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Effect of Psychoacoustic Learning on Cardiac Auscultation Proficiency in Nurse Practitioner Students

Cyphers, Natalie A., PhD, RN; Mest, Carol G., PhD, RN, ANP-BC; Doyle-Tadduni, Mary Elizabeth, PhD, MBA, RN

doi: 10.1097/NNE.0000000000000585
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Background Assessment is a vital role of all nurses, yet cardiac murmur identification remains difficult for students. Cardiac auscultation is a technical, not intellectual, skill, and a psychoacoustic approach to learning is recommended. A psychoacoustic approach involves repetition of cardiac sounds to facilitate auditory perceptual learning.

Purpose The purpose of this study was to determine the effectiveness of a psychoacoustic learning modality for identification of cardiac murmurs by nurse practitioner (NP) students.

Methods A repeated-measures design was used. Following a pretest, NP students listened to repetitions of heart sounds, then took a posttest. Students were instructed to listen to the heart sounds weekly, then given posttests at 1 and 3 months.

Results All posttest scores were higher than pretest scores; no significant difference in scores was noted between posttests.

Conclusions Psychoacoustic learning may improve cardiac assessment. Further research is recommended with prelicensure nursing and NP students.

Author Affiliations: Assistant Professor (Dr Cyphers), Professor (Dr Mest), and Associate Professor (Dr Doyle-Tadduni), Department of Nursing and Health, DeSales University, Center Valley, Pennsylvania.

This research was funded by a grant provided by Pennsylvania Higher Education Nursing Schools Association.

The authors declare no conflicts of interest.

Correspondence: Dr Cyphers, Department of Nursing and Health, 2755 Station Ave, Center Valley, PA 18034 (

Accepted for publication: June 12, 2018

Published ahead of print: August 21, 2018

Cite this article as: Cyphers NA, Mest CG, Doyle-Tadduni ME. Effect of psychoacoustic learning on cardiac auscultation proficiency in nurse practitioner students. Nurse Educ. 2019;44(2):79–83. doi: 10.1097/NNE.0000000000000585

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