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Example of using iPax and Kikuzo at Nagasaki International University Faculty of Pharmaceutical Sciences

The Faculty of Pharmaceutical Sciences at Nagasaki International University has been focusing on physical assessment education. Previously, training was centered on mannequins, but since last year they have been using our iPax and Kikuzo for auscultation training and exams.

Photo provided by: Professor Kosuke Kanda, Faculty of Pharmaceutical Sciences, Nagasaki International University

Using the iPax, you can practice listening to sounds by operating the chest piece on the computer screen, and you can also take quizzes and tests (Photo 1). This time, they used the “auscultation site recording function” (Photo 2) to record the areas that students auscultated.

Exercises and self-study from mid-September 2023
Final exam: Mid-October 2023

iPax screen and recording screen of auscultation:

Photo 1 Screen of lung sound test using iPax
Listen to the lung sounds at the area to be auscultated and choose an answer from the options.

Photo 2 Recording screen of auscultation site
The place where the stethoscope was stopped will be marked according to the number of seconds.
Each student’s data is saved on the admin page and can be viewed by the admin at any time.

iPax screen and recording screen of auscultation:Comment from Professor Kosuke Kanda
At Nagasaki International University, physical assessment exercises were conducted using mannequins. However,

the number of mannequins was small and each student’s training time was limited to a short time, which caused problems in establishing skills. To compensate for this, we have introduced iPax and Kikuzo. This year, we used the “auscultation site recording function” added to the iPax to visually understand the students’ auscultation sites, which we used for post-practice debriefing and skill tests. This is a great feature that allows me to give detailed instructions to each student. I feel that the students’ auscultation skills have improved. I have also heard that these functions will be expanded to include linking with test results, making it even more convenient. We hope that it will be widely used in pharmaceutical education.

Comments from students at Nagasaki International University, physical assessment exercises
I used iPax and Kikuzo in the physical assessment practice. It was really fun

to move the stethoscope icon to find where the abnormality was, and listen to the difference between normal and abnormal heart and lung sounds. I was familiar with words such as “fine crackles” and “coarse crackles” as characteristics of the disease, but this was the first time I had heard the actual sound, so I really learned a lot. There were some auscultation sounds that were difficult to distinguish, but it was easy to understand because the characteristics of the sounds were listed, and it was also good that I was able to check the quizzes many times on the quiz page.

Example of using iPax at a Respiratory seminar

Below is one example of using iPax and Kikuzo.

This time, the iPax quiz was used at the respiratory seminar for residents (held on July 8, 2023). We received comments from Dr. Hiroyuki Minemura, Department of Pulmonary Medicine, Fukushima Medical University.

Impressions using iPax:

Thanks to iPax, we were able to successfully complete the respiratory seminar this time.

1) I thought that the students’ understanding would be deepened if there was an explanation (basis) of the correct and incorrect answers for the quiz. Information such as the age, sex, and history of current illness of the case patient will make it easier for students to find the sound. I think this point should also be considered.
2) I think good that it can be used anywhere as long as there is a PC and internet environment.
3) I thought the sound quality of the lung sounds was good, but on the other hand, some people said that it was slightly different from the actual auscultation of the human body.

Comment from Telemedica:
There are two types of iPax lung sounds. One is for basic auscultation education and the other is for clinical education.

The former is a content that has been edited so that only one type of adventitious sounds can be heard for use in the education of medical and nursing students. In actual cases, there are many cases where multiple adventitious sounds are heard at the same time. But in teaching students, it is easier to understand if the sounds are simple.
On the other hand, from the point of view of clinical education, it would be more effective to hear like an actual patient. Therefore, iPax also has adventitious sounds (patterns in which multiple adventitious sounds are heard at the same time) collected from real cases. In that case, X-rays and CT images are also set.
We are currently increasing the number of such cases, so please look forward to future real-life case quizzes.

Evaluation of iPax at a hands-on session of the Japan Society of Early Mobilization

In a hands-on session of the Japan Society of Early Mobilization (June 24, 2023), iPax was used.

Mr. Tomoya Kuroda, who served as a lecturer, gave us his impressions of iPax, so we will introduce it below.


The lecture was very well received. Thank you very much.

We asked the participants to actually listen to the sound and confirm the difference between normal and abnormal sounds and the difference in sound depending on the part.Due to the sound equipment at the venue, we had a problem with not being able to make loud noises, but since it was a seminar with a small number of people, we were able to finish without any major problems.

Q: How did you feel about the iPax you used this time from the instructor's point of view? Please tell us about the advantages and disadvantages compared to conventional teaching materials and simulators.

A: With iPax, you can hear the sound of the part where you move the stethoscope on the screen, so it was very realistic and popular. It was difficult to hear the breath sounds in the part where I wanted to hear the sound (middle precordial lobe), and it was sometimes difficult whether it was our clumsiness or a problem with the system.

Comment from Telemedica:

In iPax, vesicular sounds are set near the middle precordial lobe. This sound is difficult to hear because it has a lower pitch and volume than tracheal breath sounds and bronchial breath sounds. When outputting the iPax auscultation sound played on a computer to the venue, the sound will be louder if it is output to speakers that support deep bass through an amplifier. Or use Kikuzo to share auscultatory sounds without the need for a large sound system.

(The following is a reference photo when I used Kikuzo in another seminar). I would appreciate it if you could refer to it.

(Photo 1) Distribute the sound using 5 Kikuzo units (using a commercially available distributor)

(Photo 2) Outputting iPax images to a large monitor and listening to the sound on the distributed Kikuzo

(Photo 3) One PC monitor and one Kikuzo set each

If you ask the participants to solve the quiz, use this setting to give feedback.

Q: What was iPax like from the participants’ point of view? Please tell us about the advantages and disadvantages of the comparison with conventional teaching materials.

A: The participants expressed their surprise at this as a new product. It seems that it was interesting to use it from an educational point of view.

Comment from Telemedica : Thank you. At other academic societies, when we exhibited iPax as a company, we received similar opinions. Please see below.

Survey from other academic society(n=141)

Extremely satisfied 71%
Satisfied 21%
Neither 6%
Slightly dissatisfied 1%
Dissatisfied 1%
  • Comments received in the questionnaire

●Looks good for education
●Because I am interested in other questions
●It was interesting
●For education, etc. Education is important.
●I want to use it for trainee guidance
●This is an unprecedented method as training for observations that are rarely involved.
●Using a stethoscope gives the tension of a real situation
●A new way of learning. Can be used in group discussions and conferences
●Never-before-seen content
●Can be shared by multiple
●For self-study, conferences and group discussions
●Repeated practice leads to improvement of diagnostic skills
●We don’t usually have this kind of opportunity.

Cardiovascular Specialist Nurse Training , Using iPax and Kikuzo

A training course for nurses specializing in cardiology was held by Japanese Educational Clinical Cardiology Society (JECCS), using iPax and Kikuzo. The instructor was Dr. Masaya Kino, Chairman of JECCS, who explained how to distinguish between S1 and S2, and how S3 and S4 are generated, and it was impressive to see the students listening intently to the Kikuzo and nodding their heads.

iPax-QR codes about aortic stenosis were also distributed at the meeting. It was very well received.

February 25, 2023

Department of Rehabilitation, Kitasato University School of Allied Health Sciences

Practical training in the Department of Physical Therapy using iPax and Kikuzo

Professor Kentaro Kamiya conducted auscultation exercises using iPax and Kikuzo for 47 third-year students of the Department of Rehabilitation, Kitasato university School of Allied Health Sciences.

In the past, training has been conducted using only one cardiology mannequin simulator, but it was not sufficient to ensure that all students received auscultation practice. So this time, we used iPax and kikuzo for the class.

Professor Kamiya praised the iPax and kikuzo, saying, “The iPax and kikuzo are convenient to carry, have good sound quality, and can even be used for palpation of the pulse. In addition, he evaluated, “Since it is possible to ‘share sounds’, which has been difficult until now, we can expect high-quality education.”

December 6,2022

Dr. Takeshi Saraya, Kyorin University

Pulmonary Auscultation Educational Seminar using iPax

Lung sounds (recordings) of actual cases of bronchiectasis and drug-induced pneumonia were loaded onto iPax and used in educational seminar ( the lecturer, Dr. T. Saraya, Department of Respiratory Medicine, Kyorin University). As a first try, some QR codes were given to the participants, which were highly appreciated.

December 4, 2022

Koyo high school nursing course

Blood pressure measurement exercise with iPax : Two students practice auscultation and palpation at the same time

Koyo High School / Nursing Course

A pair of students are doing blood pressure measurement exercises. This is an example of using a blood pressure monitor to read each other’s answers.

The answers were completely different from each other, and they said, “Teacher, we want to do it again!” This is an example of a very lively exercise.

The academic advisor also evaluated, “Using iPax allows students to participate in the exercises enthusiastically. It is a wonderful simulator with a high educational effect.” December 2021


Trial by a US cardiologist

iPax report : Telemedica’s US deployment update

Dr. Rakesh Shah, a cardiologist at the St. Mary Medical Center in the suburbs of Philadelphia, Pennsylvania, tried auditioning Telemedica’s auscultation e-learning systems iPax and Kikuzo.Dr. Shah replyed “I think this system can bring benefits to medical students and medical professionals as a tool for practicing auscultation, and has great potential to help improve auscultation diagnostic skills in the United States.” We were also impressed that he nodded a lot during the audition, saying “the sound is very natural”.We will have Dr. Shah and his hospital cardiologist evaluate it in detail and use the results as a reference for our future expansion into the United States.

Quote:US consultant  February 2022

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