title: The Ventriloscope® as an innovative tool for assessing clinical examination skills: appraisal of a novel method of simulating auscultatory findings.
abstract: BACKGROUND
  Simulation is increasingly used as a teaching tool and in assessment. The Ventriloscope® (VS) is a new auscultation simulator. This modified stethoscope allows pre-recorded sounds (activated wirelessly) to be integrated with a simulated patient (SP, professional actor).
  
  
  OBJECTIVE
  This study explores the instrument's potential for overcoming limitations of current objective structured clinical examination (OSCE) assessment by increasing validity while retaining reliability.
  
  
  METHODS
  After training SPs to synchronise the device with their breathing (recreating abnormal signs), we evaluated the VS during a third year undergraduate medical student OSCE. Students (n =  385), examiners (n = 19) and SPs (n = 10) completed post-exam questionnaires which were analysed using a coding framework. OSCE performance data were analysed using Stata 10.
  
  
  RESULTS
  When 'compared to their usual stethoscope' 40% of students found no difference in using the VS; 69% found it easier to identify sounds; 68% found examination with the VS very or fairly realistic when 'compared to examining a real patient'. Examination scores were comparable with other OSCE stations.
  
  
  CONCLUSIONS
  The VS reliably provided consistent 'abnormal' auscultatory signs within an OSCE framework. Using a VS may increase OSCE validity, allowing examiners to assess students' application of knowledge in a realistically simulated setting. The VS can help bridge the gap between simulation and real patients.
authors.affiliation: Imperial College London, UK. a.verma@imperial.ac.uk
authors.forename: Anju
authors.initials: A
authors.lastname: Verma
authors.forename: Himanshu
authors.initials: H
authors.lastname: Bhatt
authors.forename: Paul
authors.initials: P
authors.lastname: Booton
authors.forename: Roger
authors.initials: R
authors.lastname: Kneebone
mesh_terms: D001314:Auscultation / Q000295:instrumentation*; D002983:Clinical Competence / Q000592:standards*; D005069:Evaluation Studies as Topic; D006801:Humans; D008131:London; D010808:Physical Examination / Q000592:standards*; D013337:Students, Medical; D011795:Surveys and Questionnaires