Cardiac auscultation skills among junior doctors: effects of sound simulation lesson

Abstract

Objectives: To evaluate the effect of a sound simulation lesson to improve cardiac auscultation skills among junior doctors. Methods: This study is based on the design of test comparison before and after educational intervention using a convenient sample. For 50 junior doctors in Japan, diagnostic accuracy before and after a sound simulation lesson for cardiac auscultation skills was compared. There were 15 doctors who experienced cardiology rotation. The lesson used seven abnormal cardiac recordings (third heart sound, double gallop, aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation, and pericardial friction rub). At tests before and after the lesson, the doctors listened to random sound outputs of the same seven recordings, chose diagnostic findings from multiple-choice items, and obtained individual diagnostic accuracy based on the total number of choosing correct findings. Top 10 doctors obtaining the greatest individual accuracy received a commendation. Results: Pre-lesson diagnostic accuracy was not different between doctors with cardiology rotation training (total diagnostic accuracy of the group, 27/105 [26%]) and those without cardiology rotation (70/245 [29%]). Compared to prelesson, post-lesson total diagnostic accuracy significantly improved with about two-folds (97/350 [28%] vs 170/350 [61%]; McNemar Test, p<0.0001). The improvement was significant for double gallop (5/50 [10%] vs. 15/50 [30%]), mitral stenosis (0/50 [0%] vs. 6/50 [12%]), and pericardial friction rub (1/50 [2%] vs. 35/50 [70%]). Conclusions: The use of a simple sound simulation lesson may help junior doctors to learn cardiac auscultation skills. Clinician educators are encouraged to use this strategy in addition to cardiology rotation training.

A Pilot Study on the Feasibility of Developing and Implementing a Mobile App for the Acquisition of Clinical Knowledge and Competencies by Medical Students Transitioning from Preclinical to Clinical Years

“…Simulators successfully provided good correlation between the users’ results and their previous experience and knowledge [ 46 ]. Additionally, simulators’ benefits for the acquisition of knowledge and skills have been well characterized [ 34 ], ranging from auscultation skills among junior doctors [ 47 ] to highly technical ones in demanding surgical specialties [ 2 ]. This is why there has been a long tradition of their use in the history of Medical Education [ 48 , 49 , 50 ].…”

Medical Education During the Coronavirus Disease-2019 Pandemic: Learning From a Distance

“…Although case simulations and virtual standardized patients can provide some training of skills such as physical examination and clinical reasoning, these activities are generally supplementary rather than a replacement of in-person teaching. [35][36][37][38][39][40] Moreover, competency-based assessments of student skills through these virtual simulations are limited. Anecdotally, virtual objective structured clinical examinations can be used to evaluate remaining competencies required for graduation, but these techniques have never before served as substitutes for direct patient care.…”

Improved cardiac auscultation competency interweaving visual, auditory, and tactile stimuli: a preliminary study

“…1 Despite its critical importance, studies have shown that the proficiency of medical professionals in performing cardiac auscultation is in a steady decline. [2][3][4] This decline is particularly evident in a study by Mangione and colleagues that showed only 20% of the graduating medical class could accurately diagnosis cardiac sounds. They concluded that this result may be largely due to curriculum deficiencies in teaching cardiac auscultation.…”