Cardiac Auscultation in the Modern Era: Premature Requiem or Phoenix Rising?
Competent cardiac auscultation remains a most important skill for the detection of heart disease. Currently it is poorly taught and often ignored or poorly performed, resulting in inaccurate and inefficient patient assessments. This review documents that teaching can be over 90% effective with new, proven teaching methods emphasizing repetition and normal-abnormal comparisons of sounds, using computer-aided and online resources. At present, these concepts are not widely adopted by medical schools. Our current knowledge of teaching heart auscultation is critically reviewed, including traditional bedside, clinic and classroom settings, as well as computer, simulator, and multimedia-based learning. The assessment of auscultation skill in the learning process. The adoption of competence-based learning promises to integrate the assessment of auscultation skill in the learning process. Newer teaching methods, such as auditory training and repetitive listening, offer excellent murmur recognition and diagnosis learning, and hand-held ultrasound is proposed as a helpful adjunct to teaching auscultation. Although ongoing research remains important to develop better teaching methods, the adoption of proven existing concepts has great potential to improve teaching and practice of this valuable skill.