Improvement of Cardiac Auscultation Skills in Pediatric Residents With Training

Abstract

Cardiac murmurs, most of which are harmless, are present in more than 50% of children. Good auscultation skills are required to prevent unnecessary referrals. The auscultation skills of a group of 21 pediatric residents were assessed. Based on their identification of key features such as S1, S2, timing, grade, location, quality of the murmur, and any extra sounds, residents were asked to make a clinical diagnosis. The overall diagnostic accuracy for all residents was 30% and improved with years of training. The average score for correctly identified key features was 46% with no significant improvement with year of training. Residents who had completed a cardiology rotation scored better than the others (41% vs 18% for correct diagnosis). Clinical auscultation skills of pediatric residents in our institution showed significant improvement with training, especially in the ability to recognize a harmless heart murmur.

Degenerative Valvular Disease in the Cavalier King Charles Spaniel: Results of theUKBreed Scheme 1991–2010

“…The data showed that cardiologists tend to detect murmurs in younger dogs compared to GP veterinary surgeons with a difference in the median age of 1.4 years. The reason for this may be training as it has been shown that medical personnel appropriately trained detect quieter murmurs than those not trained . Younger dogs tend to be presented to cardiologists (0.8 years younger, Table ) so it is important that testing of young dogs and the “over 5” test is performed by cardiologists in order that quiet murmurs will be detected.…”

“…The reason for this may be training as it has been shown that medical personnel appropriately trained detect quieter murmurs than those not trained. 23,24 Younger dogs tend to be presented to cardiologists (0.8 years younger, Table 1) so it is important that testing of young dogs and the "over 5" test is performed by cardiologists in order that quiet murmurs will be detected. The presentation of younger dogs to cardiologists is likely to be because younger dogs tend to be brought to dog shows.…”

Skills of primary healthcare physicians in paediatric cardiac auscultation

“…b) if not, how could their performance be improved? The available literature, even when not based on the experience of a single institution , suggests that cardiac auscultatory performance of primary healthcare physicians might be inferior compared with paediatric cardiologists' performance and more comparable with that of medical students . However, their skills could be improved following well‐designed teaching interventions , including computer‐based teaching and ‘virtual’ patient evaluation .…”

Klinische verdenking op een hartafwijking: is een ECG zinvol of niet?

“…[13][14][15][16][17] Het toepassen en regelmatig herhalen van specifieke leerprogramma's blijkt nodig om tot een goede klinische beoordeling te komen. 13,16,18 Naast het gestructureerd uitvoeren van anamnese en lichamelijk onderzoek lijkt klinische ervaring bij de beoordeling van kinderen met een hartgeruis een rol te spelen. In onze studie zijn de meer ervaren artsen namelijk beter in staat op basis van anamnese en lichamelijk onderzoek een juist onderscheid te maken tussen onschuldige en pathologische geruisen.…”