I truly enjoy this stethoscope, it's served me very well in my clinicals, and I'll continue to use it in my nursing practice. Picking up faint heart and lung sounds is effortless, and the single bell design is simple and convenient. Patients never complain that the bell feels cold on their skin. I'm giving this stethoscope five stars, but if you're thinking about purchasing one yourself, you should know that the tubing is pretty sticky, and tends to collect more than its fair share of dust and lint. This feature hasn't been a concern to me, because it only encourages frequent cleaning between patients. Also, if you prefer to wear it across the back of your neck, know that the 'stickiness' takes some getting used to against your skin. That's why I normally carry mine in my pocket :D