Yongmei Bentley & Shamim Warwick, Business School, University of Bedfordshire
The collection of student feedback is a central strategy to monitor the effectiveness of teaching and learning at educational institutions (Meyer, 2010). This paper analyses the feedback and findings from a recent questionnaire survey of students' experience and perceptions of group work at the University of Bedfordshire at both undergraduate and postgraduate levels. The main objective of this study is to raise practical issues that teachers need to consider in designing and carrying out group assessments. This is aimed at overcoming the drawbacks, while amplifying the benefits, of group work, and improving students' engagement and performance in this type of assessment.
The following are the key findings from analysis of the questionnaire replies:
- a) Group assignments were indeed valued by students despite the perennial problem of perceived unequal contribution from group members. Respondents recognised the benefits of group assignments as well as the drawbacks.
- b) A wide variety of communication strategies had been employed between students for working on group assignments, as well as individual assignments when seeking input and support from peers.
- c) Students had developed a number of strategies for dealing with team members who did not 'pull their weight', and it was suggested that some of these could be formalised, such as requiring minutes to be taken of key meetings.
A comparative analysis was also undertaken of the difference in responses between the undergraduate and postgraduate student groups. Overall, the research underlined the utility of group assignments, and suggested a number of ways in which the potential drawbacks can be mitigated.
As group work is a common approach for education institutions in teaching and learning activities, the outcomes of this study should contribute to a better understanding of students' feelings and perceptions about these, and to a better designed approach to overcome the drawbacks of group assignments.
Keywords: students, group assignment, questionnaire survey
Group work at education institutions is now considered as one of the best approaches for developing students' communication skills and acquiring knowledge. This agrees with the results from the study by Smith and Bath (Smith & Bath, 2006) who revealed that interaction of members engaging in group assignments would develop generic skills, such as communication and critical thinking. Group work appears to offer teachers an effective way to engage students, to increase the complexity and challenge of the tasks that students gain experience of working on, to offer students the opportunity for collaborative working, and to offer the possibility of reduced marking loads (Gibbs, 2009). However, not everything is positive, and making group work fully effective is challenging.
This paper analyses the feedback and findings from a recent questionnaire survey of students' experience and perceptions of group assignments at the University of Bedfordshire (UoB) at both undergraduate and postgraduate levels. The purpose of this study is to raise practical issues that teachers need to consider in designing and carrying out group assessment with a view to overcoming the drawbacks, and amplifying the benefits, of such work, and to improve students' engagement and performance in these activities.
The benefits to students of group work have been demonstrated both in general (Johnson et al., 1991) and in specific contexts. For example, Mello (1993) identifies major benefits of group work: (1) 'students can gain an insight into group dynamics'; (2) 'they can tackle a more comprehensive assignments'; (3) 'interpersonal skills can be developed'; (4) 'students are more exposed to others' points of view'; and (5) 'be more prepared for the commercial world'.
A comprehensive review on the implementation of small group learning within individual discipline areas also shows very positive impacts on student performance, marks, attitudes towards learning and persistence or retention (Gibbs, 2009). For example, Springer et al. (1999) reviewed 383 studies and found evidence of 'widespread implementation of small-group learning' at undergraduate level in the three disciplines studied. Problem based learning (PBL) also uses learning in groups and meta-analyses of studies comparing PBL with other pedagogies show consistent benefits to student learning processes and outcomes from PBL (Dochy et al., 2003).
JISC (2008) recognises the benefit for academics/tutors in setting group work tasks in that these can significantly reduce [staff] workload. However, JISC also reports work by Kennedy (2006): '…there is evidence to suggest that students undertaking such projects express concern about the way in which marks are awarded for outcomes produced by the group collaboratively'.
Some of the findings from analysis of literature on key factors affecting group assignment (Meyer, 2010; Kennedy, 2006; Barfield, 2003) can be summarised as follows:
- a) Group structure – Ensuring that group members recognise the mixed talents within the group, and hence scope for assigning different roles to different members to perform specific tasks.
- b) The issue of individual domination – Emphasising the need to respect different points of view, and not have one or a few individuals dominate the group.
- c) Fair contribution – 'Ensuring equal and active participation of each group member'.
- d) Evaluation of individual contribution – This is difficult, but can be assisted by 'anonymous 'peer review', 'individual reflective report'; and/or 'tutor involvement'.
A review of relevant literature shows that there are studies on the general topics of group work and group assessment as discussed above. For example, there are case studies that were designed to address problems with the assessment of groups. However, there have been limited publications that have empirical evidence to inform the design decision of group assignments (Gibbs, 2009). It is hoped that the outcomes of this study can contribute to this.
Background of group work to this study
At the UoB where this study was conducted, we use group-based assignments for most units, and for both formative and summative assessments to enable students to benefit from one another's knowledge and experience. Group assignments include case studies, oral presentations, and group written reports, sometimes with a statement about individual contributions. The essence of the group assessment is that undertaking the assessment constitutes a learning experience in its own right.
The weight of a group assignment within a summative assessment varies between different courses, and different units within the same course – normally between 30% and 60%.
An assignment group usually consists of 3-6 members depending on the nature of the assessment. The students can form their own assignment groups, but are encouraged to mix with peers with different experiences and different culture backgrounds. Sometimes, the tutor in charge helps students to form their groups, especially in the first term of their study at the university.
For some group assignments, each member of the group submits an anonymous statement of his/her perception of the contribution by each of the group members (including himself/herself). In other cases, the group reaches agreement about the contribution by each member and submits one form which is signed by all. Some tutors conduct oral interviews on the group assignments to make sure that each student is given a fair grade for the group work.
A questionnaire survey was used for data collection for this research. The areas covered in the questionnaire were fairly broad, including student preferred type of assignment; degree of peer support; working styles; strategies for fair contribution; communication tools; skills needed for group assignments; and the perceived benefits and drawbacks of group assignments. The survey also obtained additional comments from respondents about specific problems encountered, as well as suggestions for assignment improvement.
The survey was carried out at the end of the academic year 2010/11 among two groups of students. One group was Level 1 undergraduates, and the other MSc students, in the Business School. Participation in the survey was voluntary.
In total, 140 questionnaires were distributed in the last class at the end of the second semester, and 106 were completed and returned, of which 30 were by MSc students and 76 by Level-1 undergraduates. This represented an acceptably high return rate of 75 per cent.
Data Analysis and Findings
Data analysis was conducted using Microsoft Excel. This section presents the key results from this survey in the sequence of questions in the survey form.
Question 1: What do you prefer, individual or group assignments?
It is interesting and perhaps even surprising, to see that the preference of students between group and individual assignments is very close – 51per cent to 49 per cent. Note that the level of the course (Masters vs. Level 1) and the preference for group work are statistically independent.
Questions 2 and 3: Which of the following do you do with your peers on an individual/group assignment (tick all that apply)?
Fig. 1 Working with peers on individual and group assignment
As indicated in Fig 1, it is understandable the students tend to do all the activities for their group assignments. On individual assignment they work with peers to some extent. However, possibly worryingly, some students exchange files/documents with others on an individual assignment, and this suggests further investigation
Question 4: Which do you prefer when working on a group assignment — splitting up the work or working together?
In terms of workload strategy for group work, the preference between 'splitting up the work' and 'working together' was exactly 50:50 per cent. The preference for group/individual assignments and for splitting the work/working together are not independent at the 5 per cent level: Students who prefer individual assignments prefer to split up the work; and students who prefer group assignments prefer to work together.
Question 5: Which strategies do you use to encourage fair contribution from all members to a group assignment?
Fig. 2 Strategies for fair contributions
On this important issue, students were asked to list their strategies. Fig. 2 indicates that 'share workload' stands out with a very high percentage of the total choices (39 per cent), followed by 'share ideas and information' (13 per cent), 'set deadlines' and 'have meetings' (7 per cent each), 'use peer strength' and 'encourage participation' (6 per cent each). Surprisingly, 'mutual agreement', 'better communication', and 'help each other' were not considered as key strategies for encouraging fair contributions.
Question 6: How do you feel about contributing more than your fair share (tick all that apply)?
Fig. 3 Perception of contribution of more than fair share
We were very pleased to see that nearly 80 per cent of the participants in the survey felt that they are happy to contribute more than their fair share to the group work with the explanations: 'if this will improve the work and therefore the grade' (over 30 per cent), or 'because I feel I will learn more from this experience' or 'if I can help other group members' (both over 20 per cent). Some chose they 'do not mind' (over 10 per cent), and about 4% chose: 'I don't want to because it will increase my workload'. So it seems that if the students can see the benefit, they are generally happy to make a 'more than fair share' contribution to the group assignment (see Fig. 3). However, one respondent commented: 'Sometimes it is annoying when your group mates take it for granted and assume that no matter whether they contribute or not, you are going to do their part of work as well. This reduces your interest and concentration.'
Question 7: Which communication tools do you use for group communication if you are not physically together?
To this question, three choices were given – a. Tools provided by the university systems (e.g. tools on BREO, the university's virtual learning environment); b. Other tools (e.g. Facebook, MSN, Skype); c. Other (please specify). There were about one-third of the respondents for each of the three choices (34 per cent, 32 per cent and 34 per cent respectively). When students were asked to specify 'other' in the third choice 'c', 35 per cent said 'phone only', 28 per cent 'phone and messaging', '18 per cent 'messaging only' and 10 per cent each went for 'email only' and 'email and other tools'.
Here it is worth noting that as many as 66 per cent of the respondents use many social networking systems for collaborating on their group work that were not provided by the university. These included phone calls, texting, personal e-mails, Skype, Blackberry messaging and so on.
Question 8: On a scale of 1 to 5, how do you feel about assignments which require you to work together but then submit individual work?
Surprisingly, as many as a third of the respondents love/like working together but submitting individual work, while 39 per cent do not seem to mind doing so, but nearly a quarter do not like the idea of working together but submitting individual work.
Question 9: Do you tend to keep a record of what each member has done for peer-review purposes?
For this question, more than half (55 per cent) of respondents do not keep a record for peer-review purposes. Preference for group/individual assignments and 'keeping a record of contribution for peer review purposes' are not independent at the 5 per cent level. Students who prefer individual assignments do not keep a record; fewer students than expected who prefer group assignments keep a record.
Fig. 4 Working in group but submitting individual work
Question 10: How do you grade a group member whose contribution was considerably poor compared with other group members?
To this question, we were very pleased to see that 71 per cent of the respondents selected the choice: 'I give students grades that truly reflect their low contribution', while 29 per cent chose 'I give everyone similar grades regardless of their contribution'. This suggests that tutors may need to work with students to discuss the value of peer assessment and the eventual long-term benefit to poor-contributing students which may be gained from honest grading.
Question 11: Which do you prefer? A. Each group member submits an anonymous peer review form and B. The group reach an agreement and submit one peer review form.
To this question, 57 per cent of students indicated that they prefer submitting an anonymous peer review form, and the rest prefer the group reach an agreement before they submit one peer review form.
Question 12: Do you feel that you can learn more by doing group work and why?
Three-quarters of the respondents feel that they can learn more by doing group work, while 16 per cent do not agree, and 8 per cent were not sure. Interestingly, 30 per cent of respondents who prefer individual assignments felt that they can learn more by doing group work and give the reasons as follows:
- Because ideas are shared and can be argued;
- Because some stuff I might not know, [and] I can see them doing it;
- Group can conduct more research on the topic;
- Having conflict forces deeper thought;
- Because I can see other people's opinion;
- You can pick up skills from other members.
Question 13: What skills do you feel you can develop when you work on a group assignment?
Fig. 5 Skills developed by doing group assignments
To this question two skills stood out – 'team work skills' and 'communication skills' which add up to over 50 per cent of the total responses. Other skills students developed by doing group assignments are: self-development, time management, academic development, leadership, interpersonal and inter-cultural communication. In addition, the words frequently mentioned include:
listening, sympathy, patience, adaptability, tolerance, reliability, confidence, responsibility, empowerment, motivation, intellectual, numeracy, research, critical thinking, creative thinking, courage to defend a point of view, dealing with people of different views.
Question 14: What do you feel is the biggest benefit of working on group assignments?
Fig. 6 Biggest benefit of working on group assignments
To this question the respondents gave various answers, and Fig. 6 gives a summary of the key benefits. These include: use peer strength, share workload, more input, develop interpersonal and team work skills, learn from peers, and increase self-confidence. Some of the respondents gave details of the benefits of group work which can be categorised as:
A. Good team-work skills. For example, some students mentioned the following:
- 'Working in groups prepares us for real team work for our future career';
- You learn how to work with other people as in many actual workplaces team work is required.
B. Shared workload and ideas, and improve grades. For example, some students mentioned the following:
- A chance to split the work, feel more relaxed;
- Opportunity to listen to other points of view;
- Different ideas, can work together and make assignment look good and get a good grade;
- Good team work help improve the grade;
- Some people may have more knowledge on that particular topic than yourself which could ultimately raise your grade than if you were work by yourself.
C. Other skills. For example, some students mentioned the following:
- 'Group assignments are good as it provides us experience of listening to different ideas';
- It is amazing that working in a group allows us to know each other's experiences, learning skills, their cultures & behaviour.
- 'Group work is a good learning process'.
The key benefits can perhaps be best summarised using one of the respondent's comments: 'Share information, share ideas, less workload, more input and ideas, more resources, help each other, more adaptable, more confident, can communicate with people of different culture, can exchange ideas, opportunity to understand and learn from others, become more knowledgeable, build up relationship and make new friends'.
Question 15: What do you feel is the biggest drawback of working on group assignments?
Of course the respondents also saw the drawbacks of working on group assignments. Fig. 7 summarises the key ones, which include: uneven contribution, rely on others, poor commitment and attitude, poor time management, low ability and contribution, and so on.
Fig. 7 Biggest perceived drawbacks of working on group assignments
Some respondents also listed other drawbacks of group work which can be categorised as:
A. Poor motivation and commitment. For example, some students mentioned the following:
- Difficult to co-operate if people are not well motivated;
- Difficult to bring people to the common interest;
- People not attending or working up to standards;
- Some tend to rely on others, are not on time, and waste time;
- People get distracted very easily;
- Some members take it easy and feel relaxed;
- It may take longer for tasks to be completed due to availability of members.
B. Uneven/unfair contribution. For example, some students mentioned the following:
- Some people do not contribute as much as others, and you end up doing most of the work;
- There are some who do not do any work where as others do all the work;
- Some people may not do equal amount of work which is unfair for the rest of the group;
- People uses others and contribute less for the assignments;
- Some in the group might not put in any effort into the work and bring down your grade.
Question 16: Do you have any suggestions and/or comments for group assignments?
Fig. 8 Suggestions for group assignments
Fig. 8 illustrates the main suggestions from the respondents to improve the effectiveness of doing group assignments. These include: peer review, ensure equal contribution, less group work, group work with individual elements, help with group formation, and more group meetings.
Here are some examples of comments from the respondents:
- 'Group assignments in principle is very good and helps to know course mates better, but the challenges are sometimes overwhelming.'
- 'Group work can be annoying at times because not everyone does the work.'
- 'Group work can be hard if you are working with the wrong people.'
- 'Group work can be good but sometimes you may feel that you can't learn anything. Doing individual assignments can be more effective as it's easier to learn what to do.'
- 'Group assignments are good and it is a different experience of having different ideas.'
- 'Working in groups prepares us for real team work for our future career.'
- 'Working in a group allows us to know each other's experiences, learning skills, their cultures and behaviour.'
- 'It is really good to do work in group as it helps at the professional level.'
- 'It does have its advantages and disadvantages. However, I believe that the experience looks very good on CV and will be helpful in the future.'
Group assignments are indeed valued despite perennial problems such as unequal contribution from group members. The key findings from this study are:
- a) Regarding student preference of the type of assignment, the split between like group and individual work is roughly equal, so there are no strong likes and dislikes.
- b) To encourage fair contribution and improve team performance, students have developed a number of strategies: encourage participation, have group meetings, use peer strength, share ideas, share information, share workload, and set deadlines.
- c) A wide variety of communication strategies have been involved for working on group assignments, and also for individual assignments when seeking input and support from peers. This suggests that the university should also explore and facilitate the use of these systems.
- d) Students do see both benefits and drawbacks of group work. While the biggest benefits frequently mentioned are: use peer strength, share workload, more input, develop interpersonal and team work skills, learn from peers, and increase self-confidence, the biggest drawbacks are: uneven contribution, poor commitment, poor time management, and low ability and contribution.
- e) The majority of the respondents feel that they can learn more by doing group work, especially in terms of the development of team work and communication skills.
In follow-on research, a comparative analysis will be undertaken to analyse the differences in responses between the undergraduate and postgraduate student groups. Also, the findings about students' perceptions of group assignments will be investigated in more detail through interviews with individual students randomly selected from the survey participants.
As group course work is a common approach for education institutions in their teaching and learning activities, the outcomes of this study should contribute to a better understanding of students' feelings and perceptions about these, and to a better designed approach to overcome the drawbacks of group assignments. It is recognised that the survey was conducted among students of one university only and it might have had biased results. However, as students generally have common characteristics it is believed that the findings from this study should be applicable to students groups of other education institutions.
- Barfield, R.L. (2003) 'Students' perceptions of and satisfaction with group grades and the group experience in the college classroom'. Assessment & Evaluation in Higher Education, 28 pp. 355-369.
- Dochy, F., Segers, M., Van den Bossche, P. & Giibels, D. (2003) 'Effects of problem-based learning: a meta-analysis'. Learning and Instruction, 13 (5) pp. 533-568.
- Gibbs, G. (2009) The assessment of group work: lessons from the literature, Assessment Standards Knowledge exchange, Brooks University, UK.
- JISC (2008) E-Assessment: An overview of JISC activities. JISC funded e-assessment developments. http://www.jisc.ac.uk/publications/briefingpapers/2008/bpeassessoverviewv2.aspx.
- Johnson, D.W., Johnson, R.T. & Smith, K. (1991) Co-operative learning: Increasing college faculty instructional productivity. ASHE-ERIC Higher Education report No.4. Washington DC.: The George Washington University School of Education and Human development.
- Kennedy, G.J. (2006) 'Peer assessment in Group Projects: Is It Worth it?' Australian Computing Education Conference 2005.crpit.com/confpapers/CRPITV42Kennedy.pdf, accessed on 01/10/2012.
- Mello, J.A. (1993) 'Improving individual member accountability in small work settings'. Journal of Management Education, 17(2) pp.253-259.
- Meyer, L.H. (2010) Editorial — 'Research on tertiary assessment policy and practices'. Higher Education Quarterly, Vol. 64 (3), July 2010 pp. 226–230.
- Smith, C. & Bath, D. (2006) 'The role of the learning community in the development of discipline knowledge and generic graduate outcomes'. Higher Education, 51 (2) pp. 259-86.
- Springer, L., Stanne, M.E. & Donovan, S.S. (1999) 'Effects of small group learning of undergraduate Science, Mathematics, Engineering and Technology: a meta-analysis'. Review of Educational Research, 69 (1) pp. 21-51.
This is taken in the postero-anterior (p A) direction at maximum inspiration with the heart close to the X-ray film to minimize magnification with respect to the thorax. A lateral may give additional information if the PA is abnormal. The cardiac structures and great vessels that can be seen on these X-rays are indicated.
Heart size can be reliably assessed only from the PA chest film; the maximum transverse diameter of the heart is compared with the maximum transverse diameter of the chest measured from the inside of the ribs.
The cardiothoracic ratio (CTR) is usually less than 50%, except in neonates, infants, athletes and patients with skeletal abnormalities such as scoliosis and funnel chest in general. A transverse cardiac diameter of more than 15.5 ern is abnormal. Pericardial effusion or cardiac dilatation causes an increase in the ratio. A pericardial effusion produces a globular, sharp-edged shadow. This enlargement may occur quite suddenly and, unlike heart failure, there is no associated change in the pulmonary vasculature. The echocardiogram is more specific than the chest X-ray for the diagnosis of pericardial effusion, particularly because at least 250 ml of fluid must accumulate before X-ray changes are apparent. Certain patterns of specific chamber enlargement may be seen on the chest X-ray:
Diagrams to show the heart
silhouette on the chest X-ray,
LEFT ATRIAL DILATATION results in prominence of the left atrial appendage on the left heart border, a double atrial shadow to the right of the sternum, and splaying of the carina because a large left atrium elevates the left main bronchus . On a lateral chest X-ray an enlarged left atrium bulges backwards, displacing the left main stem branches.
LEFT VENTRICULAR ENLARGEMENT results in an increase in the CTR and a smooth elongation and increased convexity of the left heart border. A left ventricular aneurysm may produce a distinct bulge or distortion of the left heart border.
RIGHT ATRIAL ENLARGEMENT results in the right border of the heart projecting into the right lower lung field.
RIGHT VENTRICULAR ENLARGEMENT, due to congenital heart disease, results in an increase of the CTR and an upward displacement of the apex of the heart because the enlarging right ventricle pushes the left ventricle leftwards, upwards and eventually backwards. Differentiation of left from right ventricular enlargement may be difficult from the shape of the left heart border alone, but the lateral view shows enlargement anteriorly for the right ventricle and posteriorly for the left ventricle.
ASCENDING AORTIC DILATATION OR ENLARGEMENT is seen as a prominence of the aortic shadow to the right of the mediastinum between the right atrium and superior vena cava.
DISSECTION OF THE ASCENDING AORTA is seen as a widening of the mediastinum, although this is often difficult to assess on an AP chest X-ray. A left-sided pleural effusion may be evident if the aneurysm is leaking or there may be blood around the apex of the lung (‘capping’). ENLARGEMENT OF THE PULMONARY ARTERY in pulmonary hypertension, pulmonary artery stenosis and left-to-right shunts produces a prominent bulge on the left-hand border of the mediastinum below the aortic knuckle.
This plain PA chest X-ray is taken from a patient
Calcification in the cardiovascular system occurs because of tissue degeneration. Calcification is visible on a lateral or a penetrated PA film, but is best studied by fluoroscopy or CT scanning. Various types of calcification can occur:
PERICARDIAL CALCIFICATION may be seen as plaquelike opacities over the surface of the heart, but particularly concentrated in the atrioventricular groove. Such calcification often results from tuberculous pericarditis and may be associated with pericardial constriction.
VALVULAR CALCIFICATION may result from longstanding rheumatic or bicuspid aortic valve disease.
The aortic and mitral valves are most commonly affected. On the lateral film, a calcified aortic valve is seen on or above a line joining the carina to the sternophrenic angle. Mitral valvular calcification is seen below and behind this line.
MYOCARDIAL CALCIFICATION may occur after myocardial infarction, especially in association with a left ventricular aneurysm.
Plain PA chest X-ray demonstrating a cardiac
CALCIFICATION OF THE AORTA is a common, normal finding in patients over the age of 40 years and appears as a curvilinear opacity around the circumference of the aortic knuckle. Calcification in the ascending aorta usually denotes syphilitic aortitis, whereas in the descending aorta it is due to atheroma or, in the younger patient, to non-specific aortitis. CORONARY ARTERIAL CALCIFICATION, especially of the proximal left coronary artery, is associated with coronary atheroma but does not necessarily correspond to the site of maximal stenosis.
Pulmonary plethora results from left-to-right shunts, e.g. atrial or ventricular septal defects. It is seen as a general increase in the vascularity of the lung fields and as an increase in the size of hilar vessels, e.g. in the right lower lobe artery, which normally should not exceed 16 mm in diameter. Pulmonary oligaemia is a paucity of vascular markings and a reduction in the width of the arteries. It occurs in situations where there is reduced pulmonary blood flow, such as pulmonary embolism, severe pulmonary stenosis and Fallot’s tetralogy. Pulmonary arterial hypertension may result from pulmonary embolism, chronic lung disease or chronic left heart disease such as shunts due to a ventricular septal defect or mitral valve stenosis. In addition to X-ray features of these conditions, the pulmonary arteries are prominent close to the hili but are very reduced in size (pruned) in the peripheral lung fields. This pattern is usually symmetrical.
limbs (I, II, III, AVR, AVL and AVF). The other six leads record potentials between points on the chest surface and an average of the three limbs: RA, LA and LL. These are designated YI-Y6 and aim to select activity from the right ventricle (YI-Y2), interventricular septum (YrY.) and left ventricle (YS-Y6). Note that leads AVR and YI are oriented towards the cavity of the heart, leads II, III and AVF face the inferior surface and leads I, AVL and Y6 face the lateral wall of the left ventricle.
The connections or directions that comprise
The ECG potentials are picked up by electrodes attached to the patient. Disposable, self-adhesive electrodes are more convenient and hygienic than the nickel plates and cup electrodes which are still used with some older machines. The electrodes are connected to the ECG recorder by a multicolour or coded cable.
Although some single-channel ECG machines still exist, most are simultaneous three-channel recorders with output either as a continuous strip or with automatic channel switching. Many modern ECG machines present the ECG (all 12 standard leads and a rhythm strip) in a convenient page-sized format. Many ECG machines also analyse the recordings and print the analysis on the record. Usually the machine interpretation is correct, but many arrhythmias still defy automatic analysis.