Training auscultatory skills: computer simulated heart sounds or additional bedside training? A randomized trial on third-year medical students

<p>Abstract</p> <p>Background</p> <p>The present study compares the value of additional use of computer simulated heart sounds, to conventional bedside auscultation training, on the cardiac auscultation skills of 3^rdyear medical students at Oslo University Medical School.</p> <p>Methods</p> <p>In addition to their usual curriculum courses, groups of seven students each were randomized to receive four hours of additional auscultation training either employing a computer simulator system or adding on more conventional bedside training. Cardiac auscultation skills were afterwards tested using live patients. Each student gave a written description of the auscultation findings in four selected patients, and was rewarded from 0-10 points for each patient. Differences between the two study groups were evaluated using student's t-test.</p> <p>Results</p> <p>At the auscultation test no significant difference in mean score was found between the students who had used additional computer based sound simulation compared to additional bedside training.</p> <p>Conclusions</p> <p>Students at an early stage of their cardiology training demonstrated equal performance of cardiac auscultation whether they had received an additional short auscultation course based on computer simulated training, or had had additional bedside training.</p

PENERAPAN ALAT PERAGA MODEL SEL DALAM MENINGKATKAN HASIL BELAJAR SISWA PADA POKOK BAHASAN SEL DI SMAN 1 SURANENGGALA KABUPATEN CIREBON

DIAN MARYANI: Penerapan Alat Peraga Model Sel Dalam Meningkatkan Hasil Belajar Siswa Pada Pokok Bahasan Sel Kelas XI Di SMAN 1 Suranenggala Kab. Cirebon Penelitian ini dilatar belakangi oleh hasil belajar siswa yang belum tercapai, karena belum adanya sarana dan prasarana yang memadai sehingga pembelajaran masih menggunakan metode ceramah. Oleh karena itu perlu adanya kreativitas seorang guru untuk menciptakan dan membuat serta menerapkan suatu alat peraga dalam proses pembelajaran untuk meningkatkan daya ingat siswa sehingga hasil belajar siswa meningkat. Proses belajar mengajar merupakan proses komunikasi antar siswa dan guru. Untuk mempermudah suatu proses komunikasi dibutuhkan suatu media untuk menyampaikan konsep agar pembelajaran lebih mudah dipahami oleh siswa. Oleh karena itu dibutuhkan peran dan kreativitas guru dalam menyesuaikan media alat peraga dengan materi. Penggunaan media alat peraga membantu siswa untuk meningkatkan daya ingat karena dalam media alat peraga mampu merangsang panca indera yang meliputi indera pendengaran dan indera penglihatan yang mampu merangsang siswa dalam memahami dan mengingat materi pembelajaran sehingga mampu meningkatkan hasil belajar siswa. Tekhnik pengumpulan data dilakukan dengan menggunakan tes tertulis (pre tes dan post test) dan angket. Populasi dalam penelitian ini adalah seluruh siswa kelas XI SMAN 1 Suranenggala yang 234 siswa. Pengambilan sampel dalam penelitian ini dilakukan secara acak, sampel dalam penelitian ini diambil 1 kelas eksperimen yaitu kelas XI ipa 2 yang terdiri dari 40 siswa dan kelas kontrol pada kelas XI IPA 4 yang terdiri dari 40 siswa.data hasil penelitian kemudian dianalisis dengan menggunakan SPSS 16 for windows melalui uji normalitas, homogenitas, dan uji T. Berdasarkan hasil penelitian dapat disimpulkan bahwa: 1). penerapan alat peraga model sel pada pokok bahasan sel perlu dilaksanakan karena dapat meningkatkan daya ingat siswa sehingga mempengaruhi hasil belajar 2). adanya perbedaan peningkatan hasil belajar yang signifikan antara siswa yang menggunakan alat peraga dan yang tanpa alat peraga, Hal ini diketahui dari analisis data soal-soal pre test dan pos test yang diberikan kepada siswa kelas XI 2 (kelas eksperimen) di SMAN 1 Surannenggala, diperoleh data peningkatan rata-rata total skor pre test ke skor post test sebesar 39,78 atau lebih besar dari pada kelas kontrol yang mengalami kenaikan sebesar 3,75, Berdasarkan hasil uji mann whitney diperoleh nilai signifikan 0,000 dengan probabilitas < 0,05. Ho ditolak dan ha diterima. 3). Penerapan alat peraga model sel pada pembelajaran biologi sangat baik untuk diterapkan, hal ini bisa dilihat dari hasil respon siswa terhadap penggunaan media alat peraga ternyata hampir seluruh 77,5% siswa berpendapat bahwa pembelajaran dengan menggunakan alat peraga dapat meningkatkan hasil belajar siswa

Cardiac auscultation training of medical students: a comparison of electronic sensor-based and acoustic stethoscopes

BACKGROUND: To determine whether the use of an electronic, sensor based stethoscope affects the cardiac auscultation skills of undergraduate medical students. METHODS: Forty eight third year medical students were randomized to use either an electronic stethoscope, or a conventional acoustic stethoscope during clinical auscultation training. After a training period of four months, cardiac auscultation skills were evaluated using four patients with different cardiac murmurs. Two experienced cardiologists determined correct answers. The students completed a questionnaire for each patient. The thirteen questions were weighted according to their relative importance, and a correct answer was credited from one to six points. RESULTS: No difference in mean score was found between the two groups (p = 0.65). Grading and characterisation of murmurs and, if present, report of non existing murmurs were also rated. None of these yielded any significant differences between the groups. CONCLUSION: Whether an electronic or a conventional stethoscope was used during training and testing did not affect the students' performance on a cardiac auscultation test

Duration of elevated heart rate Is an important predictor of exercise-induced troponin elevation

Background The precise mechanisms causing cardiac troponin (cTn) increase after exercise remain to be determined. The aim of this study was to investigate the impact of heart rate (HR) on exercise‐induced cTn increase by using sports watch data from a large bicycle competition. Methods and Results Participants were recruited from NEEDED (North Sea Race Endurance Exercise Study). All completed a 91‐km recreational mountain bike race (North Sea Race). Clinical status, ECG, blood pressure, and blood samples were obtained 24 hours before and 3 and 24 hours after the race. Participants (n=177) were, on average, 44 years old; 31 (18%) were women. Both cTnI and cTnT increased in all individuals, reaching the highest level (of the 3 time points assessed) at 3 hours after the race (P150 beats per minute was a significant predictor of both cTnI and cTnT, at both 3 and 24 hours after exercise. Neither mean HR nor mean HR in percentage of maximum HR was a significant predictor of the cTn response at 3 and 24 hours after exercise. Conclusions The duration of elevated HR is an important predictor of physiological exercise‐induced cTn elevation.publishedVersio

Insider trading with non-fiduciary market makers

The single auction equilibrium of Kyle's (1985) is studied, in which market makers are not fiduciaries. They have some market power which they utilize to set the price to their advantage, resulting in positive expected profits. This has several implications for the equilibrium, the most important being that by setting a relatively modest "fee", the market maker is able to obtain a profit of the order of magnitude, and even better than, a perfectly informed insider. Our model indicates why speculative prices are more volatile than predicted by fundamentals. Noise traders may be uninformed, or partially informed. We analyze a situation where the market maker has private information as well as being non-fiduciary. In our model this leads to a more efficient market where the insider trades less and the market maker's profit increases

Plasma Adrenaline: Relations to Blood Pressure, Blood Platelet Function and Blood Lipids in Essential Hypertension

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71506/1/j.1600-0773.1988.tb02036.x.pd