Department and Clinic of Internal Medicine, University of Veterinary Medicine, Budapest, István u. 2, 1078 Budapest, Hungary.
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853 USA.
J Vet Med Educ. 2023 Feb;50(1):104-110. doi: 10.3138/jvme-2021-0097. Epub 2022 Jan 31.
Veterinary students often struggle to correctly interpret heart sounds. This study sought to evaluate if additional online training using digital phonocardiograms (DPCGs) improves students' ability to identify normal and pathologic heart sounds in dogs. Thirty-six randomly assigned veterinary students listened to and interpreted 10 audio recordings of normal heart sounds (2), heart murmurs (4), and arrhythmias (4) at the start and the end of a 4-week period. Twenty-two students participated in training with DPCGs, including those created from these recordings during this period, via a self-study website ( = 12) or online webinar ( = 10). Their results were compared with those of a control group ( = 14) that did not undergo additional training. Although pre- and post-training test scores did not differ between groups, both training groups showed within-group improvement between the two tests ( = .024, = .037); the control group did not ( = .49). Although neither training group showed differences in ability to differentiate normal heart sounds from arrhythmias, both showed increased ability to detect and specify heart murmurs and provide refined diagnoses of detected arrhythmias. These results suggest additional training, even without actual patients, improves students' ability to identify heart murmurs and provide specific diagnoses for arrhythmias. Further study with a larger sample size and an additional group without DPCG-based training would help evaluate the effectiveness of DPCGs regarding arrhythmias. Studying a larger sample size would also allow for a training group participating in both training methods, measuring cumulative effectiveness of both methods.
兽医学生通常难以正确解读心音。本研究旨在评估在 4 周的时间内，使用数字化心音图（DPCG）进行额外的在线培训是否能提高学生识别犬正常和病理性心音的能力。36 名随机分配的兽医学生在 4 周的时间内，在开始和结束时分别听取和解释了 10 个正常心音（2 个）、心杂音（4 个）和心律失常（4 个）的音频记录。22 名学生参加了包括使用这些记录创建的 DPCG 的培训，通过自学网站（n = 12）或在线网络研讨会（n = 10）进行。他们的结果与未接受额外培训的对照组（n = 14）进行了比较。尽管培训前后的测试分数在组间没有差异，但两个培训组在两次测试之间都显示出了组内的提高（P =.024，P =.037）；对照组没有（P =.49）。虽然两个培训组在区分正常心音和心律失常的能力上没有差异，但都显示出了检测和指定心杂音的能力提高，并对检测到的心律失常提供了更精细的诊断。这些结果表明，即使没有实际患者，额外的培训也能提高学生识别心杂音和提供心律失常具体诊断的能力。进一步的研究需要更大的样本量和一个没有基于 DPCG 的培训的额外组，以评估 DPCG 对心律失常的有效性。研究更大的样本量还可以允许一个培训组同时参加两种培训方法，衡量两种方法的累积效果。
