CRAT study plan
CRAT · Give each week a clear focus.
8 weeks · About 7 hours per week
Cardiac Anatomy and Physiology & Rhythm Analysis
Map the cardiac conduction system in order from SA node through Purkinje fibers, stating the inherent firing rate of each pacemaker site
Trace the relationship between the cardiac action potential phases and the surface ECG deflections (P, QRS, T) without notes
Label the coronary artery territories and match each to the leads that best reveal ischemia in that territory
Define the normal ECG intervals and amplitudes (PR, QRS, QT, axis) and state the numeric thresholds that separate normal from abnormal
Your checkpoint
A one-page hand-drawn conduction-system and coronary-territory diagram with all pacemaker rates, interval thresholds, and lead-territory pairings annotated from memory, checked against a reference.
Rhythm Analysis
Identify sinus rhythm, sinus bradycardia, sinus tachycardia, and sinus arrhythmia on 20 single-lead strips using rate, P-wave morphology, and P-QRS relationship
Calculate heart rate by both the 300/1500 method and the 6-second method and reconcile discrepancies
Determine electrical axis from leads I and aVF and classify normal, left, right, and extreme axis
Distinguish atrial fibrillation, atrial flutter, and multifocal atrial tachycardia by atrial activity and regularity
Your checkpoint
A graded log of 25 rhythm strips with your interpretation, the objective criteria you used, and the correct answer for each; target 80% accuracy.
Rhythm Analysis
Classify AV blocks (first degree, Mobitz I, Mobitz II, third degree) using PR behavior and P-to-QRS ratios
Recognize junctional rhythms, idioventricular rhythms, and escape beats by QRS width and rate
Differentiate ventricular tachycardia from SVT with aberrancy using the criteria you can apply on a single strip
Identify premature atrial and premature ventricular complexes and describe the compensatory pause for each
Your checkpoint
A written comparison table of all bradyarrhythmias and tachyarrhythmias covered, with at least three distinguishing criteria per row, validated against 15 practice strips.
Rhythm Analysis & ECG Interpretation
Interpret 30 mixed rhythm strips under a 30-second-per-strip time limit and record accuracy
State the immediate clinical concern and first action for each of the peri-arrest rhythms (VF, pulseless VT, asystole, PEA, unstable bradycardia, unstable tachycardia)
Detect ST-segment elevation and depression and localize the territory involved
Recognize hyperkalemia, hypokalemia, and drug-effect patterns (QT prolongation, widened QRS) on the ECG
Your checkpoint
A timed 30-strip self-assessment scored by domain, with every miss rewritten as a one-line rule you will apply next time; target 85% accuracy.
ECG Interpretation
Systematically read full 12-lead ECGs using a fixed sequence (rate, rhythm, axis, intervals, hypertrophy, ischemia/infarction, comparison)
Apply the criteria for left ventricular hypertrophy and distinguish it from anterior infarction patterns
Identify bundle branch blocks and fascicular blocks from QRS morphology and axis
Describe how to recognize a prior infarction (Q waves) versus an acute injury pattern
Your checkpoint
Five complete 12-lead interpretations written in the fixed sequence, each with a final impression and a justification line for every abnormality claimed.
ECG Interpretation & Patient Care and Monitoring
Perform correct 12-lead electrode placement and explain how limb-lead reversal and precordial misplacement distort the tracing
Set up continuous monitoring: select the best lead for P-wave visibility and adjust gain and filters appropriately
Distinguish artifact from true arrhythmia and list the common sources of each (movement, tremor, loose electrode, CPR)
Interpret ST-segment changes in the context of patient symptoms, vital signs, and prior ECGs rather than in isolation
Your checkpoint
A troubleshooting checklist covering lead placement errors, artifact sources, and monitor settings, plus a written analysis of three artifact-versus-arrhythmia examples.
Patient Care and Monitoring
Assess a patient with a rhythm change using a structured approach: airway, breathing, circulation, symptoms, and vital signs before rhythm-specific action
Describe safe defibrillation and cardioversion practice: energy selection, pad placement, synchronization, and safety checks
Explain transcutaneous pacing setup, capture verification, and troubleshooting of failure to capture or sense
State monitoring and response thresholds for common drugs that affect rate, rhythm, and QT interval
Your checkpoint
A one-page peri-arrest action card for each of the six unstable rhythms, listing recognition cues, immediate actions, and safety checks, checked against current resuscitation guidance.
Rhythm Analysis & ECG Interpretation & Cardiac Anatomy and Physiology & Patient Care and Monitoring
Complete two full-length timed practice exams under test conditions and score each domain separately
Re-teach your three weakest objectives from earlier weeks by writing a short explanation for each
Review every missed item and classify the cause as knowledge gap, misread strip, or time pressure
Confirm you can state the normal values and key thresholds for rate, intervals, axis, and QT correction from memory
Your checkpoint
A final score report by domain with a written remediation list for any domain still below 80%, plus a one-page summary sheet of all thresholds and criteria.
Milestones
Week 2: Score at least 80% on a 25-strip basic-rhythm identification set and correctly calculate rate by both methods on 10 consecutive strips.
Week 4: Score at least 85% on a timed 30-strip mixed-rhythm set, with no more than one error in the peri-arrest rhythm category.
Week 6: Produce five complete 12-lead interpretations in the fixed sequence that another reader could follow, and correctly separate artifact from arrhythmia in all three assigned examples.
Week 8: Score at least 80% in every domain on the final timed practice exams, with an overall score at or above the passing threshold you are targeting.