Table 1.
Description of Included Studies
| Author, year | No. and level of participants | Intervention and comparison | Assessment* | MERSQI score† |
|---|---|---|---|---|
| No-intervention comparison studies: randomized | ||||
| Penta 197318 | 30 sophomore medical students | CPS (4.5 h) + a traditional course compared to a traditional course | Diagnostic accuracy on 6 CPS sounds | 11.5 |
| Oddone 199321 | 56 internal medicine and family medicine PGY-1 residents | Harvey® CPS (8 h) + a 4-week cardiology rotation compared to a 4-week cardiology rotation | Diagnostic accuracy on 3 real patients | 12.5 |
| Tiffen 201128 | 29 pre-practicum nursing students | VitalSimKelly CPS (1 h) + ‘usual teaching’ compared to ‘usual teaching’ | Written test and self-reported confidence in cardiac physical examination skills | 14.5 |
| No-intervention comparison studies: cohort | ||||
| Butter 201027 | 118 3rd and 4th year medical students | Harvey® CPS and UMedic multimedia computer system (2 h) compared to a no-intervention control | Written test and diagnostic accuracy on 4-5 real patients | 13.5 |
| Kern 201129 | 405 3rd year medical students | Harvey® CPS (0.5 h) and standardized patient compared to an historical standardized patient intervention | OSCE performance on a single station with standardized patients without real findings | 10.5 |
| No-intervention comparison studies: single group | ||||
| Gordon 19804 | 23 4th year medical students | Harvey® CPS (8 h) | MCQ and diagnostic accuracy on 2 CPS disorders | 8 |
| Woolliscroft 198719 | 224 pre-clinical medical students | Harvey® CPS (4 h) | Diagnostic accuracy on 1 of 2 CPS disorders | 12 |
| Harrell 199020 | 49 critical care nurses | Heart Sim II CPS (1 h) | Diagnostic accuracy on 20 CPS heart sounds | 13 |
| Takashina 199722 | 21 primary-care physicians | CPS (9 h) | Diagnostic accuracy on 5 CPS disorders | 10 |
| 37 nurses | ||||
| Issenberg 200023 | 53 Physician assistants | Harvey® CPS (2 h) | Written test | 12 |
| Issenberg 200224 | 67 internal medicine PGY-2 & -3 residents | Harvey® CPS and UMedic multimedia computer system (5 h). Included an historical cohort | MCQ | 13 |
| Issenberg 200325 | 43 osteopathic internists | Harvey® CPS (2 h) | Written test | 13 |
| 14 osteopath residents | ||||
| 7 osteopath medical students | ||||
| Fraser 200926 | 152 first year medical students | Harvey® CPS (2 h) + traditional clinical training. Second arm taught respiratory disorders. | Diagnostic accuracy on 2 CPS scenarios | 11 |
| Other intervention comparison studies: randomized | ||||
| de Giovanni 200930 | 37 3rd year medical students | Harvey® CPS (3 h) compared to CD of recorded sounds | Diagnostic accuracy on 5 real patients | 14.5 |
| Other intervention comparison studies: cohort | ||||
| Ewy 198731 | 208 4th year medical students | Harvey® CPS (10.5 h) + real patients compared to a larger volume of real patients | MCQ and checklist on 2 real patients | 13.5 |
| Waugh 199532 | 182 senior medical students | Harvey® CPS (time not specified) + UMedic multimedia computer system compared to video and UMedic system | MCQ | 9.5 |
| Simulation comparison study: randomized | ||||
| Champagne 198934 | 37 masters level nursing students | Heart Sim II heart sounds (0.5 h) with and without palpatory cues | Diagnostic accuracy on 20 CPS heart sounds | 15.5 |
| Fraser 201133 | 86 1st year medical students | Harvey® CPS (2 h) mitral regurgitation compared to Harvey® CPS (2 h) aortic stenosis | Diagnostic accuracy on real patient with mitral regurgitation | 11.5 |
*Assessment method(s) included in the meta-analysis. For studies with more than one skill assessment, one assessment was selected for the meta-analysis using pre-defined criteria
†MERSQI score is an assessment of study quality.9 Maximum score 19, low quality ≤ 12