Journal
JOURNAL OF GENERAL INTERNAL MEDICINE
Volume 25, Issue 8, Pages 780-785Publisher
SPRINGER
DOI: 10.1007/s11606-010-1309-x
Keywords
Cardiac Auscultation; simulation; medical students; learning
Funding
- Office of Medical Education and Faculty Development
- Northwestern University
- National Center for Research Resources, National Institutes of Health [UL 1 RR025741]
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Cardiac auscultation is a core clinical skill. However, prior studies show that trainee skills are often deficient and that clinical experience is not a proxy for competence. To describe a mastery model of cardiac auscultation education and evaluate its effectiveness in improving bedside cardiac auscultation skills. Untreated control group design with pretest and posttest. Third-year students who received a cardiac auscultation curriculum and fourth year students who did not. A cardiac auscultation curriculum consisting of a computer tutorial and a cardiac patient simulator. All third-year students were required to meet or exceed a minimum passing score (MPS) set by an expert panel at posttest. Diagnostic accuracy with simulated heart sounds and actual patients. Trained third-year students (n = 77) demonstrated significantly higher cardiac auscultation accuracy compared to untrained fourth year students (n = 31) in assessment of simulated heart sounds (93.8% vs. 73.9%, p < 0.001) and with real patients (81.8% vs. 75.1%, p = 0.003). USMLE scores correlated modestly with a computer-based multiple choice assessment using simulated heart sounds but not with bedside skills on real patients. A cardiac auscultation curriculum consisting of deliberate practice with a computer-based tutorial and a cardiac patient simulator resulted in improved assessment of simulated heart sounds and more accurate examination of actual patients.
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