Does a Simulated Stethoscope Complement Cardiopulmonary Knowledge and Confidence in Doctor of Physical Therapy Students? (1090-003915) (Research Abstract Oral: Procedure)
Start time: Monday, January 25, 2021, 8:00 AM End time: Monday, January 25, 2021, 9:00 AM Session Type: Research Abstracts (Completed Studies)
Simulation offers students exposure to skills that they may not otherwise encounter during their training prior to entering their practicum. Physical therapy (PT) students may not have the opportunity to perform and master cardiorespiratory skills until after they complete didactic content and participate in clinical experiences. There is limited research to support utilization of a computerized stethoscope to impact confidence and competence in cardiorespiratory assessment skills, but literature shows that laboratory-based training with a simulated stethoscope had positive impacts on cardiopulmonary skill acquisition and confidence for pharmacy (Sherman & Stover, 2011) and paramedic (Simon et al, 2012) students. The purpose of this study is to ascertain if utilizing a computerized stethoscope during a lab session will improve Doctor of Physical Therapy (DPT) student cardiopulmonary assessment knowledge and confidence in auscultation and identification of heart and lung sounds.
The study was conducted on volunteer DPT students in year two (DPT2, n=39) and year three (DPT3, n=48) of the program. All students had already completed their cardiovascular and pulmonary PT course, which did not include simulated stethoscope use in any didactic activities. As part of the study, all students completed a 12-question multiple-choice pre-test and confidence survey related to cardiopulmonary assessment. Two weeks after baseline data collection, DPT2 students attended a one-hour cardiopulmonary lab session (intervention) which included practicing cardiopulmonary assessment utilizing simulated stethoscopes. At the conclusion of the intervention, DPT2 students completed a post-test and confidence survey. Statistical analysis was carried out with SPSS 26, with alpha = 0.05 unless otherwise indicated, and effect size r was calculated. Specific details of the tests that were utilized for each comparison are given alongside the results.
After the training session, DPT2 students had significantly higher quiz scores (p=0.005, r=0.32, paired t-test). They also showed significant increases in confidence from pre-survey to post-survey (related-samples Wilcoxon signed-rank tests with Bonferroni correction, alpha=0.008), in several areas: physical assessment for respiratory system (p=0.001, r=0.37), using physical assessment tools to determine effectiveness of PT for respiratory disease (p = 0.002, r=0.35), physical assessment for cardiovascular system (p=0.006, r=0.31), and using physical assessment tools to determine effectiveness of PT for cardiovascular disease (p=0.004, r=0.32). There were no significant differences in DPT2 and DPT3 quiz scores or confidence at the pre-test. Compared to the DPT3s at baseline, the DPT2s scored significantly higher in the post quiz (p=0.001, r=0.33, independent samples t-test), and in the confidence post-survey (p<0.001, r=0.42, Mann-Whitney-U).
The results of this study show that a one-hour lab session that utilizes simulated stethoscopes results in increased cardiorespiratory assessment knowledge and confidence in DPT students. Students who participated in the session improved their score in the knowledge test, and also reported increased confidence in cardiorespiratory assessment skills, even surpassing students in later years of the program. It is important to note that although use of the same quiz and survey tools at the two time points provides internal consistency, it also creates the limitation of having students take the same quiz twice. The chances of improved performance due to item recall were minimized by the two-week period between pre- and post-data points. The use of simulated stethoscopes may thus provide an effective means of supplementing other didactic experiences for the cardiorespiratory system.