A randomized, controlled trial of an innovative, multimedia instructional program for acquiring auditory skill in identifying pediatric heart murmurs

Authors

Robin W. Doroshow, Department of Cardiology, Children's National Hospital and George Washington School of Medicine and Health Sciences, Washington, DC, United States.
Julie Aldrich, Department of Pediatrics, Children's National Hospital and George Washington School of Medicine and Health Sciences, Washington, DC, United States.
Rebecca Dorner, Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, United States.
Laurie Lyons, Department of Instructional Design and Technology, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Robert McCarter, Division of Biostatistics, Children's National Hospital and George Washington School of Medicine and Health Sciences, Washington, DC, United States.

Document Type

Journal Article

Publication Date

1-1-2023

Journal

Frontiers in pediatrics

Volume

11

DOI

10.3389/fped.2023.1283306

Keywords

cardiac auscultation; children's heart murmurs; multimedia learning; pediatric murmurs; teaching auscultation

Abstract

OBJECTIVE: To create a brief, acceptable, innovative method for self-paced learning to enhance recognition of pediatric heart murmurs by medical students, and to demonstrate this method's effectiveness in a randomized, controlled trial. MATERIALS AND METHODS: A curriculum of six 10-min online learning modules was designed to enable deliberate practice of pediatric cardiac auscultation, using recordings of patients' heart murmurs. Principles of andragogy and multimedia learning were applied to optimize acquisition of this skill. A pretest and posttest, given 4 weeks apart, were created using additional recordings and administered to 87 3rd-year medical students during their pediatric clerkship. They were randomized to have access to the modules after the pretest or after the posttest, and asked to use at least the first 2 of the modules. RESULTS: 47 subjects comprised the Intervention group, and 40 subjects the Control group. On our primary outcome, distinguishing innocent from pathological with at least moderate confidence, the posttest scores were significantly higher for the Intervention group (60.5%) than for the Control group (20.0%). For our secondary outcomes, the 2 groups also differed significantly in the ability to distinguish innocent from pathological murmurs, and in identifying the actual diagnosis. On all 3 outcomes, those Intervention group subjects who accessed 4-6 modules scored higher than those who accessed 0-3 modules, who in turn scored higher than the Control group. SUMMARY: Applying current principles of adult learning, we have created a teaching program for medical students to learn to recognize common pediatric murmurs. Its effectiveness was demonstrated in a randomized, controlled trial. The program results in a meaningful gain in this skill from 1 h of self-paced training with high acceptance to learners.

APA Citation

Doroshow, Robin W.; Aldrich, Julie; Dorner, Rebecca; Lyons, Laurie; and McCarter, Robert, "A randomized, controlled trial of an innovative, multimedia instructional program for acquiring auditory skill in identifying pediatric heart murmurs" (2023). GW Authored Works. Paper 4170.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4170

Department

Pediatrics