Digital devices for teaching cardiac auscultation - a randomized pilot study.

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dc.contributor.author Legget, Malcolm en
dc.contributor.author Toh, MeiYen en
dc.contributor.author Meintjes, Andries en
dc.contributor.author Fitzsimons, Sarah en
dc.contributor.author Gamble, Gregory en
dc.contributor.author Doughty, Robert en
dc.date.accessioned 2019-03-11T20:26:54Z en
dc.date.issued 2018-12 en
dc.identifier.citation Medical education online 23(1):1524688 Dec 2018 en
dc.identifier.issn 1087-2981 en
dc.identifier.uri http://hdl.handle.net/2292/45889 en
dc.description.abstract BACKGROUND:Competent cardiac auscultation is a declining skill. Digital stethoscopes and hand-held echocardiography (HHE) are modern devices which may improve the accuracy of heart murmur recognition and diagnosis. Their incremental value compared to conventional examination has not been evaluated in depth. OBJECTIVES:Our aim was to quantify the utility of digital stethoscopes and HHE as teaching aids to improve medical students' diagnostic accuracy in the evaluation of heart murmurs using a novel clinically weighted scoring system. DESIGN:This pilot study involved eight medical students and eight patients with heart murmurs. Four patients were examined at 2 sessions, 1 week apart. Medical students were randomised into two groups: the 'intervention group' examined patients with a standard and digital stethoscope, and then received demonstration of the valvular lesion with HHE to illustrate the diagnosis. The 'control group' used a standard stethoscope only and were taught using traditional methods. Students' scores were compared to a 'gold standard' derived from a consensus of auscultation findings of three cardiologists. RESULTS:Overall the mean percent correct of total possible score was 65.4% (SD8.4). Using a mixed models ANOVA approach to repeated measures, the mean [95% CI] increase from training to validation period for the control group was 2.5% [-11.5, 16.5] P(Tukey) = 0.95 and 15.8% [1.7,29.8] P(Tukey) = 0.027 for the intervention group. Between the validation and training sessions for both groups, there was an increase of 9.1% [1.82, 16.4] in scores (p = 0.018). The mean [95% CI] difference in scores of the control and intervention groups was 1.9% [-5.4, 9.2] (p = 0.59). The Cohen's effect size estimate was 0.9. CONCLUSION:Digital stethoscopes and hand-held echo may be useful devices for teaching cardiac auscultation. This pilot study provides a novel study design, a heart murmur grading system, and data that will help develop definitive studies to assess new teaching techniques for cardiac auscultation using digital technology. en
dc.format.medium Print en
dc.language eng en
dc.relation.ispartofseries Medical education online en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Echocardiography en
dc.subject Heart Auscultation en
dc.subject Pilot Projects en
dc.subject Stethoscopes en
dc.subject Education, Medical, Undergraduate en
dc.subject Educational Technology en
dc.title Digital devices for teaching cardiac auscultation - a randomized pilot study. en
dc.type Journal Article en
dc.identifier.doi 10.1080/10872981.2018.1524688 en
pubs.issue 1 en
pubs.begin-page 1524688 en
pubs.volume 23 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype research-article en
pubs.subtype Randomized Controlled Trial en
pubs.subtype Journal Article en
pubs.elements-id 757603 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
dc.identifier.eissn 1087-2981 en
pubs.record-created-at-source-date 2018-12-01 en
pubs.dimensions-id 30499380 en


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