The Use of Graphical Lung Sound Visualizations in Medical Education: an Evaluation of Its Impact on Clinical Clerkship

Auscultation is a simple physical examination that provides important clinical information. Many educational materials are available to facilitate students’ understanding of lung auscultation. Some studies and teaching materials have visualized lung sounds as spectrograms. However, their effectiveness as educational tools remains unclear. Accordingly, this study evaluates the effect of auscultation education using lung sound visualization on medical students’ diagnostic skills. Participants were medical students completing their four-week clinical clerkship (CC) in the Department of Respiratory Medicine of Chiba University Hospital. Sixty-three students participated in this study between November 2022 and July 2023. They were divided into two groups: the full-term visualization group (n = 31) and the half-term visualization group (n = 32). Although both groups were taught lung sound visualization using simple diagrams, there was a two-week difference in the length of exposure. We taught visualization to the full-term visualization group on the first day of the CC, and to the half-term visualization group after the midpoint test. Thus, the full-term visualization group practiced lung auscultations with visualization for four weeks, while the half-term visualization group had two weeks of practice. All the students performed lung auscultation tests with a simulator three times: pre-test at the beginning, midpoint at the end of the second week, and post-test at the end of CC. In addition, they responded to questionnaires regarding lung auscultation at the beginning and end of CC. The score gain from baseline in the lung auscultation tests at the midpoint was 0.5; p = 0.018). The increase in scores at the post-test was not significantly different between the two groups (median full-term, + 3.6; half-term, + 2.3; p = 0.060). The self-reported confidence, clinical reasoning ability, activity, and frequency of lung auscultation improved in both groups. The questionnaire responses indicated that the students accepted the value of lung sound visualization. Differing the duration of exposure to lung sound visualization (two weeks and four weeks) showed no significant difference in medical students’ auscultation skills.