Heart murmurs auscultation as professional learning problems.
OBJECTIVE
To compare the effectiveness of traditional and innovative methods of training for heart auscultation in medical students, physicians, and medical teachers, to find out the major reasons of the deficient auscultative skills, and to determine a place and significance of alternative methods of auscultation training.


METHODS
By principle of other equal conditions, the comparison of traditional and algorithmic diagnostics by the same auscultative signs in textual tasks, magnetic sound records and heart auscultation of patients. The independent diagnostics has been reflected the results of usual medical education. The same data have been used by the same examinees for diagnostics by original innovative diagnostic algorithm of heart auscultation, and programmed training.


RESULTS
Murmurs diagnostics on magnetic recording was erroneous frequently. For reliable diagnostics of acoustic phenomena is needed the constant feedback, and much more time, than is scheduled in standard curriculum.


CONCLUSIONS
Conventional training for heart auscultation is ineffective. Auscultation skills acquired by medical students do not grow up during their program of study. Even graduated cardiologists and instructors clinicians themselves make frequent errors in diagnostics of heart murmurs. The proposed diagnostic algorithm decreases the number of errors many times. The programmed teaching with constant feedback is the optimal method for flawless recognition of acoustic signs.
Naumov
Leonid B
LB
Center for Medical Decision Making, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. leonaumov@zahav.net.il
D002309:Cardiology / Q000193:education* / Q000592:standards; D002983:Clinical Competence; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004501:Education, Medical / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006326:Heart Auscultation; D006337:Heart Murmurs / Q000175:diagnosis*; D006801:Humans; D010808:Physical Examination; D013337:Students, Medical / Q000523:psychology*; D013663:Teaching / Q000379:methods*