Does Cardiac Physical Exam Teaching Using a Cardiac Simulator Improve Medical Students' Diagnostic Skills?

Background Challenges in bedside teaching may be overcome by the use of high-fidelity simulators for teaching the cardiac physical exam. The purpose of this study is to compare the ability of first-year medical students (MS1) to perform a cardiac physical exam and make the correct diagnosis after instruction using standardized patients (SPs) as compared to a cardiac simulator (Harvey, Laerdal Medical Corporation, NY, US). Methods Thirty-two MS1 were randomized to a teaching module on either SPs or Harvey.

Paging the eCardiologist: insights into referral behaviour of primary care physicians from qualitative analysis of a cardiology eConsult service.

Objective: The purpose of this study is to investigate determinants of primary care physician cardiology referrals by performing qualitative analysis of questions asked by primary care physicians in cardiology electronic consultation services (eConsults).

Setting: A health region in eastern Ontario, Canada, where primary care providers have had access to an eConsult service since 2010.

Participants: We included all consecutive cardiology eConsults initiated by registered primary care provider users of our eConsult service and who initiated one or more eConsult between July 2014 and January 2015.

New therapies in acute decompensated heart failure.

Purpose Of Review: Hospitalization and mortality rates associated with heart failure are persistently high. This is due partly to aging of the population but mostly to delayed progress in the pharmacological treatment of decompensated heart failure. We will review the current recommendations and most recent advancement in the pharmacological treatment of acute decompensated heart failure while providing a systematic approach to the management of this prevalent condition.

Sleep apnea in chronic heart failure.

Purpose Of Review: As heart failure continues to carry significant morbidity and mortality it is crucial to pursue new lines of therapy. Addressing sleep apnea, which is highly prevalent in these patients, offers just such an avenue. We discuss how sleep apnea may contribute to the propagation of heart failure, and how understanding its effects and reversing these effects might benefit heart failure patients.

Percutaneous coronary intervention for left main coronary artery disease.

Coronary artery bypass surgery is the currently accepted treatment for unprotected left main coronary artery disease. Currently, the data supporting the safety and efficacy of stents for unprotected left main coronary disease are derived mostly from nonrandomized, single-center studies or registries. These results appear promising but large randomized trials are needed to guide therapy of this potentially lethal disease.