P2.005: Little Heart Sounds: A Pediatric Auscultation Curriculum for Medical Students

Background: Cardiac murmurs are one of the most common conditions cited for cardiology referral in children. The ability to differentiate between benign and pathologic murmurs is a vital skill for physicians who care for children. However, it is well-documented that auscultation skills remain poor in medical trainees across the country. A needs assessment survey, completed by 100 third and fourth year medical students at our institution, noted lack of confidence and exposure to proper teaching resources that target pediatric cardiac auscultation. Efforts to improve cardiac auscultation training include audio databases, mannequin trainers, and virtual reality modules, yet many of these resources do not target pediatric-specific auscultation findings.

The purpose of the Little Heart Sounds (LHS) curriculum was to create an efficient and effective self-paced learning tool for pediatric cardiac auscultation. With this case-based education module, we aimed to increase medical student confidence in pediatric cardiac auscultation and identification of pathologic and benign murmurs.

Methods: The curriculum was created using Qualtrics and provides teaching on basic auscultation skills, the physiology of common pediatric murmurs, along with audio recordings of murmurs obtained from patients evaluated in pediatric cardiology clinics. The murmurs were selected based on a survey completed by 25 senior faculty. The current target population is medical students in their clinical year during their core pediatric clerkship. The module also includes pre- and post-survey assessments, as well as opportunities to provide feedback on the curriculum. Following data collected from a pilot study, LHS is now a requirement for the completion of the core clinical pediatric clerkship at our institution for the 2024-2025 academic year.

Results: Currently, three cohorts of students have completed the LHS curriculum, totaling 53 students between September 2024 and February 2025. Following a Descriptive Statistical Analysis, there was a statistically significant increase in posttest scores (3.08/5) compared to pretest scores (1.77/5, p < 0.001). The vast majority of students (50/53 - 94.3%) agreed that this module should remain a requirement for the core pediatric clerkship. The qualitative portion of the assessment tool noted several areas of strength including the quality of the audio recordings as well as providing a standardized approach to auscultation. Areas for improvement included expanding explanations for the assessment answers, expanding the basic auscultation information, and providing the ability to slow the audio recordings.

Conclusion: We created and implemented a high-quality self-paced educational curriculum, LHS, to teach medical students about benign and pathologic pediatric auscultation findings utilizing audio recordings from actual patients. Future directions include adding additional audio recordings, and creating a website to allow for easy access to review specific auscultation findings at a later time. As we continue to refine the LHS curriculum, we also hope to expand its availability to learners beyond our own institution.