Abstract 19020: Brief Hand-Held Echocardiography Teaching Improves Diagnosis of Valvular Heart Disease by Medical Students: A Controlled Study in the 2nd Year Cardiovascular Curriculum
Background: As clinical examination skills by standard teaching methods decline, Hand-Held Echo (HHE) can augment medical student physical diagnosis.
Methods: We studied whether the addition of brief HHE teaching to a 2nd year medical school Cardiac Pathophysiology course would improve students’ diagnosis of valvular heart disease (VHD). The standard VHD curriculum included lectures/small group sessions covering history, pathophysiology, physical exam, auscultation recordings and echo images of VHD lesions, followed by a quiz requiring identification of a murmur. 72 students received only this standard teaching (STD).64 students received additional 90 minute personalized HHE teaching (Vscan™, GE Healthcare, Wauwatosa, WI; VSCAN group), including review of 3D model cardiac anatomy, echo video images demonstrating classical valvular abnormalities and supervised HHE performed on classmates. All 136 students took the course final exam that included 2 clinical questions assessing correct identification of the identical cardiac murmur: 1 question provided a patient history and audio MP3 file of a classic aortic stenosis murmur; the second question provided the history and audio of the murmur plus 2D echo AVI video demonstrating severe AS.
Results: At a baseline quiz, administered prior to HHE teaching, there was no difference between STD and VSCAN students in correct diagnosis of VHD (p=NS). After HHE teaching, there was no difference between STD and Vscan groups in correct identification of VHD when provided with only the patient history and the audio file of the murmur ([MURMUR], p=NS). However, students who received Vscan training were more likely than STD to correctly identify VHD when provided echo images in addition to patient history and murmur (MURMUR + ECHO) (58 vs. 40%, p<0.05; see Figure).
Conclusion: Addition of brief hand-held echo instruction improved medical student diagnosis of valvular heart disease compared to standard teaching.
Author Disclosures: D.A. Vorchheimer: None. R.S. Copeland-Halperin: None. M. Zafar: None. P. Trubin: None. M. Seigerman: None. E. Popil: None. J. Narula: None. J.L. Halperin: None.
- © 2014 by American Heart Association, Inc.