Setting defensible standards for cardiac auscultation skills in medical students

Diane B. Wayne, John Butter, Elaine R. Cohen, William C. McGaghie

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


BACKGROUND: Cardiac auscultation is a critical clinical skill for physicians, but minimum performance standards do not exist. METHOD: One hundred third-year medical students from three schools completed a case-based computerized examination that assessed their ability to identify 12 major cardiac findings. Cohort performance was reviewed by a panel of expert judges who provided item-based (Angoff method) and group-based (Hofstee method) judgments on two occasions. Judges' ratings were used to calculate a minimum passing standard (MPS) for cardiac auscultation skills. Interrater reliabilities and test-retest reliability (stability) were calculated. RESULTS: Both methods produced reliable and stable data. Use of the Angoff method yielded a more lenient MPS than the Hofstee method. Two thirds of the students (66%) did not achieve the MPS. CONCLUSIONS: Use of a defensible standard allows for reliable evaluation of cardiac auscultation skills. Further work is needed to improve the performance of this important clinical skill by medical students.

Original languageEnglish (US)
Pages (from-to)S94-S96
JournalAcademic Medicine
Issue numberSUPPL. 10
StatePublished - Oct 2009

ASJC Scopus subject areas

  • Education


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