Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Japan.
Patient Safety Management Office, Tohoku University Hospital, Sendai, Japan.
J Cardiol. 2022 Nov;80(5):462-468. doi: 10.1016/j.jjcc.2022.06.007. Epub 2022 Jun 22.
The effectiveness of cardiac auscultation training with a cardiology patient simulator for medical students is still unclear. Starting such training earlier may help students improve their proficiency. We investigated whether cardiac auscultation training using a simulator for first-year students is feasible and effective.
A total of 43 first-year medical students (5-12 in each year, 2015-2019) participated in three 1.5-hour extra-curricular classes comprising mini-lectures, facilitated training, two different auscultation tests (the second test closer to clinical setting than the first), and a questionnaire. The test results were compared with those of 556 fourth-year medical students who participated in a compulsory 3-hour cardiac auscultation class in 2016-2019.
The accuracy rate of all heart sounds and murmurs was higher in the first-year students than in the fourth-year students in both the first (85.8 vs. 79.4 %, p = 0.001) and second (71.3 vs. 61.2 %, p = 0.02) tests. That of second/third/fourth sounds was also higher in the first-year students than in the fourth-year students in both the first (86.0 vs. 79.7 %, p = 0.01) and second (70.9 vs. 53.9 %, p = 0.002) tests. The accuracy rate of murmurs was higher in the first-year students than in the fourth-year students in the first test (85.5 vs. 78.9 %, p = 0.04), but not in the second test (72.1 vs. 75.7 %, p = 0.58). All the first-year students and 65 % of them agreed that they had received sufficient knowledge and built sufficient skills, respectively. All the first-year students and 93 % of them agreed that they were satisfied with the program, and that the program was suitable for first-year students, respectively.
Although training time was different between the two groups and it is possible that only motivated first-year students participated in the program, these results suggest that our cardiac auscultation training is feasible and effective for first-year medical students.
心脏听诊训练器在医学生中的应用效果尚不清楚。尽早开始这种训练可能有助于学生提高熟练度。我们研究了使用模拟器对一年级医学生进行心脏听诊训练是否可行和有效。
共有 43 名一年级医学生（2015-2019 年，每年级 5-12 名学生）参加了三个 1.5 小时的课外活动，包括迷你讲座、辅导训练、两次不同的听诊测试（第二次测试比第一次更接近临床环境）和一份问卷。将测试结果与 2016-2019 年 556 名四年级医学生参加的必修 3 小时心脏听诊课程的结果进行比较。
在第一次和第二次测试中，所有心音和杂音的准确率均高于四年级学生（第一次为 85.8%比 79.4%，p=0.001；第二次为 71.3%比 61.2%，p=0.02）。在第一次和第二次测试中，第二/三/四心音的准确率也高于四年级学生（第一次为 86.0%比 79.7%，p=0.01；第二次为 70.9%比 53.9%，p=0.002）。在第一次测试中，杂音的准确率高于四年级学生（85.5%比 78.9%，p=0.04），但在第二次测试中则不然（72.1%比 75.7%，p=0.58）。所有一年级学生均表示他们分别获得了足够的知识和建立了足够的技能（均为 100%），其中 65%的学生表示他们获得了充足的知识，65%的学生表示他们建立了足够的技能。所有一年级学生均表示他们对该项目感到满意（均为 100%），其中 93%的学生表示该项目适合一年级学生。
尽管两组学生的培训时间不同，而且可能只有有积极性的一年级学生参加了该项目，但这些结果表明，我们的心脏听诊培训对一年级医学生是可行和有效的。
