Harvey and murmurs

February 27, 2020

We had two Harvey teaching sessions this week, which I found to be incredibly valuable to my learning. Harvey functions as a high-fidelity simulator, which can be applied to teaching the cardiac physical exam. Learning in a small group with a facilitator to walk us through the different murmurs and then applying it to difference case scenarios really allowed me conceptualize murmurs.

I was really surprised by how much I retained from these Harvey sessions. During my cardiology clinic, I was able to appreciate a few murmurs including physiological S2 and severe regurgitation. I was also able to apply my knowledge in differentiating the different types of murmurs.

I would say that the 2 main ones that I focused on were:
1) aortic stenosis: systolic murmur, aortic area, crescendo-decrescendo, radiates to clavicles
2) mitral regurgitation: systolic murmur, holosystolic, radiates to axilla


I spent some time reading the literature around Harvey as a teaching tool. Interestingly, the article by Humphrey-Murto (2019) suggests that there are no differences between using Harvey and a standardized patient (SP) in teaching medical students physical examination skills but that the SP group had an improved ability at coming to a unifying diagnosis. Personally, I think that using both SP and Harvey would be of great value to medical students. I think it would be challenging to be able to get SPs for all the different types of murmurs that Harvey is able to reproduce. There are limitations to Harvey however that one must acknowledge and that it does not replace real life experiences.

-JT-

Reference(s):
Gauthier, N., Johnson, C., Stadnick, E., Keenan, M., Wood, T., Sostok, M., & Humphrey-Murto, S. (2019). Does Cardiac Physical Exam Teaching Using a Cardiac Simulator Improve Medical Students’ Diagnostic Skills?. Cureus, 11(5).