gms | German Medical Science

12. Internationales SkillsLab Symposium 2017

31.03. - 01.04.2017, Erlangen

Assessment of Auscultation Skills with Hybrid Simulation


12. Internationales SkillsLab Symposium 2017. Erlangen, 31.03.-01.04.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocWS05

doi: 10.3205/17isls24, urn:nbn:de:0183-17isls245

Published: March 9, 2017

© 2017 Bauer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Background: Auscultation of the lungs, heart, and the abdomen are core clinical skills in determining a patient’s status, both in a first encounter and in the evaluation of a patient's progress. Findings from auscultation are relevant for a physician’s train of thought, determining next steps in diagnosing or treating a patient. They thus represent a clinical competence that needs to be part of the assessment of clinical skills. At a graduate level, this should go far beyond seeing if candidates put their stethoscopes on the right spots on a (healthy) SP, reporting physiological findings, and waiting for the examiner to explain what they would have heard in real life, as is commonly practiced. Hearing the pathological sounds from an external audio source, then continuing with the SP encounter, as is the alternative practice, constitutes a change of media, putting at risk the candidates’ immersion into the roleplay and their suspension of disbelief.

Instead, examiners should have the capacity to see if candidates can take pathological (!) findings from a (still healthy) SP and integrate the findings into their clinical reasoning. The use of simulation stethoscopes in a hybrid simulation setting would allow for this, and increase fidelity of the patient representation as well as the fidelity of the clinical scenario.

Methods: In this workshop we will present a (short) theoretical rationale for hybrid simulation and an overview of different systems and approaches to assessing auscultation skills, and together discuss the questions of determining the respective added value of the different approaches.

Results: We propose that every approach has its own pros and cons.

Discussion: We propose that hybrid simulation and technological advances offer new possibilities and approaches in the assessment of clinical skills and the choice of approach needs careful consideration.