Barrett Michael J, Mackie Andrew S, Finley John P
From the *Morsani School of Medicine, University of South Florida, Tampa, FL; †Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada; and ‡Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Cardiol Rev. 2017 Sep/Oct;25(5):205-210. doi: 10.1097/CRD.0000000000000145.
Competent cardiac auscultation remains a most important skill for the detection of heart disease. Currently it is poorly taught and often ignored or poorly performed, resulting in inaccurate and inefficient patient assessments. This review documents that teaching can be over 90% effective with new, proven teaching methods emphasizing repetition and normal-abnormal comparisons of sounds, using computer-aided and online resources. At present, these concepts are not widely adopted by medical schools. Our current knowledge of teaching heart auscultation is critically reviewed, including traditional bedside, clinic and classroom settings, as well as computer, simulator, and multimedia-based learning. The assessment of auscultation skill in the learning process. The adoption of competence-based learning promises to integrate the assessment of auscultation skill in the learning process. Newer teaching methods, such as auditory training and repetitive listening, offer excellent murmur recognition and diagnosis learning, and hand-held ultrasound is proposed as a helpful adjunct to teaching auscultation. Although ongoing research remains important to develop better teaching methods, the adoption of proven existing concepts has great potential to improve teaching and practice of this valuable skill.
熟练的心脏听诊仍然是检测心脏病的一项极为重要的技能。目前，这项技能的教学状况不佳，常常被忽视或执行不到位，导致对患者的评估不准确且效率低下。这篇综述表明，采用新的、经过验证的教学方法，强调声音的重复以及正常与异常声音的对比，并利用计算机辅助和在线资源，教学效果可以超过90%。目前，这些理念尚未被医学院广泛采用。我们对当前心脏听诊教学的知识进行了批判性回顾，包括传统的床边、临床和课堂环境，以及基于计算机、模拟器和多媒体的学习。学习过程中听诊技能的评估。基于能力的学习有望将听诊技能的评估融入学习过程。更新的教学方法，如听觉训练和反复聆听，能提供出色的杂音识别和诊断学习，并且有人提议将手持超声作为听诊教学的有益辅助手段。尽管持续开展研究对于开发更好的教学方法依然很重要，但采用已被证实的现有理念对于改进这项重要技能的教学和实践具有巨大潜力。
