Teaching cardiac auscultation to trainees in internal medicine and family practice: Does it work?

dc.creator	Pécoud A
dc.creator	Favrat B
dc.creator	Jaussi A
dc.date	2004-03-01T00:00:00Z
dc.date.accessioned	2015-07-20T22:19:08Z
dc.date.available	2015-07-20T22:19:08Z
dc.identifier	1472-6920
dc.identifier	https://doaj.org/article/bedf9bf3ccd14458ba3c04d9e014984b
dc.identifier.uri	http://evidence.thinkportal.org/handle/123456789/19637
dc.description	<p>Abstract</p> <p>Background</p> <p>The general proficiency in physical diagnostic skills seems to be declining in relation to the development of new technologies. The few studies that have examined this question have invariably used recordings of cardiac events obtained from patients. However, this type of evaluation may not correlate particularly well with bedside skills. Our objectives were 1) To compare the cardiac auscultatory skills of physicians in training with those of experienced cardiologists by using real patients to test bedside diagnostic skills. 2) To evaluate the impact of a five-month bedside cardiac auscultation training program.</p> <p>Methods</p> <p>1) In an academic primary care center, 20 physicians (trainees in internal medicine and family practice) and two skilled academic cardiologists listened to 33 cardiac events in 13 patients directly at bedside and identified the cardiac events by completing an open questionnaire. Heart sounds, murmurs and diagnosis were determined beforehand by an independent skilled cardiologist and were validated by echocardiography. Thirteen primary cardiologic diagnoses were possible.</p> <p>2) Ten of the physicians agreed to participate in a course of 45-minute sessions once a week for 5 months. After the course they listened again to the same patients (pre/post-interventional study).</p> <p>Results</p> <p>1) The experts were the most skillful, achieving 69% recognition of heart sounds and murmurs and correct diagnoses in 62% of cases. They also heard all of the diastolic murmurs. The residents heard only 40% of the extra heart sounds and made a correct diagnosis in 24% of cases. 2) After the weekly training sessions, their mean percentage for correct diagnosis was 35% [an increase of 66% (p < 0.05)].</p> <p>Conclusions</p> <p>The level of bedside diagnostic skills in this relatively small group of physicians in training is indeed low, but can be improved by a course focusing on realistic bedside teaching.</p>
dc.language	English
dc.publisher	BioMed Central
dc.relation	http://www.biomedcentral.com/1472-6920/4/5
dc.relation	https://doaj.org/toc/1472-6920
dc.rights	CC BY
dc.source	BMC Medical Education, Vol 4, Iss 1, p 5 (2004)
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	DOAJ:Medicine (General)
dc.subject	DOAJ:Health Sciences
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	DOAJ:Education
dc.subject	DOAJ:Social Sciences
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	DOAJ:Medicine (General)
dc.subject	DOAJ:Health Sciences
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	DOAJ:Education
dc.subject	DOAJ:Social Sciences
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.title	Teaching cardiac auscultation to trainees in internal medicine and family practice: Does it work?
dc.type	article