Assessment of Auscultation Skills with Hybrid Simulation

Bauer, Daniel; Bonvin, Raphael; Breckwoldt, Jan; Bruppacher, Heinz; Schirlo, Christian; Schnabel, Kai (1 April 2017). Assessment of Auscultation Skills with Hybrid Simulation. In: 12. Internationales SkillsLab Symposium. Düsseldorf: German Medical Science GMS Publishing House 10.3205/17isls24

Text (Speech) 2017-04 iSLS_Auscultation.pptx - Presentation Available under License BORIS Standard License. Download (5MB)

Background
Auscultation of the lungs, heart, and the abdomen are core clinical skills in determining a patient’s status, both in a first encounter and in the evaluation of a patient's progress. Findings from auscultation are relevant for a physician’s train of thought, determining next steps in diagnosing or treating a patient. They thus represent a clinical competence that needs to be part of the assessment of clinical skills. At a graduate level, this should go far beyond seeing if candidates put their stethoscopes on the right spots on a (healthy) SP, reporting physiological findings, and waiting for the examiner to explain what they would have heard in real life, as is commonly practiced. Hearing the pathological sounds from an external audio source, then continuing with the SP encounter, as is the alternative practice, constitutes a change of media, putting at risk the candidates’ immersion into the roleplay and their suspension of disbelief.
Instead, examiners should have the capacity to see if candidates can take pathological (!) findings from a (still healthy) SP and integrate the findings into their clinical reasoning. The use of simulation stethoscopes in a hybrid simulation setting would allow for this, and increase fidelity of the patient representation as well as the fidelity of the clinical scenario.
Methods
In this workshop we will present a (short) theoretical rationale for hybrid simulation and an overview of different systems and approaches to assessing auscultation skills, and together discuss the questions of determining the respective added value of the different approaches.
Results
We propose that every approach has its own pros and cons.
Discussion
We propose that hybrid simulation and technological advances offer new possibilities and approaches in the assessment of clinical skills and the choice of approach needs careful consideration.

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