Using a multimedia tool to improve cardiac auscultation knowledge and skills

OBJECTIVE: Today's medical school graduates have significant deficits in ph ysical examination skills. Medical educators have been searching for method s to effectively teach and maintain these skills in students. The objective of this study was to determine if an auscultation curriculum centered on a portable multimedia CD-ROM was effective in producing and maintaining sign ificant gains in cardiac auscultatory skills. DESIGN. Controlled cohort study PARTICIPANTS: All 168 third-year medical students at 1 medical school in an academic medical center. INTERVENTIONS: Students were tested before and after exposure to 1 or more elements of the auscultation curriculum: teaching on ward/clinic rotations, CD-ROM comprehensive cases with follow-up seminars, and a CD-ROM 20-case m iniseries. The primary outcome measures were student performance on a 10-it em test of auscultation skill (listening and identifying heart sound charac teristics) and a 30-item test of auscultation knowledge (factual questions about auscultation). A subset of students was tested for attenuation effect s 9 or 12 months after the intervention. RESULTS: Compared with the control group (1 month clinical rotation alone), students who were also exposed to the CD-ROM 20-case miniseries had signif icant improvements in auscultation skills scores (P < .05), but not knowled ge. Additional months of clerkship, comprehensive CD-ROM cases, and follow- up seminars increased auscultation knowledge beyond the miniseries alone (P < .05), but did not further improve auscultation skills. Students' auscult ation knowledge diminished one year after the intervention, but auscultatio n skills did not. CONCLUSION: In addition to the standard curriculum of ward and conference t eaching, portable multimedia tools may help improve quality of physical exa mination skills.