Journal of the American Medical Association Review
An assortment of pulmonary physicians at various levels of expertise and computer literacy tested Learning Lung Sounds from Stethographics, Inc for this review.
The product is delivered on a self launching CD-ROM. Once the CD is placed in the drive, the product launches automatically to a home page with easy and intuitive navigation. No downloads or installations were required on the five different computers it was tested on, which were sound card enabled, Pentium 3 PCs with Windows 95, 98, Me, XP, 2000, and NT. The instructions are clear but minimal and could provide more depth for different types of student user on how to derive maximal benefit from the CD. The course is clearly divided into four sections: Introduction, Common Lung Sounds, Sound Patterns, and Cases.
In Common Lung Sounds, sounds are described and time amplitude plots are displayed, with convenient buttons for listening. Sound quality is good via computer speakers but exponentially more realistic with a $10 dollar headset. Narrative description allows one to listen to sounds as text is read. This and color coded graphics make comprehending sounds simple. A concise chart of description, location, and commonly associated conditions would have enhanced the content. A description of the stethoscope, with a note on bell vs diaphragm and hints for optimal use, would also have been valuable for the beginner.
The Sound Patterns section is very helpful for understanding sounds associated with different diseases. Sound patterns are illustrated with tracings of actual patients, recorded using a multichannel lung sound analyzer. The graphic displays of sounds at different locations on the chest show how sounds are distributed in various disease processes. This distribution is further clarified by a unique three-dimensional graphic animation with superimposed lung sounds. This 3-D Model animation is a unique innovation in education on lung sounds.
The cases are simple and easy to understand. At or beyond the resident level, the diagnosis will be evident from the history. The illustrations of sound patterns will bias the student to auscultate abnormal areas. It might be better not to display the graphics initially, so that students could auscultate the whole chest and form an opinion before seeing the sound distribution.
As mentioned, the product misses the chance to teach proper use of the stethoscope for optimizing examination of the patient. Given the expertise and technological assets of the company, its staff, and its other products, we were disappointed that it does not feature information on use of an electronic stethoscope for the medical record, in telemedicine consultation, or in interpretation with the phonocardiogram and a handheld computer. These drawbacks noted, the reviewers strongly recommend the product as an excellent resource for self-paced or instructor-led instruction on breath sounds. It far exceeds other efforts in sound quality, graphics, and simplicity of use. It is well worth the money for allied health professionals, medical students, and residents struggling with interpretation of sounds in the chest. We would encourage the student to purchase a two-ear headset to allow close approximation of actual stethoscopy. The product illustrates subtleties of breath sounds that we a fellow in pulmonary medicine and a clinician with 20 years of practice had not previously appreciated. For price, ease of use, and interest, the Learning Lung Sounds CD is well worth the time and money and is highly recommended.
Rehan Haque, MD, Reviewer
Pennsylvania State University
Milton S. Hershey Medical Center
--Journal of the American Medical Association Review
Among the many guidelines and targets that make general practice what it is today, there is little to test the art of using a stethoscope. So, a tool to help teach and polish this skill should be welcomed.
As a technophobe it was with some trepidation that I set out to install an interactive multimedia program. Happily, even for me, it was simple: the CD goes in and the program uses the computer s web browser to run the software strait away, on either a PC or a Mac.
The program is easy to negotiate. You can complete it in bite-size chunks, meaning you can easily nip out in the middle for a cup of tea ( or even for house call) without having to start at the beginning again.
You achieve the best quality if you plug in dedicated speakers or use headphones, but I managed perfectly with my computer s inbuilt speakers.
If you computer make a beep when you click on an icon, you need to switch this feature off. After that you can relax and listen to the gentle whooshing of aortic regurgitation to your heart s content, while watching visual images of the auditory information being presented.
Until I used this CD, I was not convinced I had ever heard mitral stenosis. It is easier when systole and diastole are mapped out in front of you.
The interactive part works best in the lung section. My 18-month-old son paused from the deep concentration required for coloring the flowers on my wall paper to wonder at the deep wheezes emanating from my computer. There are 16 different areas of the chest to listen to.
You can absorb as much physiology as you feel comfortable with. if it is enough to be reminded which valve close in lub, and which in dub, you will be happy. But if you lie awake pondering the significance of a reversed split-second heart sound you heard, you will also rest easy after this CD.
Because it is from the US, the program features one or two American terms. There are also clinical cases but only in the lung section. I would have liked them in the other section.
If you like using the stethoscope, you will enjoy this CD, and if you are not confident, it will certainly help.
I found it relaxing to listen to the gentle lub dub of a heart ticking along, it will not stop the patient talking, but it will help you concentrate hard next time you listen.
Dr. Lackey is a GP registrar in Hexham, Northumberland
GPNet 57, 17 March 2003