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International trial of online auditory training programme for distinguishing innocent and pathological murmurs
Author(s) -
Finley John P,
Caissie Rachel,
Nicol Pam,
Hoyt Brian
Publication year - 2015
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12839
Subject(s) - medicine , pathological , test (biology) , intervention (counseling) , audiology , repetition (rhetorical device) , physical therapy , pediatrics , psychiatry , paleontology , linguistics , philosophy , biology
Aim Recognition of normal and abnormal heart sounds and murmurs is an important but declining clinical skill among practitioners. Current teaching methods are often ineffective. This may result from inadequate repetition and normal–abnormal comparisons needed for auditory recognition. This paper describes a rapid new method of teaching murmur recognition using principles of auditory training. Methods Participants were 120 A ustralian and 42 C anadian medical students. The medical students were randomised to intervention and control (no intervention) groups. The 1‐h online programme structured like a computer game used auditory training methodology to teach students to distinguish between innocent and pathological murmurs. Participants underwent pre‐ and post‐testing on 20 paediatric murmurs. Post‐testing occurred immediately following training and after 2 months. Twenty‐two C anadian medical students were retested 1 year later with a brief mastery‐style reinforcement programme. Results Median pre‐ and post‐test scores improved in about 1 h from 75–95% ( P < 0.001) for A ustralian students and 85–95% ( P = 0.004) for C anadian students. Two‐month post‐test scores declined for A ustralian students to 85% ( P = 0.001), and for C anadian students to 85% ( P = 0.02). A ustralian controls had no significant change during the study period, whereas C anadian controls improved slightly. The group receiving reinforcement after 1 year had a median final score of 90%. Conclusions This auditory training programme rapidly teaches students to distinguish innocent and pathological murmurs with at least 90% accuracy. The skill declines within 2 months but can be restored with brief mastery reinforcement 1 year later.