MURMURQUIZ: A TOOL FOR CARDIAC AUSCULTATION TRAINING AND EVALUATION

Abstract

Background: Echocardiography has caused a decline in cardiac auscultation (CA) skills. Medical school curricula spend less time on this, with students diagnosing a murmur in ~20% of cases. Proficiency doesn't improve in residency. Current resources use digitally created sounds, which are unnatural and don't capture subtle variations in patients. We previously created a large database, murmurLab.org, of recorded patient heart sounds (HS) with associated diagnoses, echos, and other clinical information, which MurmurQuiz.org (MQ) uses to create a novel educational tool. Methods: In MQ each case addresses fundamental aspects of CA. The user auscultates locations on the chest, selects basic maneuvers, and listens using the bell or diaphragm, similar to examining a patient. MQ is designed to test both skill, identifying abnormal HS, and knowledge, associating the HS description with the echo. Users track progress and compare to others. Results: MQ launched February 2016 and has 900+ users. The correct HS descriptions and echo diagnoses are selected in ~50% of cases. Users identifying as medical students perform better than residents, but fellows score better than both (Figure 1). Conclusions: MQ allows trainees to develop and test CA skills using HS from real patients. Early data suggests greater accuracy than previously reported. MQ will enhance training and be an adjunct to other resources, use at different training levels may provide insight for creating standardized questions on certification boards.