Teaching Cardiac Auscultation: Effectiveness of Virtual Simulation-Based Training on Improving Cardiac Auscultatory Skills in Post-graduate Trainees in the COVID-19 Era.

Background: The art of cardiac auscultation is an essential clinical skill being lost amid growing reliance on modern technology and the steady decline in bedside teaching in the wake of the COVID-19 pandemic.

Objective: This study aimed to assess the cardiac auscultatory skills of post-graduate trainees within a single-center design before and after a virtual simulation-based training course and to determine the effectiveness of this teaching method on improving diagnostic proficiency.

Methods: Fifty-eight residents attended a seven-hour virtual simulation-based training course on cardiac auscultation, one hour per month, during their daily graduate medical education sessions. Residents completed a pre-test and post-test on their ability to diagnose 12 important heart sounds and murmurs produced via Harvey, the Cardiology Patient Simulator. Scores were compared using a two-tailed test. Residents also completed a feedback survey before and after the course.

Results: All 58 residents completed the course as well as the pre- and post-quiz. Of the 12 auscultatory events analyzed, an overall pre-test identification score of 27.44% and a post-test score of 39.08% (an increase of 42%) were observed, with a response rate of 100%. This represents a statistically significant improvement in diagnostic proficiency (p<0.001).

Conclusions: Although not a substitute for in-person bedside teaching, a virtual simulation-based training course is an effective method of teaching cardiac auscultatory skills and improving the diagnostic proficiency of post-graduate trainees in the COVID-19 era.