Owning Auscultation Skills in a Physical Therapy Program: A Qualitative Study
Purpose
The profession of physical therapy has experienced remarkable growth through the years with the entry-level degree now at a clinical doctorate level. The added responsibility of direct access in most states and advances in practice acts to include new treatment strategies, and the current COVID-19 situation has challenged programs with how to best solidify clinical skills such as auscultation. Considering these health, social, political, and economic challenges, an evolution within the profession needs to occur and incorporate progressive educational examination processes for the evaluation of patients. Considering the increased rate and severity of patientsÕ comorbid status, the physical therapy profession needs to elevate standards for patient examination. The skill of auscultation should become an essential function in the PT examination process, similar to the transformation that occurred with vitals several years ago. Auscultation can help to identify abnormalities in the cardiac, vascular, and pulmonary systems.
Methods/Description:
A DPT program in the Midwest implemented the use of auscultation manikins over a three-year period to advance and test studentsÕ auscultation ability. The students had 24/7 access to two computerized manikins. One manikin was used as a learning/review tool by the students and the other was set up for auscultation quizzes. Students could review sounds and take the quizzes anytime it was convenient for them. This learning and testing process was incorporated into two main courses in the curriculum, cardiovascular/pulmonary physical therapy and differential diagnosis. At the conclusion of these two courses, each student provided feedback regarding the experience in a reflective self-analysis SOAP note.
Results/Outcomes:
Student SOAP notes were analyzed using a whole-parts-whole method where three researchers developed themes or constituents independently. The research team came together to discuss the themes common to the description of the experience of using the computerized manikin system. Common themes that emerged included: 1) very beneficial experience & beneficial tool learning; 2) afforded the opportunity to learning individually & in group settings; 3) initial feelings of nervousness & being overwhelmed gave way to feelings of accomplishment & success; 4) grateful for the experience & the 24/7 availability; 5) re-enforced the fact that PTs have an ownership in auscultation. Overall, the interactions increased the understanding of the scope of what a DPT can & should do, decreased fear & increased excitement associated with acute care.
Conclusions/Relevance to the conference theme:
Learning to be proficient in auscultation can be time-intensive and is often a daunting task for physical therapy students. A system that decreases stress levels and allows students to learn at their own pace is very beneficial in improving their auscultation skill level and decreasing anxiety when performing patient evaluations. Students feel a sense of accomplishment and appear more likely to utilize auscultation during patient examination following a low-stakes, but high quality manikin experience situated through two academic courses. The experience further enhanced students ability to recognize the importance of assessing heart and lung sounds in clinical practice.