Does Cardiac Physical Exam Teaching Using a Cardiac Simulator Improve Medical Students' Diagnostic Skills?

Background Challenges in bedside teaching may be overcome by the use of high-fidelity simulators for teaching the cardiac physical exam. The purpose of this study is to compare the ability of first-year medical students (MS1) to perform a cardiac physical exam and make the correct diagnosis after instruction using standardized patients (SPs) as compared to a cardiac simulator (Harvey, Laerdal Medical Corporation, NY, US). Methods Thirty-two MS1 were randomized to a teaching module on either SPs or Harvey. Their performance and ability to make the correct diagnosis were evaluated during a posttest objective structured clinical examination (OSCE) on real patients. Results No difference in the mean OSCE score was observed (SP: M=62.2% vs. Harvey: M=57.2%, p=0.32). The SP group obtained a higher frequency of correct diagnoses (M=61.5% SP vs. M=21.0% Harvey, p=0.03). Student feedback revealed that Harvey offered superior clinical findings; however, 34.4% of students requested a combination of teaching modalities as opposed to either method alone. Conclusions Performance in examination skills did not differ between the SP and Harvey groups but the SP group demonstrated an improved ability to arrive at a unifying diagnosis. A combined teaching program may be ideal for transferability to patients.