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Assessing housestaff diagnostic skills using a cardiology patient simulator.

Publication ,  Journal Article
St Clair, EW; Oddone, EZ; Waugh, RA; Corey, GR; Feussner, JR
Published in: Ann Intern Med
November 1, 1992

OBJECTIVE: To assess the cardiovascular physical examination skills of internal medicine housestaff. DESIGN: Cross-sectional assessment of housestaff performance on three valvular abnormality simulations conducted on the cardiology patient simulator, "Harvey." Evaluations were done at the beginning (session I) and end (session II) of the academic year. SETTING: Duke University Medical Center internal medicine training program. SUBJECTS: Sixty-three (59%) of 107 eligible internal medicine housestaff (postgraduate years 1 through 3) agreed to participate and completed session I; 60 (95%) completed session II. MEASUREMENTS: All volunteers were tested on three preprogrammed simulations (mitral regurgitation, mitral stenosis, and aortic regurgitation). RESULTS: The overall correct response rates for all housestaff were 52% for mitral regurgitation, 37% for mitral stenosis, and 54% for aortic regurgitation. No difference was noted in correct response rates between sessions I and II. For mitral regurgitation, correct assessment of the contour of the holosystolic murmur predicted a correct diagnosis (P = 0.002). For mitral stenosis, identification of an opening snap and proper characterization of the mitral area diastolic murmur predicted a correct diagnosis (P < 0.0001). No individual observations were noted for the aortic regurgitation simulation, whose identification by the housestaff was associated with a correct diagnosis. CONCLUSIONS: Housestaff had difficulty establishing a correct diagnosis for simulations of three common valvular heart diseases. Accurate recognition of a few "key" observations was associated with a correct diagnosis in two of the three diseases. Teaching housestaff to elicit and interpret a few critical signs accurately may improve their physical diagnosis abilities.

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Published In

Ann Intern Med

DOI

ISSN

0003-4819

Publication Date

November 1, 1992

Volume

117

Issue

9

Start / End Page

751 / 756

Location

United States

Related Subject Headings

  • Teaching Materials
  • Statistics as Topic
  • North Carolina
  • Manikins
  • Internship and Residency
  • Hospitals, University
  • Hospital Bed Capacity, 500 and over
  • Heart Valve Diseases
  • General & Internal Medicine
  • Cross-Sectional Studies
 

Citation

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St Clair, E. W., Oddone, E. Z., Waugh, R. A., Corey, G. R., & Feussner, J. R. (1992). Assessing housestaff diagnostic skills using a cardiology patient simulator. Ann Intern Med, 117(9), 751–756. https://doi.org/10.7326/0003-4819-117-9-751
St Clair, E. W., E. Z. Oddone, R. A. Waugh, G. R. Corey, and J. R. Feussner. “Assessing housestaff diagnostic skills using a cardiology patient simulator.Ann Intern Med 117, no. 9 (November 1, 1992): 751–56. https://doi.org/10.7326/0003-4819-117-9-751.
St Clair EW, Oddone EZ, Waugh RA, Corey GR, Feussner JR. Assessing housestaff diagnostic skills using a cardiology patient simulator. Ann Intern Med. 1992 Nov 1;117(9):751–6.
St Clair, E. W., et al. “Assessing housestaff diagnostic skills using a cardiology patient simulator.Ann Intern Med, vol. 117, no. 9, Nov. 1992, pp. 751–56. Pubmed, doi:10.7326/0003-4819-117-9-751.
St Clair EW, Oddone EZ, Waugh RA, Corey GR, Feussner JR. Assessing housestaff diagnostic skills using a cardiology patient simulator. Ann Intern Med. 1992 Nov 1;117(9):751–756.

Published In

Ann Intern Med

DOI

ISSN

0003-4819

Publication Date

November 1, 1992

Volume

117

Issue

9

Start / End Page

751 / 756

Location

United States

Related Subject Headings

  • Teaching Materials
  • Statistics as Topic
  • North Carolina
  • Manikins
  • Internship and Residency
  • Hospitals, University
  • Hospital Bed Capacity, 500 and over
  • Heart Valve Diseases
  • General & Internal Medicine
  • Cross-Sectional Studies