Instruction Using a High-Fidelity Cardiopulmonary Simulator Improves Examination Skills and Resource Allocation in Family Medicine Trainees

Abstract

High-fidelity cardiopulmonary simulators have proven promising in various areas of medical education but have yet to be studied in Family Medicine training. A 2-hour curriculum, combining didactic and simulator exposure, and addressing common valvular pathologies, was offered to post-graduate year 1 and 2 Family Medicine residents. Residents' abilities to describe and diagnose four simulated murmurs were assessed before the teaching sessions and 2 to 4 weeks after. Confidence in physical examination skills, as well as the use of echocardiography, was also measured. Twenty residents participated. Mean composite murmur description scores improved in 95% of residents (P < 0.001), as did mean diagnostic accuracy (from 43.8% to 85.0%; P < 0.001). For pathologic murmurs, the number of echocardiograms recommended did not change, whereas for the nonpathologic murmur, 16 residents who recommended echocardiography presession no longer did postsession (P < 0.001). Mean confidence significantly increased (P < 0.001). The mean satisfaction score for the session was 4.9/5, and all residents recommended that the session be repeated in future years. A didactic and simulator-based session is very well received by Family Medicine residents. It significantly improves description and diagnosis of murmurs and reduces unnecessary echocardiogram use without affecting appropriate use.