Using a multimedia tool to improve cardiac auscultation knowledge and skills

Abstract

OBJECTIVE: Today's medical school graduates have significant deficits in physical examination skills. Medical educators have been searching for methods to effectively teach and maintain these skills in students. The objective of this study was to determine if an auscultation curriculum centered on a portable multimedia CD-ROM was effective in producing and maintaining significant gains in cardiac auscultatory skills. DESIGN: Controlled cohort studyPARTICIPANTS: All 168 third-year medical students at 1 medical school in an academic medical center. INTERVENTIONS:Students were tested before and after exposure to 1 or more elements of the auscultation curriculum: teaching on ward/clinic rotations, CD-ROM comprehensive cases with follow-up seminars, and a CD-ROM 20-case miniseries. The primary outcome measures were student performance on a 10-item test of auscultation skill (listening and identifying heart sound characteristics) and a 30-item test of auscultation knowledge (factual questions about auscultation). A subset of students was tested for attenuation effects 9 or 12 months after the intervention. RESULTS:Compared with the control group (1 month clinical rotation alone), students who were also exposed to the CD-ROM 20-case miniseries had significant improvements in auscultation skills scores (P < .05), but not knowledge. Additional months of clerkship, comprehensive CD-ROM cases, and follow-up seminars increased auscultation knowledge beyond the miniseries alone (P < .05), but did not further improve auscultation skills. Students' auscultation knowledge diminished one year after the intervention, but auscultation skills did not. CONCLUSION:In addition to the standard curriculum of ward and conference teaching, portable multimedia tools may help improve quality of physical examination skills.

Improved Auscultation Skills in Paramedic Students Using a Modified Stethoscope

“…Current standardized auscultation training for physicians has proven to be an ineffective way to improve most physicians' ability to distinguish abnormal heart, lung, abdominal, and vascular pathologies (4). Previous studies have demonstrated poor auscultation skills in physicians regardless of training level, medical specialty, or country of training (5)(6)(7)(8)(9)(10)(11)(12)(13). A nationwide investigation that tested students' auscultation skills on 12 pre-recorded heart sounds found that the recognition of heart sounds did not improve with lecture-based teaching over 9 months.…”

Combining simulated patients and simulators: pilot study of hybrid simulation in teaching cardiac auscultation

“…Nevertheless, only a few innovative approaches have been used to teach auscultation. The only change since the introduction of auscultation of mannequins in the 1970s has been in the presentation of the findings, which were formerly presented using audio cassettes and vinyl records instead of digital technology (22).…”

Using Virtual Patients to Improve Cardiac Examination Competency in Medical Students

“…In addition to clerkship rotations, current teaching methods range from classroom lectures and courses, 10 and discussion and audiotape, 4 to heart sound simulators 11 and computer-assisted instructions. 12 None of these methods have been widely adopted or shown to be clearly superior.…”