Multimedia items may be capable of measuring some constructs different from what text items can measure. Effective multimedia items with reasonable psychometric properties can be intentionally developed.

Current auscultation training systems reproduce physiologic sounds routinely heard during patient examination; however, they do not capture, model and reproduce auditory/spatial physician‐patient interactions as immersive learning experiences. We hypothesize a schema for the capture and replay of diagnostic sound patterns and spatial coordination as exemplified by stethoscope placement coupled with the synched viewing of 3D CT anatomy that would significantly increase clinical insight and recall. Our simulation system digitally captures actual physician‐patient auscultation experiences as thoracic sound combinations, stethoscope head coordinate positions within a standardized space, and diagnostic signs and impressions as dictated by the examining physician. This is accomplished using an electronic stethoscope with spatial tracking capabilities and a laptop computer. This multimedia experiential “case profile” is then additionally enhanced via 3D CT/MRI visualizations synchronized with stethoscope head placement location patterns. Finally, our training system is able to replay this coordinated experience to students interactively using fellow students registered to the standard anatomic space.