Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May 29:16:10904.
doi: 10.15766/mep_2374-8265.10904.

The Murmur Online Learning Experience (MOLE) Curriculum Improves Medical Students' Ability to Correctly Identify Cardiac Murmurs

Juliette E Power  1 , Lorrel E B Toft  2 , Michael Barrett  3
Affiliations

The Murmur Online Learning Experience (MOLE) Curriculum Improves Medical Students' Ability to Correctly Identify Cardiac Murmurs

Juliette E Power et al. MedEdPORTAL. .

Abstract

Introduction: Physical examination skills are receiving less attention in curricula and clinical practice, being supplanted by imaging and other technologies. We developed an online module to introduce auscultation of common cardiac murmurs to second-year medical students.

Methods: The Murmur Online Learning Experience (MOLE) curriculum focused on nine common, unique, or highly testable cardiac murmurs, chosen collaboratively by the authors. The curriculum consisted of (1) a nine-item multiple-choice pretest containing a clinical vignette, a photo of stethoscope location, and an auditory clip; (2) nine modules each containing a several-minute-long auditory clip and a written description (location, quality, radiation, change with exam maneuvers); and (3) a nine-item multiple-choice posttest, identical to the pretest but randomly ordered. All second-year medical students at the University of Louisville were given access to MOLE during their cardiovascular curriculum and given an incentive to complete the ungraded activity.

Results: One hundred forty-seven (91.8%) students voluntarily completed the pretest and posttest. The mean pretest score was 3.76 out of 9 (SD = 1.77). The mean posttest score was 7.14 out of 9 (SD = 1.78). Paired t-test results demonstrated a p value of <.001.

Discussion: An online murmur curriculum consisting of repetitive auditory murmurs and narrative description of murmurs improved second-year medical students' ability to correctly identify common cardiac murmurs. This method of learning murmurs via online curriculum is a practical and effective way to hone students' physical exam skills in the modern era.

Keywords: Auscultation; Cardiac; Friction Rub; Heart; Hypertrophic Cardiomyopathy; Murmur; Patent Ductus Arteriosis; Regurgitation; Stenosis; Ventricular Septal Defect.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Change in pretest and posttest scores.
Figure 2.
Figure 2.. Change in student score versus time spent on module.
See this image and copyright information in PMC

References

    1. Mangione S, Nieman LZ, Gracely E, Kaye D. The teaching and practice of cardiac auscultation during internal medicine and cardiology training: a nationwide survey. Ann Intern Med. 1993;119(1):47–54. 10.7326/0003-4819-119-1-199307010-00009 - DOI - PubMed
    1. Roy D, Sargeant J, Gray J, Hoyt B, Allen M, Fleming M. Helping family physicians improve their cardiac auscultation skills with an interactive CD-ROM. J Contin Educ Health Prof. 2002;22(3):152–159. 10.1002/chp.1340220304 - DOI - PubMed
    1. Elder A, Japp A, Verghese A. How valuable is physical examination of the cardiovascular system? BMJ. 2016;354:i3309. 10.1136/bmj.i3309 - DOI - PubMed
    1. Tavel ME. Cardiac auscultation: a glorious past—but does it have a future? Circulation. 1996;93:1250–1253. 10.1161/01.CIR.93.6.1250 - DOI - PubMed
    1. Shams L, Seitz AR. . Benefits of multisensory learning. Trends Cogn Sci. 2008;12(11):411–417. 10.1016/j.tics.2008.07.006 - DOI - PubMed

LinkOut - more resources