Doctors Improve Stethoscope Skills Using iPods

Intensive repetition--listening at least 400 times to each heart sound--significantly improved the stethoscope abilities of doctors, according to a new report.

Researchers at Temple University School of Medicine (Philadelphia, PA, USA) tested 149 general internists who listened 400 times repeatedly to heart sounds on their iPods. The internists listened to five common heart murmurs: aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation, and innocent systolic murmur. The test was conducted during a single 90-minute session. Previous studies have found the average rate of correct heart sound identification in physicians is 40%; after the session, the average improved to 80%. The study was presented at the American College of Cardiology's annual meeting, held during March 2007 in New Orleans (LA, USA).

"You don't build this proficiency by osmosis. It's important to know when to order a costly echocardiogram or stress test,” said lead investigator Michael Barrett, M.D., a clinical associate professor of medicine, and a cardiologist. "Plus, internists are now tested on this skill for board recertification. Requirements for residents and other specialists are sure to follow.”

Temple University School of Medicine recently started a four-year curriculum on cardiac auscultation that relies on different types of simulators, including iPods, to teach medical students this important but vanishing skill. Demand for the recordings of heart sounds has been intense, and because of a partnership with the American College of Cardiology (ACC), the heart sounds can now be accessed online and are available on compact disk (CD). Dr. Barret has advised the ACC to make the CDs car-friendly and about the length of an average commute to work.


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