Smith CA, Hart AS, Sadowski LS, Riddle J, Evans AT, Clarke PM, Ganschow PS, Mason E, Sequeira W, Wang Y. Teaching cardiac examination skills. A controlled trial of two methods.
J Gen Intern Med 2006;
21:7-12. [PMID:
16423116 PMCID:
PMC1484605 DOI:
10.1111/j.1525-1497.2005.00254.x]
[Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE
To determine if structured teaching of bedside cardiac examination skills improves medical residents' examination technique and their identification of key clinical findings.
DESIGN
Firm-based single-blinded controlled trial.
SETTING
Inpatient service at a university-affiliated public teaching hospital.
PARTICIPANTS
Eighty Internal Medicine residents.
METHODS
The study assessed 2 intervention groups that received 3-hour bedside teaching sessions during their 4-week rotation using either: (1) a traditional teaching method, "demonstration and practice" (DP) (n=26) or (2) an innovative method, "collaborative discovery" (CD) (n=24). The control group received their usual ward teaching sessions (n=25). The main outcome measures were scores on examination technique and correct identification of key clinical findings on an objective structured clinical examination (OSCE).
RESULTS
All 3 groups had similar scores for both their examination technique and identification of key findings in the preintervention OSCE. After teaching, both intervention groups significantly improved their technical examination skills compared with the control group. The increase was 10% (95% confidence interval [CI] 4% to 17%) for CD versus control and 12% (95% CI 6% to 19%) for DP versus control (both P<.005) equivalent to an additional 3 to 4 examination skills being correctly performed. Improvement in key findings was limited to a 5% (95% CI 2% to 9%) increase for the CD teaching method, CD versus control P=.046, equivalent to the identification of an additional 2 key clinical findings.
CONCLUSIONS
Both programs of bedside teaching increase the technical examination skills of residents but improvements in the identification of key clinical findings were modest and only demonstrated with a new method of teaching.
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