DEMONSTRATION
Development of a Self-Teaching System (STS) for
Cardiovascular Physical Diagnosis
Steven A. Lieberman, M.D.
ABSTRACT:
Several studies over
the past decade have demonstrated the deterioration in student and resident
physical examination skills, notably those related to cardiovascular diagnosis.
But as faculty are pulled in numerous directions, the time available for
bedside instruction in physical diagnosis is continuously threatened. The
cardiovascular Self-Teaching System (STS) developed by UTMB Cardiologist Dr.
William E. Thornton was designed to address both of these issues.
The system reproduces
heart sounds and pulses via two portable transducers in combination with a
self-paced PC-based tutorial, allowing students to learn the physical
manifestations of cardiac abnormalities in direct relationship to the
underlying pathophysiology. The two transducers connect to the PC via a single
headphone jack.
The highly
interactive, self-paced series of four lessons feature a step-by-step
pathophysiologically based approach to basic cardiac diagnosis, covering both
tactile and auditory findings. Rigorous use of sound diagrams and self-examination
are also features of this program. Other key features include full range
stethophonic sound reproduction, realistic pulse reproduction, interactive
self- testing, and a text workbook.
The four lessons are
entitled:
Introduction
to Cardiac Auscultation and the Normal Heart Sounds,
Normal
Variant Cardiac Sounds
Abnormal
Heart Sounds
Murmurs
They provide
comprehensive instruction in fundamental skills. The text workbooks complement
the computer-based didactic material in helping students to understand the
auscultatory process and the basic individual cardiac sounds, as well as giving
them material for later review. As individual sounds are described the
appropriate sounds and pulses are reproduced for demonstration and practice.
Students also diagram the sounds for comparison to correct diagrams and
descriptions. A review and self-evaluation with typical examples of sounds
studied is part of each lesson.
In addition, the
transducers can be used with any ordinary CD player, allowing the sounds and
pulses to be easily incorporated with standardized patients into clinical
skills testing of cardiac diagnosis.
An important feature
of this system is that students may be individually scheduled at any time,
instructor’s time is small or non-existent, and fidelity is such that
transition to clinical patient signs is easily done. Preliminary studies
comparing the STS with live instruction show greater student satisfaction and
comparable proficiency with the STS.
BENEFIT TO PARTICIPANTS ATTENDING SESSION: ‘
This demonstration
will allow attendees to acquire hands-on experience with this innovative
self-paced method for learning skills in cardiovascular physical diagnosis. The
interactive computer-based tutorial is accompanied by haptic (pulse) and audio
(heart sounds) transducers, allowing students to learn the pathophysiologic
principles underlying normal and abnormal cardiovascular exam findings in
integrated fashion at their own pace.
Steven A. Lieberman,
M.D.
301 University Blvd
Galveston, TX
77555-0133
USA
Phone: 409-772-3619
Fax: 409-772-2684
mailto:steven.lieberman@utmb.edu
CO-AUTHORS:
William E. Thornton,
M.D.
301 University Blvd.
Galveston, TX
77555-0133
USA
Phone: 409-772-3619
Fax: 409-772-2684
mailto:william.thornton@utmb.edu