Use of hand-carried ultrasound devices to augment the accuracy of medical student bedside cardiac diagnoses.
BACKGROUND
Hand-carried ultrasound (HCU) devices used by cardiologists as extensions of the physical examination have been shown to improve the accuracy of bedside diagnoses. We tested the feasibility of teaching medical students to use HCU devices to make bedside cardiac diagnoses and compared the accuracy of their HCU and physical examinations.


METHODS
In all, 10 fourth-year medical students enrolled in a 4-week medical school course on the cardiac examination. Students examined 12 standardized patients at 3 different time intervals: (1) on day 1 of the course; (2) on day 10 after review of cardiac physical examination using traditional teaching methods; and (3) after instruction on the use of HCU devices. Students were scored at each time interval for primary findings (most salient) and all findings, accounting for both errors of commission and omission. Scores could range from +12 to -12 for primary findings and from +22 to -22 for all findings. A perfect score was +12 for primary findings and +22 for all findings.


RESULTS
The average score for all students at baseline was -3.2 +/- 3.1 and -5.7 +/- 4.8 for primary and all findings, respectively. A significant improvement in the scores was noted with use of the HCU device (2.6 +/- 3.1 and 5.2 +/- 6.6 for primary and all findings, respectively) compared with the baseline and two subsequent physical examinations.


CONCLUSIONS
Instruction of fourth-year medical students on the use of HCU device is feasible and results in significantly more accurate bedside diagnoses.
Decara
Jeanne M
JM
Department of Medicine and Section of Cardiology, University of Chicago Hospitals, IL, USA. jdecara@medicine.bsd.uchicago.edu
Kirkpatrick
James N
JN
Spencer
Kirk T
KT
Ward
R Parker
RP
Kasza
Kristen
K
Furlong
Kathleen
K
Lang
Roberto M
RM
D000704:Analysis of Variance; D002983:Clinical Competence; D004452:Echocardiography / Q000295:instrumentation*; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D004867:Equipment Design; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D010808:Physical Examination / Q000379:methods; D019095:Point-of-Care Systems; D018709:Statistics, Nonparametric; D013337:Students, Medical