Beyond Heart Sounds: an interactive teaching and skills testing program for cardiac examination

Cardiac examination and auscultation are skills that are not adequately taught in training programs, and as a result are poorly performed by trainees in internal medicine and cardiology. In an attempt to address these deficiencies, the authors have videotaped bedside physical findings along with stethoscopic heart sound recordings in over 100 patients with "classical" forms of heart disease, and have developed a series of interactive multimedia programs designed to be used in training programs for medical students and residents. The programs have tutorial as well as skills-testing content. Formal evaluation of the program's ability to teach cardiac examination skills is under way. Preliminary results from third-year medical students before and after training with software showed a significant improvement (P=0.02). After training, these students tested at the level of first-year cardiology fellows.