VIRTUAL CARDIOLOGY CLINICAL SKILLS TEACHING FOR MEDICAL STUDENTS USING AN ELECTRONIC STETHOSCOPE DURING THE COVID-19 PANDEMIC: FEASIBILITY AND FEEDBACK.

BACKGROUND: The provision of teaching within medical schools, particularly at the pre-clerkship level, has been difficult during the COVID-19 pandemic due to the need for limited patient contact. The opportunities for Med I and Med 2 students for bedside teaching have been a particular challenge. During the Cardiology clinical skills unit at Dalhousie University there was a shift in Public Health recommendations necessitating a quick change in teaching strategy during the second wave of the pandemic. With medical students no longer able to enter the hospital for practice histories and physicals on ‘real’ cardiac patients, an effort was made to provide a similar experience using a virtual platform. METHODS AND RESULTS: Bedside teaching for cardiology at Dalhousie (Halifax site) involves three 4-week rotations of roughly 28 students per group. One of these groups was provided with a virtual experience using a hospitalized patient with cardiac disease on week one, followed by in-person clinical skills teaching with a standardized patient without cardiac disease in weeks 2-4. For the virtual experience the history portion was conducted using Zoom, and the physical examination was demonstrated using an iPhone connected to an electronic stethoscope which allowed broadcast of heart sounds to the students over the Zoom platform. The stethoscope used was the Thinklabs One(TM) digital. The three in-person sessions were provided in groups of 4 students to one standardized patient along with a cardiologist. At the end of the four-week session the students were asked to evaluate the experience of the virtual history and physical examination with the ‘real’ patient in a short survey and compare it to the standardized patient experience. Of the 28 students, 16 completed the evaluation survey (57%). All students (100%) selected either ‘Agree’ or ‘Strongly agree’ on a 5-point Likert scale when asked if the virtual session provided a valuable learning experience for both history taking and physical examination. The majority of students (87.5%) also felt that the virtual bedside teaching was either equivalent or preferable to the in-person learning experience with the standardized patient. CONCLUSION: Virtual clinical skills teaching using a Zoom platform and an electronic stethoscope was both feasible and provided a valuable alternative learning experience for medical students during the COVID-19 pandemic.