Journal of General Internal Medicine

, Volume 25, Issue 8, pp 780–785

Simulation-based Mastery Learning Improves Cardiac Auscultation Skills in Medical Students

Authors

    • Augusta Webster, MD Office of Medical Education and Faculty DevelopmentNorthwestern University Feinberg School of Medicine
    • Department of MedicineNorthwestern University Feinberg School of Medicine
  • William C. McGaghie
    • Augusta Webster, MD Office of Medical Education and Faculty DevelopmentNorthwestern University Feinberg School of Medicine
  • Elaine R. Cohen
    • Department of MedicineNorthwestern University Feinberg School of Medicine
  • Marsha Kaye
    • Augusta Webster, MD Office of Medical Education and Faculty DevelopmentNorthwestern University Feinberg School of Medicine
  • Diane B. Wayne
    • Department of MedicineNorthwestern University Feinberg School of Medicine
Original Article

DOI: 10.1007/s11606-010-1309-x

Cite this article as:
Butter, J., McGaghie, W.C., Cohen, E.R. et al. J GEN INTERN MED (2010) 25: 780. doi:10.1007/s11606-010-1309-x

Abstract

Background

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.

Objective

To describe a mastery model of cardiac auscultation education and evaluate its effectiveness in improving bedside cardiac auscultation skills.

Design

Untreated control group design with pretest and posttest.

Participants

Third-year students who received a cardiac auscultation curriculum and fourth year students who did not.

Intervention

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.

Measurements

Diagnostic accuracy with simulated heart sounds and actual patients.

Results

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.

Conclusions

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.

Key words

Cardiac Auscultationsimulationmedical studentslearning

Copyright information

© Society of General Internal Medicine 2010