Trust & Learning Cardiac Assessment
BU Researchers Find that New Curriculum’s Focus on Patient Trust Makes Learning Bedside Cardiac Assessment Meaningful
“Researchers used an educational approach in which the process of learning was seen as meaningful, not just learning isolated facts or skills.”
(Boston) — The patient–doctor relationship is built on trust—not only in a doctor’s knowledge and skills, but in their attitudes. Over time, medical education has focused on trainees becoming “entrustable” to carry out critical tasks with confidence and care.
In a new study published in Advances in Medical Education and Practice, researchers from Boston University Chobanian & Avedisian School of Medicine explored how medical students learned about trust while mastering bedside cardiac assessment.
The two-year study included 268 students across four medical schools, including BU. Funded in part by a BUMC Faculty Development Committee grant, the curriculum was built to blend humility, trust, and technical skills into the students’ training.
“There was something we couldn’t quite put our hands on about the way we were teaching bedside cardiac assessment,” said James Meisel, MD, MHPE. “We realized that knowledge, skills, and attitudes worked together. And that’s what we endeavored to teach.”
Students were encouraged to ask themselves: “Why should I trust your clinical skills?” before even using a stethoscope. The idea: listen to the patient first, learn their story, then apply a structured six-step approach to cardiac assessment.
The curriculum incorporated short videos, simulated patient interactions, and diagnostic reasoning activities—all focused on patient-centered communication and professional identity formation.
After participating in two class sessions, 67 BU students submitted written reflections. Themes emerged around learning through peer interaction, hands-on practice, and the value of humility. Students described how these elements made them more confident and compassionate future physicians.
“The bedside cardiac assessment curriculum taught humility alongside hard clinical skills,” said Meisel. “This helps students see themselves as trustworthy professionals.”
The researchers argue that this new curriculum encourages the development of “confident humility,” a characteristic emphasized by the Coalition for Physician Accountability for med school graduates entering residency.
“Our hope is that the key takeaway from this work is that humility, patient centeredness, and opportunities for professional identity formation are recognized at every level of health professions education,” Meisel said.
He added that the study’s relatively small sample size limits some conclusions but believes the findings can stimulate broader conversations around trust and professionalism in clinical training.
Explore the full curriculum: Bedside Cardiac Assessment Curriculum on OpenBU
Other BU contributors: Sheilah Bernard, MD, Hugo Carmona, MD, and the late Gail March Cohen, PhD.