Abstract
Background:
An undergraduate medical student, in their first professional year, is required to know the appliedphysiology of electrocardiogram (ECG). This includes recording and interpreting normal and abnormal ECG. Usually, the topic is taught in classes as didactic lectures. However, teaching scenarios that occur in real-life situations within the confines of a classroom may not produce optimal learning outcomes. Simulation-based learning is an interactive and active learning methodology that provides immersive and experiential learning to students. We conducted this study to determine whether simulation and virtual learning have an impact on the applied physiology of ECG and its clinical application among undergraduate medical students.

Aim:
To evaluate the impact of simulation and virtual learning on the applied physiology of ECG and its clinical application among undergraduate medical students.

Methods:
A total of 250 undergraduate students in their first professional year of MBBS, who were between 17 and 24 years old and belonged to both male and female genders, were included in this experimental study. Each student had a hands-on experience of the ALS simulator using an ECG machine, for recording the ECG and the SIMMAN 3G plus Hi-fidelity simulator to interpret normal and abnormal ECG. This was done to facilitate a better understanding of the applied physiology of ECG. A self-administered, pretested questionnaire was administered with pre- and posttest questionnaire. The data were analyzed using SPSS version 22.0 with a paired t-test.

Results:
The participants of the study were aged between 17 and 23 years, of which 204 (81.6%) were between 17 and 19 years, 42 (16.8%) were between 19 and 22 years, and 4 (1.6%) were above 22 years. Regarding the sex of the participants, 97 (38.8%) belonged to male and 153 (61.2%) belonged to the female sex. The pre- and post-test results were evaluated, which suggest that the intervention had a statistically significant positive impact on the participant scores, as the p value is < 0.05. It was found that the pre-assessment scores had the largest effect size, followed by sex and age. With an increase in age, the post-assessment score decreases by 0.203 points, and the female participants are
expected to have a post-assessment score that is 0.508 points higher than the male participants.

Conclusion:
This study highlighted that simulation and virtual learning about the applied physiology of ECG and its clinical application have an impact on undergraduate medical students.