Abstract:The graphic display system can often provide more information than can be obtained by standard auscultation alone, especially in the detection of low-frequency and multiple sounds, and in the accurate timing of intervals. It is often unable to detect soft high-frequency murmurs. Permanent records allow for more objective comparison of the auscultatory findings of various examiners at different times. This system provides an excellent means by which auscultation skills may be taught or enhanced, especially sinc… Show more
“…Thus, they learned to disassemble and to analyze more in depth/detail what they were listening to. This method, which requires to relate murmur timing to heart sounds, is a legacy from the past, when cardiac examination was taught with the help of phonocardiography, and the visual display of sounds was used not only for purposes of teaching, but also to provide permanent medical records [13, 14]. On the other hand, in lung auscultation, students had only to match a diagnosis to what they were listening to.…”
Section: Discussionmentioning
confidence: 99%
“…The rationale underlying the difference in the teaching/testing method of heart and lung auscultation comes from the tradition of teaching heart auscultation with the support of graphic sound display (i.e. phonocardiography) [13, 14]. Fig.…”
Background
The use of simulation technology for skill training and assessment in medical education has progressively increased over the last decade. Nevertheless, the teaching efficacy of most technologies remains to be fully determined. The aim of this prospective study was to evaluate if a short individual training on a patient simulator could improve heart and lung auscultation skills in undergraduate students.
Methods
A group of fifth-year medical school students, who had trained on a patient simulator in their third year (EXP,
n
= 55), was compared to a group of fifth-year medical school students who had not previously trained on it (CNT,
n
= 49). Students were recruited on a voluntary basis. Students were evaluated in terms of their ability to correctly identify three heart (II sound wide split, mitral regurgitation, aortic stenosis) and five lung sounds (coarse crackles, fine crackles, pleural rubs, rhonchi, wheezes), which were reproduced in a random order on the Kyoto-Kagaku patient simulator.
Results
Exposure to patient simulator significantly improved heart auscultation skills, as mitral regurgitation was correctly recognized by 89.7% of EXP students as compared to 71.4% of CNT students (
p
= 0.02). In addition, a significantly greater percentage of EXP students correctly graphed all the heart diagnoses as compared to CNT students. There were no differences between the groups in lung auscultation.
Conclusions
This study demonstrates that training medical students with a patient simulator, individually for one hour, significantly ameliorated their heart auscultation skills. Our data suggests that patient simulation might be useful for learning auscultation skills, especially when it is combined with graphic sound display.
“…Thus, they learned to disassemble and to analyze more in depth/detail what they were listening to. This method, which requires to relate murmur timing to heart sounds, is a legacy from the past, when cardiac examination was taught with the help of phonocardiography, and the visual display of sounds was used not only for purposes of teaching, but also to provide permanent medical records [13, 14]. On the other hand, in lung auscultation, students had only to match a diagnosis to what they were listening to.…”
Section: Discussionmentioning
confidence: 99%
“…The rationale underlying the difference in the teaching/testing method of heart and lung auscultation comes from the tradition of teaching heart auscultation with the support of graphic sound display (i.e. phonocardiography) [13, 14]. Fig.…”
Background
The use of simulation technology for skill training and assessment in medical education has progressively increased over the last decade. Nevertheless, the teaching efficacy of most technologies remains to be fully determined. The aim of this prospective study was to evaluate if a short individual training on a patient simulator could improve heart and lung auscultation skills in undergraduate students.
Methods
A group of fifth-year medical school students, who had trained on a patient simulator in their third year (EXP,
n
= 55), was compared to a group of fifth-year medical school students who had not previously trained on it (CNT,
n
= 49). Students were recruited on a voluntary basis. Students were evaluated in terms of their ability to correctly identify three heart (II sound wide split, mitral regurgitation, aortic stenosis) and five lung sounds (coarse crackles, fine crackles, pleural rubs, rhonchi, wheezes), which were reproduced in a random order on the Kyoto-Kagaku patient simulator.
Results
Exposure to patient simulator significantly improved heart auscultation skills, as mitral regurgitation was correctly recognized by 89.7% of EXP students as compared to 71.4% of CNT students (
p
= 0.02). In addition, a significantly greater percentage of EXP students correctly graphed all the heart diagnoses as compared to CNT students. There were no differences between the groups in lung auscultation.
Conclusions
This study demonstrates that training medical students with a patient simulator, individually for one hour, significantly ameliorated their heart auscultation skills. Our data suggests that patient simulation might be useful for learning auscultation skills, especially when it is combined with graphic sound display.
Experienced cardiologists can usually recognize pathologic heart murmurs with high sensitivity and specificity, although nonspecialists with less clinical experience may have more difficulty. Harsh, pansystolic murmurs of intensity grade > or = 3 at the left upper sternal border (LUSB) are likely to be associated with pathology. In this study, we designed a system for automatically detecting systolic murmurs due to a variety of conditions and examined the correlation between relative murmur intensity and likelihood of pathology. Cardiac auscultatory examinations of 194 children and young adults were recorded, digitized, and stored along with corresponding echocardiographic diagnoses, and automated spectral analysis using continuous wavelet transforms was performed. Patients without heart disease and either no murmur or an innocent murmur (n = 95) were compared to patients with a variety of cardiac diagnoses and a pathologic systolic murmur present at the LUSB (n = 99). The sensitivity and specificity of the automated system for detecting pathologic murmurs with intensity grade > or = 2 were both 96%, and for grade > or = 3 murmurs they were 100%. Automated cardiac auscultation and interpretation may be useful as a diagnostic aid to support clinical decision making.
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