A Decision-Directed Cardiac Exam in Medical School

What most physicians need when performing a physical examination is the ability to be able to recognize normal from abnormal and, if abnormal findings are present, to be able to diagnose or categorize disease in a useful fashion. This manuscript describes a technique that is feasible and acceptable in accomplishing this by changing the learning objectives for teaching cardiac auscultation to focus on recognizing audible decision-making findings and ensuring competency by requiring passing an auscultation-only examination that is limited to such findings. Medical students indicated the program was helpful and increased their confidence in performing cardiac auscultation.