Small Steps in Impacting Clinical Auscultation of Medical Students

Binka, Edem; Lewin, Linda; Gaskin, Peter

doi:10.1177/2333794x16669013

Cited by 10 publications

(15 citation statements)

References 12 publications

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“…There was no significant improvement in the diagnostic accuracy of the MS even after the intervention. The results of our study are consistent with the study of Birdane et al (2012) and Binka et al (2016), where students also better recognized systolic murmurs compared to diastolic murmurs [7], [17]. Physical examination has limited ability to evaluate diastolic murmurs, with a sensitivity of only 14-33% for the diagnosis of aortic regurgitation [18], [19].…”

Section: Discussionsupporting

confidence: 89%

The Effectiveness of Training on Auscultation of Heart with a Simulator of Cardiology in Medical Students

Koshmaganbetova

Bazargaliyev

et al. 2021

Open Access Maced J Med Sci

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The purpose of this study was to determine whether the training module with a simulator of cardiology improves auscultation skills in medical students. Methods. Medical students of the third year after completing the module of the cardiovascular system of the discipline “Propaedeutics of internal diseases, passed a two-hour or four-hour training module in clinical auscultation with retesting immediately after the intervention and in the fourth year. The control group consisted of fourth-year medical students who had no intervention. Results. The diagnostic accuracy in two-hour training was 45.9% vs 35.3% in four-hour training p <.001. The use of a cardio simulator significantly increased the accurate detection of mitral regurgitation immediately after training on a simulator (more than 73%) p <.001. The next academic year, regression was observed in the diagnostic accuracy of mitral insufficiency in the intervention group after six months of observation by 4%. The auscultation skills of students at the bedside of real patients did not increase after training on a simulator: the accuracy of diagnosis of the auscultatory picture of the defect was equally low in the intervention group and the control group (35.0% vs 30.8%, p = 0.651). Conclusions. Two-hour training was more effective than four-hour training. After training on cardiac auscultation using a patient’s cardiological simulator, the accuracy rate was low in a situation close to the clinical conditions and a clinic on a real patient.

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Section: Discussionsupporting

confidence: 89%

The Effectiveness of Training on Auscultation of Heart with a Simulator of Cardiology in Medical Students

Koshmaganbetova

Bazargaliyev

et al. 2021

Open Access Maced J Med Sci

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“…4 The results showed that the highest sensitivity to auscultation was in the senior stage pediatric resident, 42% and the lowest sensitivity in the junior stage pediatric resident, 12%, while the specificity was 88% -90.7%. 6,11,13 The study of Haney et al (1999) showed that the sensitivity and specificity of cardiac auscultation examination in pediatricians were 82% and 24%, which…”

Section: Discussionmentioning

confidence: 99%

“…Perhaps only a portion of the heart defects will be detected on screening by cardiac auscultation, but this method is currently better than other screening methods such as echocardiography which are difficult to perform. 7,[10][11][12][13] This study aims to determine the accuracy of the screening method by listening to heart murmurs by various competency levels of doctors in the detection of heart defects in children in Palembang City.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Heart Auscultation Examination by General Practitioners From Various Levels of Competency in Detection of Heart Abnormality in Basic School Children

et al. 2022

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Background. Most of heart defects in children do not show typical clinical symptoms. Ten percent of the cases are late detected. Echocardiography is an examination with high sensitivity and specificity in detecting heart defects in children, but it cannot be performed by all health workers, expensive and not always available in hospitals. Auscultation is an important part of a physical examination that inexpensive, easy examination, and becomes a competency of all doctors. The aim of this study to determine the accuracy of the screening method by listening to murmurs on heart auscultation by various levels of physician competence. Methods. This is a diagnostic test of 250 elementary school children held in the pediatric ward of dr. Mohammad Hoesin Palembang from September to November 2019. The auscultation examination was performed by three pediatrics resident from three stages (i.e. junior, middle and senior), followed by echocardiography examinations by a pediatric cardiologist. Results. The highest sensitivity of auscultation was found in senior resident, 42.4%, while the lowest was found in junior resident, 12.1%. The results of the kappa analysis of the cardiac auscultation examination on the three examiners showed a poor level of agreement on junior stage compared to senior resident (k = 0.189; CI = 0.033-0.346) and the level of agreement was sufficient in junior stage compared to middle stage resident (k = 0.297; CI = 0.134 -0.461) and middle stage compared to senior resident (k = 0.301; CI = 0.147-0.456). Conclusion. Experience and length of learning will affect the accuracy of the auscultation examination in detecting heart defects in children.

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“…The intervention group demonstrated a significant increase in the ability to successfully identify eight of the 12 heart sounds. The eight heart sounds identified at higher percentages posttest were continuous murmur (81% vs 51%, p<0.001), systolic click (51% vs 22%, p<0.001), pericardial rub (94% vs 56%, p<0.001), fourth heart sound (70% vs 18%, p<0.001), innocent murmur (69% vs 37%, p<0.001), third heart sound (39% vs 6%, p<0.001), tricuspid regurgitation (62% vs 38%, p<0.001), and split in inspiration (52% vs 28%, p<0.001) [ 8 ]. These exact percentages were not provided numerically within the publication but were approximated by referencing the axes of the bar graphs depicted within the study report.…”

Section: Reviewmentioning

confidence: 99%

The Effectiveness of Different Teaching Modalities for the Detection of Heart Murmurs in Undergraduate Medical Education: A Review

Nagi,

Boots,

Ajlouni

et al. 2024

Cureus

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One of the many physical exam skills introduced to medical students during their pre-clerkship education is cardiac auscultation, one purpose of which is to teach the detection and identification of heart murmurs. Cardiac auscultation with a stethoscope has been the standard method of teaching. Another method, point-of-care ultrasound (POCUS), has been recently introduced as another modality by which students learn to detect and identify murmurs. The emerging popularity of POCUS in undergraduate medical curricula has led many institutions to include it in their curricula; however, doing so is challenging. Not only is cost a major factor, but reorganizing curricula to allow sufficient time for POCUS training has proven to be difficult. Additionally, the presence of notable gaps in the literature regarding the efficacy of POCUS for teaching the detection and identification of heart murmur has increased scrutiny of its value. Studies that assessed teaching cardiac auscultation to medical students in their pre-clinical years via stethoscope have used different teaching methods. However, evaluation of these studies identified numerous limitations, one being little long-term retention of cardiac auscultation knowledge. Furthermore, several barriers to integration of POCUS in undergraduate medical education were identified. The purpose of this review is to synthesize the literature comparing the effectiveness of these different tools of a cardiac exam for detection of heart murmurs in undergraduate medical education and identify gaps in literature requiring future exploration.

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Small Steps in Impacting Clinical Auscultation of Medical Students

Cited by 10 publications

References 12 publications

The Effectiveness of Training on Auscultation of Heart with a Simulator of Cardiology in Medical Students

The Effectiveness of Training on Auscultation of Heart with a Simulator of Cardiology in Medical Students

Accuracy of Heart Auscultation Examination by General Practitioners From Various Levels of Competency in Detection of Heart Abnormality in Basic School Children

The Effectiveness of Different Teaching Modalities for the Detection of Heart Murmurs in Undergraduate Medical Education: A Review

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