Dhuper Sarita, Vashist Sudhir, Shah Nishant, Sokal Myron
Department of Pediatrics, Brookdale University Hospital & Medical Center, Brooklyn, NY 11212, USA.
Clin Pediatr (Phila). 2007 Apr;46(3):236-40. doi: 10.1177/0009922806290028.
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.
心脏杂音在超过50%的儿童中存在，其中大多数是无害的。需要良好的听诊技能以避免不必要的转诊。对一组21名儿科住院医师的听诊技能进行了评估。根据他们对诸如S1、S2、时间、分级、位置、杂音性质以及任何额外心音等关键特征的识别，要求住院医师做出临床诊断。所有住院医师的总体诊断准确率为30%，且随着培训年限的增加而提高。正确识别关键特征的平均得分为46%，并未随着培训年限的增加而显著提高。完成心脏病学轮转的住院医师得分高于其他人（正确诊断率分别为41%和18%）。我们机构儿科住院医师的临床听诊技能经培训后有显著提高，尤其是在识别无害心脏杂音的能力方面。
