Stethoscope and laptop

The importance of listening – a new way of teaching auscultation to medical students

  • Education

Most people are familiar with the cool metal of a doctor’s stethoscope and instruction to breathe deeply but not everyone will know what this old diagnostic practice is called – auscultation. A new digitally enhanced learning resource developed through a staff-student partnership at RCSI provides an innovative approach to teaching this essential skill.

Auscultation: then and now

Auscultation is the act of listening to the internal sounds of the body when examining a patient. First thought to have been carried out by Hippocrates placing his ear on the patient’s chest, the stethoscope was introduced for auscultation by René-Théophile-Hyacinthe Laennec in in 1816 and became an integral tool.

As well as listening to the heart for abnormal sounds that could indicate cardiac or circulatory issues, medical professionals also use auscultation to identify respiratory problems by listening to the breath and gastrointestinal problems by listening to the bowel.

A key element of medical diagnosis, auscultation is routinely used to provide evidence for including or excluding different pathological conditions and remains an important part of modern medical training.

Unlike many concepts taught to healthcare professionals, auscultation cannot be mastered through memorisation or understanding of physiological concepts. Furthermore, due to infrequent exposure to less common pathologies, the impracticality of teacher and learner listening simultaneously, and (in many settings) high ambient noise levels and ratio of learners to patients, the task of teaching auscultation is also challenging.

A new way of learning

To enhance the auscultation training process, a lecturer at RCSI has collaborated with a medical student to create a learning tool that bridges the gap between theory and clinical practice. The Art of Auscultation: A Digitally Enhanced Learning Resource embeds high-quality cardio-respiratory and gastrointestinal auscultation sounds, visualisations, and descriptions into an e-book format.

Developed by Dr Shona Pfeiffer from the Department of Physiology & Medical Physics at RCSI, in collaboration with medical student Patrick Kennelly, this novel approach to teaching and learning in auscultation allows students to develop a deeper understanding and appreciation of the complexity of the technique.

The Art of Auscultation includes a combination of fully-licenced material along with originally produced content, allowing a graduated progression from simplistic to more challenging auscultation sounds with multiple variations of the same pathology in both slow motion and real time.

A key benefit of the resource is enhancing career readiness – equipping students with the auscultation skills they need to make a competent transition to challenging ward environments.

International impact

By allowing students to study at the pace and location of their choosing, this digitally-adapted learning resource is particularly relevant given the recent focus on online education during COVID-19. It enhances the teaching of complex physiological and pathological auscultation sounds that could traditionally only be carried out through in-person patient examinations.

Published on the RCSI Repository, it is an open access resource that can be used by students and teachers of auscultation all over the world.

This important learning tool was developed as part of the RCSI StEP staff-student partnership programme and is another contribution by RCSI to Health Professions Education. It also won the RCSI Education Innovation Award 2021.


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