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Cardiac Response to β-Adrenergic Stimulation Determined by Pressure-Volume Loop Analysis

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Listen Before You Auscultate: An Active-Learning Approach to Bedside Cardiac Assessment.

James L Meisel¹, Daniel C R Chen², Gail March Cohen³

¹Associate Chief of Staff for Education, VA Bedford Healthcare System; Associate Professor of Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine.

Mededportal : the Journal of Teaching and Learning Resources

|November 2, 2023

Summary

A new curriculum improved bedside cardiac assessment (BCA) skills for medical trainees. This patient-centered approach enhanced confidence and knowledge, addressing deficiencies in noncardiology learners.

Keywords:

Bedside Cardiac Assessment Cardiovascular Medicine Clinical Reasoning/Diagnostic Reasoning Clinical Teaching/Bedside Teaching Competency-Based Medical Education (Competencies, Milestones, EPAs)Flipped Classroom Humanism in Health Professions Education Online/Distance Learning Point-of-Care Ultrasound Professional Identity Formation

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Published on: February 25, 2016

Area of Science:

Medical Education
Cardiology
Clinical Skills Training

Background:

Bedside cardiac assessment (BCA) skills are often deficient among noncardiology trainees.
This deficiency can perpetuate through generations of medical educators and learners.
A need exists for improved, accessible BCA training methods.

Purpose of the Study:

To develop and evaluate a patient-centered curriculum to enhance bedside cardiac assessment (BCA) teaching and learning.
To create a flexible and accessible curriculum for medical clerkship students and other health professions learners.

Main Methods:

A constructivist approach was used, aligning learning goals, activities, and assessments.
A flipped classroom model incorporated pre-class videos and practice questions, followed by in-class activities integrating diagnostic reasoning, pathophysiology, and physical diagnosis.
The curriculum featured a six-step systematic approach with a 'listen before you auscultate' framework. Two hundred sixty-eight students from four medical schools participated.

Main Results:

Students reported increased confidence in their bedside cardiac assessment (BCA) abilities.
Learner knowledge showed improvement in both BCA and control groups.
Thematic analysis indicated that instructional design, peer interactions, skills practice, and educator encounters were valuable components of the curriculum.

Conclusions:

The developed curriculum effectively supports active learning of clinical competencies and promotes professional identity formation.
Increased confidence and knowledge suggest potential for durable learning outcomes.
Further research is recommended to confirm knowledge, skill acquisition, and behavioral impacts, including effects on professional identity.