Torre Dario M, Pfeifer Kurt J, Lamb Geoffrey C, Walters Matthew P, Sebastian James L, Simpson Deborah E
a Department of Medicine Division of General Internal Medicine Medical College of Wisconsin.
c Clement J. Zablocki Veterans Affairs Medical Center Milwaukee , Wisconsin.
Med Educ Online. 2004 Dec;9(1):4364. doi: 10.3402/meo.v9i.4364.
Previous studies have shown that medical students and post-graduate trainees need to improve their proficiency in cardiac auscultation. Technologic advances have created new learner-centered opportunities to enhance proficiency in this important physical examination skill.
We sought to determine if technology-based, self-directed learning tools improved the cardiac auscultation skills of third-year medical students.
Sixteen (16) third-year medical (M3) students were exposed to three educational inter-ventions: a one-hour cardiac auscultation lecture that featured computer-generated heart sounds, a PDA-based heart sounds/murmur form and a web-based cardiac auscultation program. Thirteen (13) internal medicine (IM) residents who served as a comparison group attended a cardiac auscultation lecture identical in content and format to the student lecture. At the end of the study period, we evaluated the ability of both groups to accurately identify heart sounds and cardiac murmurs via a twelve-item performance-based examination utilizing computer-generated heart sounds.
Following our teaching interventions, findingsM3 students correctly identified 80% of the computer-simulated heart sounds/murmurs while the comparison group of IM residents accurately detected 60% of the same cardiac findings (p<. 005).
The combination of traditional lecture and multi-media, technology-based, self-directed learning tools appears to be an effective and efficient strategy for teaching and reinforcing cardiac auscultation skills to third year medical students.
先前的研究表明,医学生和研究生需要提高他们心脏听诊的熟练程度。技术进步创造了以学习者为中心的新机会,以提高这项重要体格检查技能的熟练程度。
我们试图确定基于技术的自主学习工具是否能提高三年级医学生的心脏听诊技能。
16名三年级医学生(M3)接受了三种教育干预:一场时长一小时、以计算机生成的心音为特色的心脏听诊讲座、一个基于个人数字助理(PDA)的心音/杂音表格以及一个基于网络的心脏听诊程序。13名作为对照组的内科住院医师参加了一场内容和形式与学生讲座相同的心脏听诊讲座。在研究期结束时我们通过一项利用计算机生成的心音的、基于表现的12项检查评估了两组准确识别心音和心脏杂音的能力。
在我们的教学干预之后,三年级医学生正确识别了80%的计算机模拟的心音/杂音,而内科住院医师对照组准确检测出了相同心脏表现中的60%(p<0.005)。
传统讲座与基于多媒体、技术的自主学习工具相结合似乎是一种向三年级医学生教授和强化心脏听诊技能的有效策略。