Physicians' ability to recognize adventitious lung sounds

Lung auscultation is an important tool for diagnosing respiratory diseases. However, the ability of observers to recognize respiratory sounds varies considerably and depends on the sound. The present study aimed to assess the auscultatory skills of healthcare professionals and medical students.

A total of 295 physicians (185 pediatricians, 69 pulmonologists, and 41 physicians of general/internal medicine and subspecialties), 55 residents, and 50 medical students participated in the survey. They listened to five audio-recorded respiratory sounds and described them in free-form answers.

The rates of correct answers were 55.2% for fine crackles, 74.5% for coarse crackles, 72.2% for wheezes, 18.75% for squawks, and 11.25% for pleural friction rub. The medical specialty was correlated with the correct answers and both pediatricians and physicians of general/internal medicine and subspecialties recognized fewer sounds compared with respiratory physicians (odds ratio [OR]: 0.37; confidence interval [CI]: 0.22-0.62; p < 0.001 and, OR: 0.47; CI: 0.22-0.99, p = 0.048, respectively). Years of experience were negatively correlated with the number of correct answers (OR: 0.73; CI:0.62-0.84; p = 0.001).

Gaps remain in both terminology and recognition of lung sounds among a wide population of Greek physicians. Less experienced physicians perform better on lung auscultation, indicating that continuing education with critical feedback should be offered.