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

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.

Racial disparities in emergency medicine: Implementation of a novel educational module in the emergency medicine clerkship

“…We chose a multiple‐choice test as our assessment modality to measure change in medical knowledge on the topic of RD pre‐ and postimplementation. This modality has been used previously to measure this competency in medical education curricular developements 22–24 . Students took the test prior to and 2 weeks after completing the module to assess for improvement and retention in knowledge.…”

“…This modality has been used previously to measure this competency in medical education curricular developements. [22][23][24] Students took the test prior to and 2 weeks after completing the module to assess for improvement and retention in knowledge. They were asked to include a unique identifier to pair their responses for data analysis.…”

The Effectiveness of Different Teaching Modalities for the Detection of Heart Murmurs in Undergraduate Medical Education: A Review

“…Cardiac auscultation via stethoscope is the most common method of educating undergraduate medical students on how to listen to heart sounds [ 6 ]. Medical students are taught during the pre-clinical years of medical school the appropriate landmarks for auscultation on the patient during a cardiac exam.…”

“…Medical students are taught during the pre-clinical years of medical school the appropriate landmarks for auscultation on the patient during a cardiac exam. This optimizes the volume and quality of the various heart sounds to detect abnormalities in patients who may have cardiac valvular disease [ 6 ]. Students also acquire the knowledge necessary to differentiate heart murmurs by various means, which may include listening to various recordings of heart tones.…”

“…In 2020, Power, Toft and Barrett studied the effectiveness of this program, which included 147 second-year medical students who were given a pretest, online learning modules, and a posttest evaluating their ability to identify murmurs. With a mean pretest score of 3.76 out of 9 and a mean posttest score of 7.14 out of 9, the authors concluded that the repetitive and descriptive nature of the online learning modules was an effective method of teaching medical students how to identify various types of heart murmurs [ 6 ].…”