Auscultation Training, Health Professions Education
Conditions
Keywords
Ventriloscope, Simulation stethoscope, Auscultation, Physical therapy education, Athletic training education, Simulation-based learning
Brief summary
This longitudinal, single-cohort, within-subjects study evaluates whether sequential exposure to Ventriloscope simulation stethoscope training, delivered after traditional auscultation instruction, enhances auscultation knowledge, clinical sound recognition skill, and self-reported confidence in Physical Therapy (PT) and Athletic Training (AT) students, and whether any enhancement is retained two months after training. All participating students receive both training modalities in sequence. Knowledge, skill, and confidence are measured at five timepoints (T1-T5) across approximately five months. A qualitative component examines student perceptions of the two training modalities.
Detailed description
Auscultation is a required clinical competency for physical therapists and athletic trainers, yet evidence-based instructional tools remain limited. Simulation stethoscopes, such as the Ventriloscope (Lecat's SimplySim, Canton, OH), pair a standard-appearing stethoscope with a wireless transmitter that delivers pre-recorded pathologic heart and lung sounds to the learner as though originating from a live patient. Prior work has shown benefit in pharmacy, paramedic, and DPT populations, but no published study has evaluated this technology in Athletic Training students, used a within-subjects longitudinal design tracking the same participants across traditional and simulation training, or included a qualitative comparison of student perceptions. Design: Single-cohort, longitudinal, within-subjects repeated-measures study with an embedded qualitative component. Timepoints: T1 Pre-Traditional (May 2026); T2 Post-Traditional (May 2026); T3 Pre-Ventriloscope, \ 2-month retention check (July 2026); T4 Post-Ventriloscope (July 2026); T5 2-month Follow-Up (September 2026). Interventions: (1) Traditional auscultation training session (\ 90 min) including didactic lecture and peer auscultation with standard stethoscopes; (2) Ventriloscope simulation training session (\ 90 min) including device orientation, three-step technique instruction, and rotation through eight pre-programmed PT/AT-relevant case stations. Rationale for single-cohort design: A two-arm design would require withholding a potentially beneficial educational intervention from half of a required clinical curriculum, which presents ethical concerns in a health professions education context. All participants receive both interventions sequentially.
Interventions
BEHAVIORALTraditional Auscultation Training
Approximately 90-minute faculty-led session delivered in a skills laboratory. Components include: (1) introduction and stethoscope device orientation; (2) didactic lecture on cardiac/pulmonary anatomy, sound generation; (3) peer cardiac auscultation practice at the four standard landmarks with standard stethoscopes; (4) peer pulmonary auscultation practice with standard stethoscopes; and (6) Q\&A and wrap-up
BEHAVIORALVentriloscope Simulation Training
Approximately 90-minute faculty-led session delivered in the same skills laboratory by the same instructor(s) approximately two months after the traditional session. The Ventriloscope (Lecat's SimplySim, Canton, OH) pairs a standard-appearing stethoscope with a wireless transmitter; a trained faculty facilitator triggers pre-recorded pathologic sounds via remote when the student places the chest piece on a peer standardized patient. Components include: (1) device orientation; (2) three-step technique and troubleshooting instruction; (3) rotation through eight pre-programmed clinical case stations; (4) post-station faculty-facilitated debrief; and (5) Q\&A and wrap-up.
Sponsors
Youngstown State University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Masking description
Participants and training facilitators cannot be masked given the nature of the educational interventions.
Intervention model description
Single-cohort, longitudinal, within-subjects repeated-measures design. All enrolled participants receive both the traditional auscultation training intervention and the Ventriloscope simulation training intervention in sequence, with quantitative outcomes assessed at five timepoints across approximately five months.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Non-Probability Sample was utilized which included a sample of convenience drawn from the current cohort of YSU PT and AT graduate students. Graduate students currently enrolled in the Youngstown State University Doctor of Physical Therapy (DPT) program or the Master of Athletic Training (MAT) program who are concurrently receiving auscultation instruction as part of their standard curriculum. Inclusion Criteria: * Currently enrolled in the YSU PT (DPT) or AT (MAT) professional program * Enrolled in Human Anatomy PHYT 8810 (PT) or Human Anatomy MAT 6908 (AT), in which auscultation instruction is delivered * Age 18 years or older * Able to provide voluntary written informed consent
Exclusion criteria
* Prior formal clinical auscultation training as part of a prior healthcare degree (e.g., nursing, respiratory therapy, medicine, physician assistant) * Inability to participate in both training sessions due to academic leave, course withdrawal, or scheduling conflict that cannot be reasonably accommodated
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Auscultaqtion Knowledge Score | Measured at T1 (baseline, Week 0), T2 (immediately post-traditional, Week 0), T3 (~Week 8, pre-Ventriloscope retention check), T4 (immediately post-Ventriloscope, ~Week 8), and T5 (~Week 16, 2-month follow-up) | Written multiple-choice knowledge assessment measuring clinical interpretation and procedures for auscultation, adapted with permission from Sherman et al. (2011) and revised to reflect PT and AT scope of practice. Parallel-form versions are used across timepoints to reduce test-retest effects. Scores are reported as percent correct (0-100). |
| Clinical Sound Recognition Skill Score | Measured at T1, T2, T3, T4, and T5 (same schedule as the knowledge outcome; spanning approximately 16 weeks) | Structured 16-item practical assessment (7 cardiac: 3 normal, 4 abnormal; 9 pulmonary: 3 normal, 6 abnormal) in which students listen to standardized audio presentations blinded to training condition and identify sound type and normal/abnormal clinical significance. Items scored dichotomously (1 = correct, 0 = incorrect); total score range 0-16. Item order randomized at each administration. |
| Self-Reported Auscultation Confidence | Measured at T1, T2, T3, T4, and T5 (spanning approximately 16 weeks) | 9-item Likert-scale survey (1 = Not at all confident to 5 = Extremely confident) adapted from Sherman et al. (2011) and Vatwani et al. (2023), measuring confidence across four domains: (a) performing auscultation technique, (b) identifying normal heart and lung sounds, (c) identifying abnormal heart and lung sounds, and (d) applying auscultation findings in a clinical context, with additional items addressing PT/AT scope-of-practice considerations. Total score reported as mean item response. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Student Perceptions of Training Modalities (Qualitative) | Measured at T4 (immediately post-Ventriloscope, ~Week 8) and T5 (2-month follow-up, ~Week 16) | Open-ended questionnaire asking participants to describe and compare their experiences with traditional and Ventriloscope training across four domains: perceived realism, engagement, clinical relevance, and perceived impact on clinical readiness. Responses analyzed via conventional content analysis (Hsieh \& Shannon, 2005) with two independent coders; inter-rater reliability calculated using Cohen's kappa (target \> 0.70). Outcome reported as thematic categories with frequency and representative de-identified quotes. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATOREdmund Ickert, PT, DPT, PhD
Youngstown State University
Outcome results
None listed