Using Virtual Patients to Improve Cardiac Examination Competency in Medical Students

Vukanovic‐Criley, Jasminka M.; Boker, John R.; Criley, Stuart Ross; Rajagopalan, Shobita; Criley, J. Michael

doi:10.1002/clc.20213

Cited by 36 publications

(24 citation statements)

References 8 publications

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“…Virtual worlds have shown promise in developing teamwork and crisis management skills, and have proven, in one pilot study, equally as effective as simulated clinical immersion (Youngblood et al 2008). Computer-based simulators are also effective for learning or developing skills and procedures, especially in novice learners, before hands-on experience is introduced (Vukanovic-Criley et al 2008).…”

Section: Id In Simulation and The Outcomes Of Learningmentioning

confidence: 99%

Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection

Chiniara

Cole²,

Brisbin³

et al. 2012

Medical Teacher

182

140

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Background: Simulation in healthcare lacks a dedicated framework and supporting taxonomy for instructional design (ID) to assist educators in creating appropriate simulation learning experiences. Aims: This article aims to fill the identified gap. It provides a conceptual framework for ID of healthcare simulation. Methods: The work is based on published literature and authors' experience with simulation-based education. Results: The framework for ID itself presents four progressive levels describing the educational intervention. Medium is the mode of delivery of instruction. Simulation modality is the broad description of the simulation experience and includes four modalities (computer-based simulation, simulated patient (SP), simulated clinical immersion, and procedural simulation) in addition to mixed, hybrid simulations. Instructional method describes the techniques used for learning. Presentation describes the detailed characteristics of the intervention. The choice of simulation as a learning medium is based on a matrix of simulation relating acuity (severity) to opportunity (frequency) of events, with a corresponding zone of simulation. An accompanying chart assists in the selection of appropriate media and simulation modalities based on learning outcomes. Conclusion: This framework should help educators incorporate simulation in their ID efforts. It also provides a taxonomy to streamline future research and ID efforts in simulation.

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Section: Id In Simulation and The Outcomes Of Learningmentioning

confidence: 99%

Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection

Chiniara

Cole²,

Brisbin³

et al. 2012

Medical Teacher

182

140

View full text Add to dashboard Cite

show abstract

“…33, 3, E36 -E42 (2010) not undergo this intensive training. Other approaches, including the use of virtual patient examination 27 and Web-based interactive educational programs, 28 have been shown to improve cardiac examination competence. These educational approaches highlight the importance of measuring and improving physician competence in physical examination skills.…”

Section: Discussionmentioning

confidence: 99%

Experienced Clinicians Improve Detection of Third and Fourth Heart Sounds by Viewing Acoustic Cardiography

Michaels

Khan

Moyers

2010

Clinical Cardiology

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Background: Clinical assessment of diastolic heart sounds is challenging. Hypothesis: We sought to examine whether visual inspection of acoustic cardiographic tracings augments the accuracy of medical students' and physicians' detection of third and fourth heart sounds (S 3 , S 4 ) compared to auscultation alone. Methods: A total of 90 adults referred for left heart catheterization underwent digital precordial heart sound recordings by computerized acoustic cardiography. Two blinded, experienced readers using a consensus method determined the presence of the S 3 /S 4 on each file. There were 35 subjects from the following 5 groups participating in this study from 1 teaching institution: first-year medical students (n = 5), fourth-year medical students (n = 5), interns (n = 5), medicine residents (n = 5), cardiology fellows (n = 5), and attendings (n = 10). Using a computer module, each subject listened to the heart sounds alone and documented whether an S 3 /S 4 was present. Next, subjects listened to each recording in random order while viewing phonocardiographic tracings, and recorded S 3 /S 4 presence. Results: An S 3 was present in 21 patients (23%) and an S 4 in 31 patients (34%) by consensus overread in 90 recordings. Baseline accuracy for auscultation of S 3 /S 4 did not change with level of experience. While viewing the acoustic cardiogram, first-year medical students had minimal improvement in S 3 (2%) and S 4 (11%) accuracy. More experienced subjects improved S 3 accuracy by 8% to 18% and S 4 by 15% to 32% (P < .05). Accuracy was superior for S 3 compared to S 4 in all ausculatory groups. Conclusions: While listening to heart sound recordings, viewing acoustic cardiography increased subjects' accuracy in detecting diastolic heart sounds, particularly among more experienced subjects. There was greater improvement for S 4 compared to S 3 detection. BackgroundThe atrial and ventricular gallop was first described in the literature by Potain in 1880. 1 The low-pitched third heart sound (S 3 ) is known as the ventricular gallop, and occurs 0.12 to 0.16 seconds after the second heart sound in diastole. The S 3 is caused by the sudden deceleration of rapid diastolic filling into a distended or incompliant ventricle.2 The fourth

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“…They spent the first year working with highly respected cardiologists to hone their own clinical skills, reviewing the literature on the evidence-based cardiac physical examination and effective teaching methods, 12,13 researching the use of electronic stethoscopes and related technology for teaching at the bedside, and piloting a variety of approaches to teaching their busy colleagues these skills.…”

Section: Methodsmentioning

confidence: 99%

Development of a hospitalist‐led‐and‐directed physical examination curriculum

Janjigian

Charap

Kalet

2012

Journal of Hospital Medicine

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BACKGROUND: Deficiencies in physical examination skills among medical students, housestaff, and even faculty have been reported for decades, though specifics on how to address this deficit are lacking.METHODS: Our institution has made a commitment to improving key physical examination competencies across our general medicine faculty. Development of the Merrin Bedside Teaching Program was guided by a comprehensive needs assessment and based on a learner‐centered educational model. First, selected faculty fellows achieve expertise through mentorship with a master clinician. They then develop a bedside teaching curriculum in the selected domain and conclude by delivering the curriculum to peer faculty.RESULTS: We have developed curricula in examination of the heart, shoulder, knee, and skin. Currently, curricula are being developed in the examination of the lungs, critical care bedside rounds, and motivational interviewing. Curricula are integrated with educational activities of the internal medicine residency and medical school whenever possible.CONCLUSIONS: A hospitalist‐led physical examination curriculum is an innovative way to address deficits in physical exam skills at all levels of training, engenders enthusiasm for skills development from faculty and learners, offers scholarship opportunities to general medicine faculty, encourages collaboration within and between institutions, and augments the education of residents and medical students. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine.

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Using Virtual Patients to Improve Cardiac Examination Competency in Medical Students

Cited by 36 publications

References 8 publications

Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection

Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection

Experienced Clinicians Improve Detection of Third and Fourth Heart Sounds by Viewing Acoustic Cardiography

Development of a hospitalist‐led‐and‐directed physical examination curriculum

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