Abstract
Challenges in clinical bedside teaching can lead to sub-optimal cardiac physical exam skills among medical trainees. To address these challenges, simulation using high-fidelity simulators may provide a realistic alternative for teaching the cardiac physical examination. The purpose of this study is to measure the ability of medical students to perform a cardiac physical exam and make the correct clinical diagnosis after a learning module using standardized Simulated Patients (SP) with real cardiac findings compared to a cardiac simulator (Harvey). After a pretest Multiple Choice Questionnaire test on Harvey, 32 first-year medical students were randomized to a one-hour teaching module on either a Standardized Patient (SP) or Harvey. Their performance and ability to make the correct diagnosis for three cardiac conditions (Aortic stenosis, Mitral regurgitation, Normal Findings) were evaluated during a videotaped posttest Objective Structured Clinical Examination (OSCE) on real patients. No difference in the mean OSCE score was observed between the two groups (SP group: M=62.2% vs. Harvey group: M =57.2%, p = 0.32). The SP group obtained a higher frequency of correct diagnoses (M = 61%) than the Harvey group (M = 21% p = 0.03). Feedback on teaching showed that Harvey offered significantly superior clinical findings. However, 34.4% of students requested a combination of either teaching modalities as opposed to Harvey alone (9.4%) or SP alone (6.2%). The medical students’ ability to perform a cardiac physical exam did not vary when taught using SP vs. Harvey. Teaching on SP did lead to better performance in correctly diagnosing cardiac conditions. Harvey, the high-fidelity simulator, was the preferred method of teaching but the combined teaching program using both SP and Harvey may be the ideal method of teaching to attain transferability to patients.View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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