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PATHWAY-1
pattern-first electrophysiology training
The pattern, before the drug.
A pattern-first curriculum drilled on mixed novel rhythm strips, with adaptive sequencing and seconds-level feedback. Built around the FBI cascade — fast, broad, irregular — for emergency physicians, cardiology fellows, and internal medicine residents who need bedside-reliable discrimination, not certificate hours.
window targeted by
the curriculum
drilled per learner
per cohort
threshold for
bedside reliability
threshold across
2024 cohorts
A drill loop, not a content delivery system.
Pattern recognition for arrhythmia discrimination is not knowledge that fails to be acquired. It is a perceptual skill that fails to transfer from declarative memory into bedside behaviour. PATHWAY-1 is built around a single, repeatable drill loop designed to close that transfer gap.
The PATHWAY-1 drill loop. Each step has a defined latency target, and the loop only advances to the next category once the threshold gate is passed. Stylized for educational purposes.
Mixed-case drilling rule
No category arrives twice in a row. Pre-excited atrial fibrillation is interleaved with regular wide-complex tachycardia, narrow-complex SVT, sinus tachycardia with bundle branch block, and sinus rhythm with frequent ectopy. The trainee learns the boundary by being forced to draw it on cases where the boundary is not pre-announced.
Adaptive sequencing engine
Cases the trainee gets wrong reappear, with morphological variation, until the property cascade stabilises. Cases that already trigger five-second recognition are not padded into the curriculum to inflate completion percentages. Time spent is allocated to the discriminations that have not yet transferred.
Proprietary discrimination metric
A composite score combining reaction-time distribution, false-recognition profile, and adaptive-difficulty trajectory. Used internally to calibrate cohort progression and to identify learners who plateau below the bedside-reliability threshold.
Disclosure expected Q3 2026Cohort-cohort calibration model
The instrument that lets a 24-learner residency cohort and a 240-learner multi-institution cohort be compared on the same scale despite differences in baseline experience, specialty mix, and prior curriculum exposure.
Available under institutional MSAPattern-first pedagogy versus the alternatives.
Comparative positioning across four EP-education platforms and the traditional lecture-and-textbook baseline. Where the comparator publishes its methods, those are reflected directly. Where methods are proprietary, the entry reflects what the platform documents publicly. All comparator entries are illustrative composites for this demonstration; they do not represent any real licensed product.
| PATHWAY-1 Axiom EP Academy pattern-first · this product | RhythmIQ Pro simulator-based | Cardia Learn video + timed quiz | WaveForms Online case-conference review | Traditional curriculum lecture & textbook | |
|---|---|---|---|---|---|
| Curriculum unit | Rhythm strip | Simulated case scenario | Video module | Conference case | Textbook chapter |
| Forced-discrimination drilling | Yes · mixed novel strips, no skip | Partial · scenario-bound | No · quiz follows content | Partial · group discussion | No |
| Adaptive sequencing | Yes · per-learner | Partial · difficulty levels | No · linear sequence | No | No |
| Feedback latency | < 5 seconds | End of scenario | End of quiz | Post-conference, varies | Days to weeks |
| Mixed-case rule | Yes · no consecutive same-category | No · topic-organised | No · topic-organised | Partial · case-of-the-week | No · chapter-organised |
| Bedside-reliability metric | Forced-discrimination accuracy at ≤ 5s | Scenario completion score | Quiz percentage | Attendance · participation | Written examination |
| Cohort calibration | Yes · cross-cohort scaling | No | No | No | No |
| Median time-to-threshold | ~ 8 months | ~ 14 months | plateau below threshold | plateau below threshold | plateau below threshold |
Threshold defined as 92% forced-discrimination accuracy on mixed novel rhythm strips at a 5-second response window. Plateau values for Cardia Learn, WaveForms Online, and traditional curriculum are illustrative composites reflecting the absence of a published forced-discrimination accuracy metric in those platforms; they should not be read as benchmarked outcomes.
Two anonymized cohorts. One curve that crosses the threshold.
The curves below trace forced-discrimination accuracy on mixed novel rhythm strips over a twelve-month period. PATHWAY-1 learners are compared, on the same scale, against a contemporaneous group using a simulator-based platform and against a baseline group on traditional lecture-and-review preparation. All cohort data shown is illustrative composite for this demonstration.
Single-institution residency
to threshold
completing 12 mo
at 6 months
Cohort enrolled Q1 2024 · followed to Q1 2025 · figures are illustrative composites
Multi-institution rollout
to threshold
completing 12 mo
at 6 months
Cohort enrolled Q2 2024 · six-centre design · figures are illustrative composites
The pattern that should never be forgotten.
Every senior emergency physician carries a small library of strips they will never forget — the strip that almost killed someone, or did. Pre-excited atrial fibrillation, in a young patient with a previously asymptomatic accessory pathway, is on every such list. PATHWAY-1 was developed because the same case, in the same recognition window, continues to find clinicians whose curricula did not drill them on it.
The patient was twenty-something. The strip was on the monitor for six minutes before the right drug arrived. Everyone on the team passed boards in the top decile. The contraindication was in the textbook every one of us had read. It did not help. We drilled this exact pattern at every M&M for two years afterward — it should never have been the M&M, and the curriculum that produced us should never have left us un-drilled in the first place. PATHWAY-1 is the curriculum I wish my residents had had before I needed it for my own.
— Composite illustrative faculty narrative · Department of Emergency Medicine · 2025
Built for the trainee at the bedside and for the program that fields them.
PATHWAY-1 was designed from the start to deliver value at two different scales: the individual learner discriminating a strip in five seconds, and the residency programme accountable for fielding bedside-reliable graduates at the end of training. The curriculum, the metrics, and the contractual structure are different at each level.
Drill the discrimination, not the chapter.
The unit of training is the strip. Forced discrimination on mixed novel cases, with feedback measured in seconds, until the property cascade fires before the rhythm is named.
- Strip-level mastery · not module-level completion. Threshold is bedside-reliable accuracy at a 5-second response window.
- Adaptive sequencing · the cases you get wrong come back; the cases you already recognise step aside.
- Mixed-case rule · no two same-category strips in a row. The boundary is what you train, not the centre.
- Seconds-level feedback · the answer arrives before your reasoning has time to rationalise the wrong choice.
- For HCPs only · emergency physicians, cardiology fellows, internal medicine residents. Verification at enrolment.
Specialty distribution across PATHWAY-1 cohorts in 2024. Schematic representation; numbers are illustrative composites and do not reflect a specific licensed dataset.
Cohort-grade curriculum integration.
Replace the part of the residency curriculum that produces clinicians who can recite contraindications and still misclassify under pressure. Recover the learner-hours, raise the accuracy plateau, document both.
- Cohort calibration · your residency’s data sits on the same scale as the multi-institution benchmark cohort.
- Threshold reporting · per-learner and per-cohort dashboards, exportable for ACGME documentation purposes.
- Curriculum integration · designed as a 12-month longitudinal layer alongside existing didactic and clinical training.
- Faculty time-cost · 4–6 hours per cohort for setup and end-of-cycle review; no week-by-week faculty hours required.
- Institutional MSA · standard agreement, three pricing tiers, scaling with cohort size and modality access.
Projections are illustrative composites for this demonstration. Actual time-cost and accuracy plateau will vary by baseline curriculum, specialty mix, and integration depth. Numbers are not the result of a head-to-head trial.
What is shipping next.
A snapshot of the curriculum modules and data drops queued for release through 2027. Locked cards indicate content visible to active subscribers and to institutional partners under MSA.
Curriculum modules in development
Three additional discrimination modules: atrial flutter recognition with variable conduction; wide-complex VT versus SVT-with-aberrancy; pediatric arrhythmia patterns for residency programmes with combined paediatric coverage.
Available Q4 2026 to active subscribersCohort outcome data drop
Multi-institution registry results with 24-month longitudinal follow-up across the 2024-A and 2024-B cohorts, including bedside-decision audit data linked to learner discrimination scores at completion.
Expected Q1 2027Institutional licensing tiers
Pricing structure across three tiers (single-residency, multi-site network, fellowship-grade extended modality), cohort-size scaling, and integration depth. Disclosed under standard partnership NDA.
Contact partnerships teamWhere the curriculum has been presented.
Selected appearances of PATHWAY-1 in continuing-education venues, peer-reviewed methods literature, and partnership announcements through 2025. All venues, dates, and attribution shown here are illustrative composites for this demonstration.
Cohort 2024-A interim results: forced-discrimination accuracy in EM residencies
Journal of Continuing Medical EducationPattern-first pedagogy in arrhythmia training: a position statement
Series B partnership announcementPATHWAY-1 selected for Series B partnership pilot across 12 EM residencies
Methods paperAdaptive sequencing in EP curricula: cohort-cohort calibration methodology
Drill the pattern. Then drill the drug list. Not the other way around.
Whether you are a clinician who has been on the wrong side of a five-second recognition window, a programme director responsible for fielding bedside-reliable graduates, or a partnership team evaluating curriculum integration — one of the next steps below is the one that fits.