Simulation-based mastery learning improves cardiac auscultation skills in medical students.

Augusta Webster, MD Office of Medical Education and Faculty Development, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 03/2010; 25(8):780-5. DOI: 10.1007/s11606-010-1309-x
Source: PubMed

ABSTRACT 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.
To describe a mastery model of cardiac auscultation education and evaluate its effectiveness in improving bedside cardiac auscultation skills.
Untreated control group design with pretest and posttest.
Third-year students who received a cardiac auscultation curriculum and fourth year students who did not.
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.
Diagnostic accuracy with simulated heart sounds and actual patients.
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.
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.

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