Document Detail


Simulation training improves diagnostic performance on a real patient with similar clinical findings.
MedLine Citation:
PMID:  20829332     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Training on a cardiopulmonary simulator improves subsequent diagnostic performance on the same simulator. But data are lacking on transfer of learning. The objective of this study was to determine whether training on a cardiorespiratory simulator improves diagnostic performance on a real patient.
METHODS: We randomly allocated first-year medical students at the University of Calgary to simulator training in one of three clinical scenarios of acute-onset chest pain: pulmonary embolism with right ventricular strain but no murmur, symptomatic aortic stenosis, or myocardial ischemia causing mitral regurgitation. Simulation sessions ran for 20 min, after which participants had a standardized debriefing session and reviewed the physical findings. Immediately following the training sessions, students assessed the auscultatory findings of a real patient with mitral regurgitation. Our outcome measures were accuracy of identifying abnormal auscultatory findings and diagnosing the underlying cardiac abnormality (mitral regurgitation).
RESULTS: Eighty-six students participated in the study. Students trained on mitral regurgitation were more likely to identify and diagnose these findings on a real patient with mitral regurgitation than those who had trained on aortic stenosis or a scenario with no cardiac murmur. The accuracy (SD) of identifying clinical features of mitral regurgitation for these three groups was 74.0 (36.4) vs 56.2 (34.3) vs 36.8 (33.1), respectively (P = .0005), and for diagnosing mitral regurgitation, the accuracy was 68.0 (45.4) vs 51.6 (50.0) vs 29.9 (40.7), respectively (P = .01).
CONCLUSIONS: Simulator training on mitral regurgitation increases the likelihood of diagnosing this abnormality on a real patient.
Authors:
Kristin Fraser; Bruce Wright; Louis Girard; Janet Tworek; Mike Paget; Lisa Welikovich; Kevin McLaughlin
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-09-09
Journal Detail:
Title:  Chest     Volume:  139     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-02     Completed Date:  2011-03-17     Revised Date:  2011-06-20    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  376-81     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Calgary, Calgary, AB, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Aortic Diseases / complications,  diagnosis*
Auscultation
Chest Pain / diagnosis*,  etiology
Clinical Competence
Education, Medical, Undergraduate / methods*
Educational Measurement
Female
Humans
Male
Mitral Valve Insufficiency / complications,  diagnosis*
Patient Simulation*
Prospective Studies
Comments/Corrections
Comment In:
Chest. 2011 May;139(5):1257-8; author reply 1258   [PMID:  21540230 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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