips (80%) to advance; errors on interval measurement are corrected before the next lesson.
2	Normal Sinus Rhythm and Sinus Variants	4	theory	Students will distinguish normal sinus rhythm from sinus bradycardia, sinus tachycardia, sinus arrhythmia, and sinus arrest by applying rate criteria and waveform regularity analysis.	Lecture with annotated slides presenting diagnostic criteria for each sinus rhythm variant; students complete a fill-in table of rate ranges and defining features as the lesson progresses. Students sort a shuffled packet of 20 labeled and unlabeled rhythm strips into five categories (NSR, sinus bradycardia, sinus tachycardia, sinus arrhythmia, sinus arrest), justify each classification in writing. Small-group case discussion: given patient scenario cards (e.g., 'athlete at rest, HR 48, no symptoms'), students decide whether intervention or notification is within the EKG tech scope of practice and document their reasoning.	Annotated slide set, printed rhythm strip packets, classification sorting cards, patient scenario cards, NHA CET Study Guide	Five-question exit quiz on identifying and naming sinus rhythms from strips; passing score 80%; instructor reviews any missed items individually before Lesson 3.
3	Atrial Dysrhythmias	5	theory	Students will identify premature atrial contractions, supraventricular tachycardia, atrial flutter, and atrial fibrillation on rhythm strips by evaluating P-wave morphology, atrial rate, and ventricular response.	Instructor-led walkthrough of the electrophysiological origin of each atrial dysrhythmia using an anatomical heart diagram alongside corresponding rhythm strip; students annotate P waves and flutter waves on printed strips. Students complete a rhythm strip identification worksheet of 15 atrial rhythm strips—mix of all four dysrhythmia types—using the five-step method, recording rate, regularity, P-wave description, PR interval, and QRS width. Group 'stump the class' activity: each student selects one difficult strip, presents their interpretation to the group, and classmates provide peer critique using a structured feedback checklist.	Anatomical heart diagram, printed 15-strip worksheet, structured feedback checklist, EKG calipers, NHA CET Study Guide, Dubin's Rapid Interpretation of EKG's (reference)	Rhythm strip identification quiz of 10 atrial dysrhythmia strips; 80% correct (8/10) required; each error is reviewed with the student to correct systematic mistakes.
4	Junctional Rhythms and AV Blocks	5	theory	Students will differentiate junctional escape rhythm, accelerated junctional rhythm, first-degree AV block, second-degree AV block (Mobitz I and Mobitz II), and third-degree (complete) AV block using PR interval and P-to-QRS relationship analysis.	Instructor presents ladder diagrams alongside rhythm strips to illustrate the conduction pathway abnormality in each block type; students draw P-wave and QRS markers on blank ladder diagram templates for three example strips. Structured comparison exercise: students complete a side-by-side table contrasting the three degrees of AV block across six features (PR interval, pattern, P:QRS ratio, QRS width, rate, clinical significance note) using their textbook and notes. Simulation scenario: instructor announces a 'complete heart block found on a patient's monitor'—students state their scope-of-practice response step by step, and the class evaluates the response against a posted protocol checklist.	Ladder diagram templates, printed rhythm strip set, comparison table worksheet, scope-of-practice protocol checklist, NHA CET Study Guide	Ten-strip identification quiz covering junctional and AV block rhythms; 80% required; complete heart block must be identified correctly (critical safety item—any miss triggers mandatory instructor review before proceeding).
5	Ventricular Dysrhythmias and Life-Threatening Rhythms	6	theory	Students will identify premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, idioventricular rhythm, and asystole on rhythm strips and state the correct emergency response for life-threatening findings within EKG technician scope of practice.	Instructor presents wide-QRS morphology criteria and compensatory pause analysis; students measure and annotate QRS width, morphology, and coupling intervals on printed PVC-containing strips in three pattern types (unifocal, multifocal, couplets, bigeminy). Life-threat recognition drill: instructor rapidly displays 20 strips on the projector for 10 seconds each; students write 'CALL' (emergency response needed) or 'DOCUMENT' on a numbered response sheet; immediate group review follows. Role-play: student acting as EKG tech 'discovers' a ventricular fibrillation rhythm on a monitor during Holter hook-up; partner acts as supervising nurse; student demonstrates correct verbal notification and documents the event in writing.	Projected rhythm strip set, numbered response sheets, role-play scenario cards, emergency response protocol checklist, NHA CET Study Guide	All four life-threatening rhythms (VF, pulseless VT, complete heart block, asystole) must be identified with 100% accuracy on a dedicated six-strip safety quiz; any miss requires repeat instruction and re-quiz before student may continue; overall ventricular dysrhythmia quiz pass mark is 80%.
6	Pacemaker Rhythms and Artifact Recognition	4	demo	Students will identify pacemaker spikes, determine pacemaker capture, and distinguish common artifacts (somatic tremor, AC interference, lead wander, loose electrode) from true dysrhythmias on rhythm strips.	Instructor demonstrates pacemaker spike identification on a rhythm monitor trainer, showing atrial, ventricular, and dual-chamber pacing with and without capture; students annotate spikes and captured beats on printed strips. Artifact gallery walk: eight stations around the room each display an enlarged strip showing one artifact type; students rotate, identify the artifact at each station on a recording sheet, and list one corrective action. Paired troubleshooting exercise: one student operates an EKG practice trainer to introduce deliberate artifact (by moving the lead wire); partner identifies artifact type and states corrective steps; roles switch.	Rhythm monitor trainer or EKG simulator, printed pacemaker strip set, artifact gallery station sheets, recording worksheets, EKG practice trainer or simulator with lead wires	Ten-item written and strip-based quiz: five pacemaker rhythm strips (identify type and capture status) and five artifact strips (name artifact and correction); 80% required to pass.
7	Integrated Rhythm Identification Lab	5	lab	Students will apply the systematic five-step method to a mixed set of 30 rhythm strips representing all rhythm categories studied, achieving at least 85% correct classification within a timed session.	Timed individual practice session: students work through a 30-strip packet using calipers and interpretation worksheets, documenting all five parameters for each strip; instructor circulates to observe technique without providing answers. After time is called, students self-score against an answer key and calculate their percentage; for every missed strip, they write a one-sentence explanation of why the misidentification occurred. Instructor-led debrief of the five most commonly missed strips projected on screen; students revise their technique notes with corrected reasoning.	30-strip mixed rhythm packet, EKG calipers, interpretation worksheets, printed answer key, NHA CET Study Guide	Score on the 30-strip packet must reach 85% (26/30) correct final classification; students below 85% receive targeted remediation strips in their error categories and must retest on a parallel 10-strip set at 80% before the next lesson.
8	Introduction to Ambulatory Monitoring: Holter Monitor Principles	4	theory	Students will explain the clinical purpose of Holter monitoring, describe standard lead placement for a 2-lead and 3-lead Holter recorder, and list the required elements of accurate patient diary documentation.	Lecture and slide presentation on indications for ambulatory monitoring, how continuous 24- to 48-hour recording differs from a resting 12-lead EKG, and how the cardiologist uses the diary to correlate symptoms with rhythm findings. Students examine a sample completed patient diary and a sample Holter report side by side; they identify five diary entries that were documented correctly and two that contain errors, then rewrite the errors in proper format. Class discussion of real-world patient education challenges (language barriers, limited health literacy, activity restrictions during monitoring); students draft three plain-language instructions they would give a patient before attaching a Holter monitor.	Slide set, sample patient diary (de-identified), sample Holter report (de-identified), NHA CET Study Guide (ambulatory monitoring section), plain-language instruction worksheet	Ten-question written quiz on Holter indications, lead placement rationale, and diary elements; 80% required; instructor reviews incorrect answers before the skills lab.
9	Holter Monitor Application Skills Lab	6	lab	Students will prepare the skin, place electrodes in correct anatomical positions for a standard Holter lead configuration, connect and activate the recorder, verify signal quality on all channels, and provide complete written and verbal patient instructions with zero critical errors.	Instructor demonstrates full Holter application on a volunteer student-model: skin prep, electrode placement, lead wire connection, recorder activation, signal quality check on laptop software, and patient instruction; students observe and annotate a placement diagram. Each student performs a complete Holter application on a lab partner using the department skills checklist as a guide; instructor observes one station at a time and completes a real-time checklist for each student. Students simulate the patient-discharge conversation: standing at the 'door' of the lab, each student delivers all required discharge instructions to their partner who role-plays a patient with questions; the interaction is evaluated by the instructor using the communication rubric.	Holter monitors (or training units), disposable electrodes, skin prep supplies (razor, abrasive pads, alcohol wipes, gauze), lead wires, laptop with Holter analysis software (demo mode), skills competency checklist, patient instruction sheet, communication rubric	Holter application skills checklist: all critical items (correct electrode placement, secure lead connections, confirmed signal quality on each channel, complete patient instruction) must be rated 'satisfactory'; any critical item rated 'unsatisfactory' requires immediate repeat with instructor supervision; overall checklist pass mark is 90% of total items.
10	Event Monitors and Extended Ambulatory Monitoring Technologies	4	demo	Students will distinguish among cardiac event monitors (loop recorders, post-event recorders, mobile cardiac telemetry) by describing how each captures data and when each is clinically indicated, and demonstrate patient instruction for a loop event monitor.	Instructor-led demonstration comparing three types of ambulatory monitoring devices side by side: a loop recorder, a post-event recorder, and a mobile cardiac telemetry unit; students complete a comparison chart of recording method, transmission method, and typical indication. Students watch a brief manufacturer training video on loop event monitor patient operation, then practice instructing a partner on how to activate the device, recognize a symptom episode, and transmit data using a scripted patient scenario. Structured Q&A: instructor poses realistic patient questions ('Can I shower with this on?' 'What if I forget to press the button?') and cold-calls students to answer in patient-appropriate language; class evaluates each response using a simple accuracy checklist.	Event monitor devices or training models, manufacturer instruction sheets, comparison chart worksheet, scripted patient scenario cards, accuracy checklist	Completion of comparison chart with at least 80% of items correct; instructor evaluates one patient-instruction demonstration per student against a five-item checklist; all five items must be present to pass.
11	Clinical Correlation: Rhythms, Symptoms, and Scope of Practice	5	practice	Students will match identified dysrhythmias to common associated symptoms and hemodynamic effects, and for each scenario state the EKG technician's appropriate action within professional scope of practice.	Case-based small-group work: each group receives a patient scenario card (rhythm strip, brief history, stated vital signs) and must identify the rhythm, list one likely symptom the patient may report, and document the technician's required action; groups present findings to the class. Debate-format activity: instructor presents ambiguous scenarios (e.g., symptomatic bradycardia in a patient who states they feel fine) and students argue the correct scope-of-practice response; class reaches consensus and documents the agreed protocol response. Individual written reflection: each student selects one rhythm from the course and writes a half-page explanation connecting its electrophysiological mechanism, likely patient presentation, and the technician's documented responsibilities—submitted to instructor for feedback.	Patient scenario cards, scope-of-practice reference document (facility policy template), reflection rubric, NHA CET Study Guide	Scenario-response worksheet scored by instructor: rhythm identification must be correct, scope-of-practice action must align with the reference document; 80% of scenarios correct required; any scenario involving a life-threatening rhythm where the action is incorrect triggers mandatory re-instruction.
12	Course Comprehensive Assessment and CET Exam Alignment Review	8	practice	Students will complete a comprehensive written examination covering all rhythm categories and ambulatory monitoring content mapped to NHA CET exam domains, review performance gaps, and produce a personalized study plan targeting weak areas before the credential exam.	Timed comprehensive written exam (50 questions, multiple-choice and strip-based) covering all lesson content; questions are organized by NHA CET exam domain so that score reports can be disaggregated by content area. After graded exams are returned, students use a score-analysis worksheet to identify their two lowest-scoring content domains and locate corresponding pages in the NHA CET Study Guide and their course notes for targeted review. Each student writes a one-page personalized study plan listing specific weak rhythm types or ambulatory monitoring procedures to practice before Course 7 (Certification Exam Preparation), with a self-set daily review schedule.	Comprehensive exam (instructor-prepared, 50 questions), answer key with NHA CET domain mapping, score-analysis worksheet, NHA CET Study Guide, personalized study plan template	Passing score on comprehensive exam is 78% (39/50); students below 78% receive instructor feedback and a targeted remediation assignment (additional strip set and concept review) to be completed before the Clinical Practicum; all life-threatening rhythm questions must be answered correctly regardless of overall score.

Assessments

Assessment	Type	Weight	Pass standard	Method & rubric

HLT-EKGT89-05 Capstone

Capstone Project: Integrated EKG Technician Practice

40 hr · ~~$400~~ COMPLIMENTARY

Students synthesize all prior learning by designing, executing, and defending a complete EKG workflow project that mirrors real clinical conditions, from patient preparation and 12-lead acquisition through rhythm analysis and documentation. The capstone requires students to demonstrate technical accuracy, professional communication, infection control compliance, and scope-of-practice judgment in a single integrated performance. Successful completion confirms readiness for the clinical practicum and the NHA Certified EKG Technician (CET) examination.

Outcomes

Perform a complete, artifact-free 12-lead EKG on a simulated patient while applying standard infection control and patient safety protocols without prompting.
Accurately identify at least five distinct rhythm types on a rhythm strip, label each component correctly, and calculate rate and intervals within accepted clinical tolerances.
Produce a fully compliant patient record including demographic data entry, acquisition notes, and a written technician report suitable for provider review.
Apply scope-of-practice boundaries by correctly distinguishing observations a CET may document from those requiring immediate escalation to a licensed clinician.
Deliver an organized verbal defense of project decisions—equipment choices, lead placement, artifact troubleshooting, and documentation—using correct cardiac and EKG terminology.
Evaluate a peer's completed EKG workflow using a structured rubric, providing specific, evidence-based written feedback aligned with NHA CET exam competency areas.

Course text

How the course runs. 4 blocks: Project Design and Patient Scenario Planning; Full Workflow Execution: Acquisition and Troubleshooting; Rhythm Analysis, Documentation, and Portfolio Assembly; Capstone Defense and Peer Evaluation.

What competent looks like. Perform a complete, artifact-free 12-lead EKG on a simulated patient while applying standard infection control and patient safety protocols without prompting. Accurately identify at least five distinct rhythm types on a rhythm strip, label each component correctly, and calculate rate and intervals within accepted clinical tolerances. Produce a fully compliant patient record including demographic data entry, acquisition notes, and a written technician report suitable for provider review. Apply scope-of-practice boundaries by correctly distinguishing observations a CET may document from those requiring immediate escalation to a licensed clinician. Deliver an organized verbal defense of project decisions—equipment choices, lead placement, artifact troubleshooting, and documentation—using correct cardiac and EKG terminology. Evaluate a peer's completed EKG workflow using a structured rubric, providing specific, evidence-based written feedback aligned with NHA CET exam competency areas.

Lessons · 4 blocks

#	Lesson	Hr	Type	Objective	Activities	Materials	Check
1	Project Design and Patient Scenario Planning	8	theory	Given a set of three assigned patient scenarios, the student will create a written project plan that identifies required equipment, infection control steps, anticipated artifact risks, documentation requirements, and escalation triggers for each scenario.	Students receive three written patient scenarios—one routine adult acquisition, one patient with a pacemaker, one patient with reported dextrocardia—and individually map each scenario to a workflow checklist covering preparation, acquisition, documentation, and escalation decision points. Small groups compare workflow checklists, debate conflicting decisions (e.g., whether a specific finding requires immediate clinician notification), and revise individual plans based on discussion; instructor facilitates using the NHA CET exam content outline as a reference frame. Each student submits a one-page written project plan per scenario, including a labeled equipment list, infection control sequence, and a brief rationale for any anticipated lead-placement modifications, which the instructor reviews and annotates before Lesson 2.	Written patient scenario packets, NHA CET Candidate Handbook (current edition), EKG equipment checklist templates, OSHA Bloodborne Pathogens standard summary, course textbook (e.g., Arrhythmia Recognition: The Art of Interpretation, Phalen & Aehlert or equivalent adopted text), whiteboard for group discussion	Instructor reviews each written project plan using a 10-point rubric (equipment list accuracy, infection control sequence completeness, artifact risk identification, escalation logic, documentation elements, terminology correctness); students must score 8/10 or higher to proceed; those scoring below meet individually with instructor to correct deficiencies before Lesson 2.
2	Full Workflow Execution: Acquisition and Troubleshooting	14	lab	The student will perform a complete, interpretable 12-lead EKG on each of the three assigned simulated-patient scenarios, troubleshoot at least one introduced artifact per scenario, and produce a clean final tracing for each within the session.	Using a peer as the simulated patient (rotating roles), each student completes the full pre-acquisition protocol—verifies identity, explains the procedure in plain language, positions the patient, applies electrodes with correct anatomical landmarks, and enters demographic data into the EKG machine or a simulated EHR form—while the partner scores performance on a step-by-step competency checklist. The instructor or a designated peer introduces one artifact during each acquisition (loose electrode, patient movement, AC interference, or lead reversal); the student must verbally identify the artifact type, state its likely cause, and correct it before reprinting, documenting the troubleshooting action in the technician note field. After each of the three scenario runs, the student tapes the final tracing into the project portfolio, annotates lead placement adjustments made for the pacemaker and dextrocardia scenarios directly on the tracing, and writes a two-sentence technician note per tracing describing acquisition conditions and any deviations from standard protocol.	Diagnostic-quality EKG machine (multichannel), disposable electrodes, examination table, patient drape, alcohol prep pads, razor (simulation only), EKG calipers, simulated EHR intake form or machine demographic-entry screen, project portfolio binder, step-by-step competency checklist, artifact scenario cards prepared by instructor	Competency checklist scored by both peer and instructor; student must achieve a pass on every mandatory safety and placement step (zero tolerance for misplaced precordial leads and failure to verify patient identity) and an overall checklist score of 80% or higher; any mandatory-step failure requires an immediate repeat of that scenario run before the session ends.
3	Rhythm Analysis, Documentation, and Portfolio Assembly	10	practice	The student will analyze and formally document rhythm interpretations for a minimum of eight rhythm strips—including at least one from each of their own acquired tracings and five instructor-selected strips spanning normal and abnormal rhythms—producing a complete, professionally formatted project portfolio.	Students use calipers and a standardized rhythm analysis worksheet to calculate rate, PR interval, QRS duration, and QT interval for each strip, label P waves, QRS complexes, and T waves, classify the rhythm using accepted nomenclature (e.g., normal sinus rhythm, sinus bradycardia, atrial fibrillation, premature ventricular contraction), and note whether findings are within or outside normal reference ranges. For each strip, students complete a scope-of-practice decision log: they write one sentence stating what the CET technician should document and report, and one sentence identifying findings—if any—that require immediate escalation to a licensed clinician, citing the scope boundary rather than speculating on diagnosis. Students assemble all tracings, analysis worksheets, decision logs, technician notes, and equipment checklists into a single project portfolio with a title page, table of contents, and a one-page reflective summary describing two technical challenges encountered during acquisition and how each was resolved.	EKG calipers, printed rhythm strips (instructor-selected set covering normal sinus rhythm, sinus bradycardia, sinus tachycardia, atrial fibrillation, atrial flutter, first-degree AV block, premature ventricular contractions, and ventricular tachycardia as a minimum set), rhythm analysis worksheets, scope-of-practice decision log template, portfolio binder with dividers, course textbook rhythm atlas section	Instructor scores each rhythm analysis worksheet using an answer key; rate calculations must be within 10 beats per minute of the reference value and interval measurements within 20 milliseconds; rhythm classification must match the reference label exactly for passing credit on that strip; students must pass at least seven of eight strips and all three self-acquired tracings to advance; portfolio assembly is checked against a required-elements checklist (pass = all elements present).
4	Capstone Defense and Peer Evaluation	8	practice	The student will deliver an eight-to-ten-minute verbal defense of the completed project portfolio to a panel and complete a structured written evaluation of one peer's portfolio using a provided rubric.	Each student presents the portfolio to a two-person panel (instructor plus one additional evaluator such as a program director or clinical affiliate) covering: rationale for equipment setup decisions, explanation of lead placement modifications made for the pacemaker and dextrocardia scenarios, description of one artifact troubleshooting episode, and a walk-through of two rhythm interpretations chosen by the panel from the student's own strips; the student must use correct anatomical and electrophysiological terminology throughout and answer at least two unscripted follow-up questions. Following the defense, each student exchanges portfolios with an assigned peer and completes a structured peer-evaluation form addressing technical accuracy of rhythm labels, completeness of documentation, appropriateness of scope-of-practice decisions, and clarity of the reflective summary; the form requires specific written evidence for each rating rather than general comments. Students receive instructor feedback on both the defense and the peer evaluation form; the session closes with a full-group debrief mapping the project competencies explicitly to NHA CET exam content domains so students understand which capstone experiences directly prepare them for specific exam question areas.	Completed project portfolios, defense scoring rubric (panel version), peer evaluation form (student version), NHA CET exam content outline for domain-mapping debrief, projector or display for showing tracings during defense if available	Panel scores the defense on a 25-point rubric (terminology accuracy, technical justification, rhythm interpretation accuracy, response to follow-up questions, professional communication); passing score is 20/25; peer evaluation form is graded on specificity and completeness (pass = all sections completed with evidence-based written commentary, no blank fields); any student who does not pass the defense on the first attempt completes a documented remediation session with the instructor and presents a second defense within one week.

Assessments

Assessment	Type	Weight	Pass standard	Method & rubric

HLT-EKGT89-06 Externship / clinical

Clinical Practicum: EKG Technician Externship

80 hr · ~~$320~~ COMPLIMENTARY

Students complete 80 supervised hours at an approved clinical site—such as a hospital cardiac unit, outpatient cardiology office, or physician practice—performing EKG acquisition and related tasks under the direct oversight of a credentialed preceptor. Each student demonstrates professional, safe, and accurate patient care in a real workplace setting, integrating all skills developed in prior coursework. Performance is evaluated continuously by the site preceptor using a structured employer evaluation tool.

Outcomes

Perform technically accurate 12-lead EKG acquisitions on actual patients, including proper lead placement, artifact elimination, and documentation, meeting site quality standards.
Apply infection control, standard precautions, and patient privacy (HIPAA) procedures consistently throughout every clinical shift without prompting.
Communicate professionally with patients, families, and interdisciplinary team members, using clear verbal and written skills appropriate to the cardiac care setting.
Recognize and immediately report to the supervising clinician any rhythm or patient condition that falls outside the EKG technician's scope of practice.
Complete all required workplace documentation—EKG requisitions, patient logs, and preceptor evaluation forms—accurately and on time.
Demonstrate professional conduct, punctuality, and workplace readiness behaviors that meet employer expectations as documented by the site preceptor.

Course text

How the course runs. 4 blocks: Orientation, Safety, and Site Integration; Supervised EKG Acquisition and Documentation; Scope of Practice and Critical Rhythm Reporting; Preceptor Evaluation, Encounter Log Review, and Exit Conference.

What competent looks like. Perform technically accurate 12-lead EKG acquisitions on actual patients, including proper lead placement, artifact elimination, and documentation, meeting site quality standards. Apply infection control, standard precautions, and patient privacy (HIPAA) procedures consistently throughout every clinical shift without prompting. Communicate professionally with patients, families, and interdisciplinary team members, using clear verbal and written skills appropriate to the cardiac care setting. Recognize and immediately report to the supervising clinician any rhythm or patient condition that falls outside the EKG technician's scope of practice. Complete all required workplace documentation—EKG requisitions, patient logs, and preceptor evaluation forms—accurately and on time. Demonstrate professional conduct, punctuality, and workplace readiness behaviors that meet employer expectations as documented by the site preceptor.

Lessons · 4 blocks

#	Lesson	Hr	Type	Objective	Activities	Materials	Check
1	Orientation, Safety, and Site Integration	10	field	The student will orient to the clinical site by completing all required onboarding steps, locating emergency equipment and exits, reviewing site policies, and performing an observed return demonstration of hand hygiene and standard precautions before beginning independent patient contact.	Complete site-specific onboarding checklist: review HIPAA privacy policy, emergency codes, fire and evacuation routes, and department-specific infection control protocols; sign acknowledgment form kept in student clinical file. Shadow the preceptor for a full shift, observing patient identification, consent for EKG, proper draping and positioning, and equipment handling; take structured observation notes on at least three patient encounters using the provided observation log template. Perform a return demonstration of hand hygiene (WHO five-moment technique) and proper donning/doffing of PPE for the preceptor, who uses a pass/fail checklist; repeat until checklist is passed without errors.	Site onboarding packet, HIPAA acknowledgment form, student observation log template, hand hygiene and PPE competency checklist, site emergency code reference card, site EHR orientation (read-only access), personal protective equipment (gloves, gown, mask) supplied by site	Preceptor signs off on completed onboarding checklist and passes the student on the hand hygiene/PPE return demonstration checklist (100% of critical safety steps correct before patient contact is permitted; no partial credit on safety items).
2	Supervised EKG Acquisition and Documentation	40	field	The student will acquire technically acceptable 12-lead EKGs on a minimum of 40 patients across varied clinical presentations, correctly placing all 10 electrodes, eliminating artifact, labeling each tracing, and entering required data into the site documentation system, with preceptor sign-off on each tracing.	Perform 12-lead EKG acquisition on assigned patients under preceptor observation, beginning with direct supervision on every tracing and progressing toward indirect supervision as competence is established; the preceptor scores each acquisition using the site's EKG quality rubric (electrode placement, skin prep, artifact level, patient ID, labeling) and provides immediate corrective feedback when any item is below standard. Complete the site EKG requisition and electronic documentation for each procedure, recording patient name, date of birth, ordering provider, date, time, indication, and technician name; the student maintains a personal patient encounter log listing each tracing date, site, and preceptor initials confirming quality acceptance. Participate in at least two department huddles or team briefings, reporting verbally on assigned patients' EKG status to the supervising nurse or physician using structured handoff language (situation, background, observation, request/recommendation at the technician level), then debriefing with the preceptor afterward on communication accuracy and professionalism.	Site 12-lead EKG machines (multichannel), disposable electrodes, razors and skin prep supplies, measuring tape for precordial placement, site EHR (documentation module), EKG quality rubric, student patient encounter log booklet, site requisition forms	Student accumulates a minimum of 40 preceptor-signed acceptable tracings by end of this lesson block; no tracing is counted unless the preceptor marks it acceptable on the quality rubric (all mandatory fields correct and tracing free of sustained artifact). Students who do not reach 40 acceptable tracings by the scheduled endpoint meet with the program director to arrange additional hours.
3	Scope of Practice and Critical Rhythm Reporting	20	field	The student will identify, in real time on printed or displayed rhythm strips encountered at the clinical site, rhythm findings that require immediate escalation, and will demonstrate the correct verbal reporting procedure to the supervising clinician on at least five documented occasions.	During each shift, review rhythm strips or monitor displays as directed by the preceptor; when a rhythm outside the technician's scope to interpret (such as sustained wide-complex tachycardia, ventricular fibrillation, complete heart block, or asystole) is encountered or pointed out by the preceptor, the student practices the exact scripted escalation phrase ('I am seeing an abnormal pattern on this tracing and I am bringing it to you immediately') and documents the encounter in the critical event log with date, shift, rhythm description given by the preceptor post-event, and preceptor initials. Complete five structured scope-of-practice reflection entries in the student clinical journal: each entry describes a specific patient encounter, what the student observed on the tracing, what action the student took (including whether escalation was needed), and what the preceptor confirmed was the appropriate response; entries are reviewed and signed by the preceptor. Role-play with the preceptor during a low-census period: preceptor presents printed rhythm strips representing at least six different rhythms (including normal sinus rhythm, sinus bradycardia, atrial fibrillation, premature ventricular contractions, and two rhythms requiring urgent escalation) and student states, for each, whether the finding requires immediate reporting and what the scripted reporting phrase is; preceptor scores using the scope-of-practice role-play checklist.	Student clinical journal with structured reflection prompts, critical event log forms, scope-of-practice role-play checklist, printed rhythm strip set (prepared by program and approved by site preceptor), NHA CET exam content outline (Rhythm Recognition domain) for student reference	Student completes five signed reflection entries and achieves a score of 5 out of 6 (83%) or higher on the scope-of-practice role-play checklist; any scenario involving a life-threatening rhythm must be answered correctly (escalation identified and scripted phrase stated) to pass—errors on life-threatening scenarios require immediate remediation and repeat role-play before the student continues.
4	Preceptor Evaluation, Encounter Log Review, and Exit Conference	10	field	The student will compile and present a complete, verified clinical portfolio—including the patient encounter log, signed preceptor mid-point and final evaluation forms, and clinical journal—and participate in a structured exit conference with the preceptor and program coordinator, demonstrating the ability to self-assess performance and articulate a professional development plan.	Compile the full clinical portfolio: assemble the completed patient encounter log (minimum 40 signed tracings), all signed reflection entries, the critical event log, the preceptor mid-point feedback form, and any corrective action notes; verify all preceptor signatures and dates are present and submit the portfolio to the program coordinator at least 48 hours before the exit conference. Participate in the preceptor's completion of the final employer evaluation form, which rates the student across domains including technical skill, professional conduct, communication, safety compliance, and reliability; the student reads each rating aloud, acknowledges the feedback without argument, and asks one clarifying question per domain where a rating is below 'meets expectations.' Conduct a 15-minute structured self-assessment during the exit conference: using the employer evaluation form as a guide, the student states one strength and one area for growth in each rated domain, then proposes two specific, actionable steps to address the identified growth areas before sitting the NHA CET exam; the program coordinator documents the self-assessment in the student's program file.	Student clinical portfolio folder, patient encounter log booklet, employer evaluation form (site-standard or program-issued), preceptor mid-point feedback form, clinical journal, exit conference agenda template, program coordinator's student file	Portfolio is complete with all required signatures and the minimum 40 acceptable tracings documented; the employer evaluation final form shows an average rating of 'meets expectations' or higher across all domains, with no domain rated below 'needs improvement' on more than one item. Any 'unsatisfactory' rating on a safety or patient identification item automatically triggers a remediation meeting with the program director before the student advances to Course 7.

Assessments

Assessment	Type	Weight	Pass standard	Method & rubric

HLT-EKGT89-07 Exam prep

CET Exam Preparation: EKG Technician Certification Review

24 hr · ~~$240~~ COMPLIMENTARY

This course systematically reviews every content domain tested on the National Healthcareer Association Certified EKG Technician (CET) exam, using mapped practice questions, timed mock exams, and targeted remediation to close individual knowledge gaps. Students analyze their own performance data, refine test-taking strategies, and build the confidence and readiness needed to pass the CET on the first attempt. Scope-of-practice boundaries and patient safety principles are reinforced throughout as non-negotiable professional standards.

Outcomes

Correctly answer practice questions in each NHA CET exam content domain at a rate consistent with a passing score before sitting the credential exam.
Identify personal knowledge gaps by domain using practice-exam performance data and apply a focused remediation plan.
Apply time-management and question-analysis strategies to complete a timed, full-length mock exam within the allotted time.
Distinguish scope-of-practice boundaries for an EKG Technician and select the professionally correct action in scenario-based exam questions.
Interpret rhythm strips and 12-lead EKG tracings at the level of recognition and accurate documentation required by the CET exam.
Demonstrate exam-day readiness by scoring at or above the program's benchmark on a final full-length mock exam administered under standardized conditions.

Course text

How the course runs. 4 blocks: CET Exam Blueprint Orientation and Diagnostic Assessment; Domain Deep-Dive: Cardiac Science, Equipment, and Patient Safety; Domain Deep-Dive: Rhythm Recognition, Ambulatory Monitoring, and Professional Responsibilities; Full-Length Mock Exams, Score Analysis, and Readiness Confirmation.

What competent looks like. Correctly answer practice questions in each NHA CET exam content domain at a rate consistent with a passing score before sitting the credential exam. Identify personal knowledge gaps by domain using practice-exam performance data and apply a focused remediation plan. Apply time-management and question-analysis strategies to complete a timed, full-length mock exam within the allotted time. Distinguish scope-of-practice boundaries for an EKG Technician and select the professionally correct action in scenario-based exam questions. Interpret rhythm strips and 12-lead EKG tracings at the level of recognition and accurate documentation required by the CET exam. Demonstrate exam-day readiness by scoring at or above the program's benchmark on a final full-length mock exam administered under standardized conditions.

Lessons · 4 blocks

#	Lesson	Hr	Type	Objective	Activities	Materials	Check
1	CET Exam Blueprint Orientation and Diagnostic Assessment	4	practice	Given the official NHA CET exam content outline, students map their own diagnostic-quiz scores to each domain and produce a written remediation priority list.	Instructor-led walkthrough of the NHA CET content domains — cardiac anatomy and physiology, EKG acquisition and equipment, rhythm recognition, patient care and safety, and professional responsibilities — using the published exam blueprint so students see the exact weighting of each area. Students complete a 60-question timed diagnostic quiz drawn from all domains, then individually score their results by domain and enter percentages into a personal performance tracking worksheet. Each student writes a one-page remediation plan listing their two lowest-scoring domains, the specific topics within those domains that need review, and the study resources (textbook chapters, flashcard sets, practice-question banks) they will use before Lesson 2.	NHA CET candidate handbook and published content outline; 60-question diagnostic quiz (instructor-prepared from validated item banks); performance tracking worksheet; student notes and textbooks from Courses 2–6; calculator; pencils	Student correctly categorizes every diagnostic-quiz item by domain and produces a remediation plan that accurately reflects their lowest-scoring areas; instructor reviews plans for accuracy and realistic action steps — accepted when the domain scoring is correct and the plan is specific rather than generic.
2	Domain Deep-Dive: Cardiac Science, Equipment, and Patient Safety	6	theory	Students answer targeted review questions on cardiac anatomy and physiology, EKG equipment operation and troubleshooting, lead placement, and patient care and safety at a rate of 75 percent or higher on a domain-specific quiz.	Rotating small-group stations (20 minutes each) cover: (1) cardiac conduction system structures and their roles in normal waveform generation; (2) electrode placement for standard 12-lead, right-sided, and posterior leads with common error identification using annotated tracing examples; (3) equipment artifacts — somatic tremor, AC interference, wandering baseline, lead-wire problems — and the corrective actions within EKG Technician scope of practice. Whole-class case-scenario discussion: instructor presents five patient-encounter vignettes involving patient refusal, electrode site preparation on a diaphoretic patient, and a lead that produces a flat line — students verbally defend their chosen actions and cite the scope-of-practice boundary that governs each decision. Students complete a 40-question domain-focused quiz (cardiac anatomy/physiology, acquisition, patient safety) under timed conditions (1 minute per question), then pair-share to explain the rationale for each answer using terminology from their Course 2 and Course 3 notes.	Anatomical heart diagrams; limb and precordial electrode placement reference cards; sample 12-lead tracings showing artifact types; NHA study guide; domain-specific quiz; EKG machine or simulator for artifact demonstration; whiteboard	Students score 75 percent or higher on the 40-question domain quiz; any student below 75 percent receives targeted flashcard sets for the missed sub-topics and is verbally quizzed by the instructor on at least three missed items before the next lesson.
3	Domain Deep-Dive: Rhythm Recognition, Ambulatory Monitoring, and Professional Responsibilities	6	lab	Students correctly identify at least 18 of 20 rhythm strips presented in exam-format and answer professional-responsibility scenario questions at 75 percent or higher on a combined domain quiz.	Rhythm strip relay: students rotate through a set of 30 printed or projected rhythm strips spanning normal sinus rhythm, sinus bradycardia, sinus tachycardia, atrial fibrillation, atrial flutter, first-degree AV block, second-degree AV block (Mobitz I and II), third-degree AV block, premature atrial contractions, premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation — each student labels rate, rhythm, P-wave, PR interval, QRS duration, and interpretation on a structured answer form, then checks against the instructor answer key. Ambulatory monitoring mini-lecture and Q&A covers Holter monitor application, patient diary instructions, event monitor differences, and the technician's documentation responsibilities; students then answer 10 scenario questions about technician actions when a patient calls in a symptom or when a downloaded Holter strip shows a critical rhythm. Professional-responsibilities case studies: small groups analyze three scenarios involving HIPAA-compliant communication, mandatory reporting of an observed patient fall, and a physician request that falls outside the EKG Technician scope of practice — groups present their reasoning and the class reaches consensus on the correct action, with the instructor providing authoritative clarification.	Printed rhythm strip sets (30 strips); structured interpretation answer forms; answer key with rationales; Holter monitor and electrodes for demonstration; ambulatory monitoring patient instruction sheet; professional-responsibilities case-study handouts; NHA CET study guide	Students correctly interpret at least 18 of 20 designated rhythm strips on the relay answer forms AND score 75 percent or higher on the 30-question combined domain quiz covering rhythms, ambulatory monitoring, and professional responsibilities; students below either threshold receive instructor-assigned remediation strips or question sets to complete before the mock exam.
4	Full-Length Mock Exams, Score Analysis, and Readiness Confirmation	8	practice	Students complete two full-length timed mock exams under standardized conditions, analyze their scores by domain, and demonstrate overall readiness by achieving the program benchmark on the second mock exam.	Mock Exam 1 (full length, all domains, timed to match NHA CET exam conditions): students work independently with no notes or references, then receive a scored report broken down by domain; instructor facilitates a whole-class review of the 10 most frequently missed items, explaining the reasoning behind the correct answer and the misconception that drives each common wrong choice. Targeted remediation block: using their Mock Exam 1 domain reports, students spend focused independent study time on their weakest domain using textbooks, NHA study guide chapters, or instructor-prepared rapid-review sheets; the instructor circulates to answer questions and confirms that each student has a clear understanding of previously missed content before Mock Exam 2. Mock Exam 2 (full length, all domains, timed, standardized conditions): upon completion, each student compares their Mock Exam 1 and Mock Exam 2 domain scores on their tracking worksheet, writes a two-paragraph reflection identifying growth areas and any remaining concerns, and meets individually with the instructor for a 5-minute readiness confirmation conversation that confirms exam registration logistics, approved ID requirements, and test-center or remote-proctoring procedures per the current NHA candidate handbook.	Two full-length mock exams (instructor-prepared from validated item banks covering all NHA CET content domains); answer sheets; timer; performance tracking worksheet; NHA CET candidate handbook; NHA study guide; course textbooks for remediation reference	Students must score at or above 75 percent overall on Mock Exam 2, with no single domain below 65 percent, to receive instructor confirmation of exam readiness; students who do not meet the benchmark receive a documented individual remediation plan and may request a scheduled retake of Mock Exam 2 before the credential exam date.

Assessments

Assessment	Type	Weight	Pass standard	Method & rubric

Back to EKG Technician · How the school gets authority to award these credentials