Dawn Mangine

    Auscultation, which is the science of listening to sounds from the heart, lung, and other organs, is a basic and important skill for healthcare professionals. Yet, study after study shows that healthcare professionals are only able to identify a small percentage of heart sounds. How can instructors bridge this gap?

    Using Simulation to Teach Auscultation

    Using simulation and task trainers to teach heart, lung, and organ sounds in the classroom is a viable option. More and more tools and devices exist to help instructors teach the art of listening. Dedicated instruction and repetition are necessary to learn the sounds that can be identified with a stethoscope.

    Read our post Simulated Heart Sounds: Learning to Listen

    “Medical students who were presented with prerecorded heart sounds from computers and patient simulators demonstrated better diagnostic abilities than their counterparts…. Other studies have shown that trainees who listened to a particular murmur or heart sound over 300 times demonstrated an increased ability to recognize that sound on a real patient.” (Source)

    The University of Texas Medical Branch School of Medicine (UTMB) had a challenge for Cardionics, a 3B Scientific Company: They were seeking an excellent auscultation simulator that required minimal setup and operational support. As they say, everything is big in Texas and UTMB is no exception: Established in 1891, UTMB is one of the largest academic health centers in the nation offering programs in medicine, nursing, health professions, and biomedical sciences.

    UTMB reached out to Cardionics, a Pocket Nurse vendor, to expand their usage due to the ease of use. As Bill Boudreaux, EdN, RN, CEN Assistant Professor/Medical Education Office of Clinical Simulation, states: “With 1200 students a year using them, the SAM Models are my most useful tool. They're very dependable and functional. There's a big difference between the SAM II model and other high-fidelity manikins. Anybody can use a SAM II right out of the box, there's almost zero learning curve.”

    Shop Cardionics at Pocket Nurse

    Bill Boudreaux summed it up quite nicely, saying, “Seeing that ‘aha’ moment when it all comes together for our students is very gratifying. It's proof that we're improving their educational experience.”

    Meanwhile Cardionics released a third-generation model, SAM 3G®. The new enhanced simulator comes with case videos, a real sound library, echocardiogram videos, and more. In addition, the Texas-based company developed a wearable simulator called the Bionic Hybrid Simulator, which can be worn by a manikin or a standardized participant. A student can learn how to connect a 5-wire EKG, diagnose heart, breath, and bowel sounds, check the pulse, and use a blood pressure cuff.

    Read more about the BHS at HealthySimulation.com.

    A Novel Approach

    Authors Graham Peigh and Joseph Majdan explored another type of novel approach to teaching cardiac auscultation. They emphasized a process-based technique to help students learn to reliably identify common heart sounds, including pathologies.

    They had a group of 64 students visually divide a patient’s sternum in half with an imaginary line, and listen to heart sounds above and below the mid-sternal line. If they hear a murmur, the next step is to determine where the abnormal sound is loudest, above or below the line. Finally, they determine if the murmur is best heard in systole or diastole.

    “As students undergo this method of instruction, they are encouraged to visualize the heart sounds both physically and within the cardiac cycle.” The research showed increased ability and confidence in the trainees. (Source)

    Ideally, simulation and better critical thinking will be combined to increase healthcare professionals’ auscultation abilities.

    This post includes testimonial information from a Cardionics client, Bill Boudreaux from University of Texas Medical Branch School of Medicine (UTMB). To learn more about Cardionics and 3B Scientific, you can visit their websites.