Miguel Silva*, School of Health Sciences, University of Minho, Braga, Portugal Damião Cunha, School of Health Sciences, University of Minho, Porto, Portugal Olga Azevedo, Cardiology Department, Centro Hospitalar Alto Ave, Guimarães, Portugal Ana Luísa Neves, Pediatric Cardiology Department, Hospital São João, Porto, Portugal Track: Practice Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Rapid-Fire Presentation Submission Type: Single Presentation Building: Mermaid Room: Room 2 - Aldgate/Bishopsgate Date: 2013-09-23 02:00 PM – 03:30 PM Last modified: 2013-09-25

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Cardiac auscultation is going through some serious difficulties. Its relevance in clinical practice is at stake, partly because of the imposing force of echocardiography in the diagnosis of cardiac disease, but also because of its progressive neglect in medical education. The latter is well reflected in the form of abysmal results in knowledge tests, as reported in various notable studies. Nevertheless, echocardiography has important limitations and the cost-benefit of using cardiac auscultation still presents too much of an advantage to simply be ignored.

Unfortunately, in regards to education, most of the existing tools for teaching cardiac auscultation are flawed in several ways. These often resort to simulated sounds instead of actual recordings of patients (which are harder and time-consuming to obtain), have inexistent or very limited interactivity and haven’t managed to keep up with the wealth of multimedia resources and devices that are available nowadays. More importantly, however, there just seems to be something missing from the typical teaching paradigm that goes beyond memorizing a handful of murmurs.

We wish to present an innovative cardiac auscultation education app, called Auscultation Master: Heart Sounds Edition (http://auscultationmaster.com), which was specially built for Apple’s mobile devices, the iPhone and the iPad.

This app makes use of a carefully curated library of auscultation recordings of actual patients with relevant and confirmed heart pathology, obtained with a digital stethoscope. Each recording is visually supported by an animated phonocardiogram and a video of an echocardiogram or cardiac MRI from the same patient, all precisely synchronized together. This allows for an impressive and didactic visualization of the pathophysiological correlates involved in the production of the abnormal sounds.
Reducing the rate of playback is allowed, making it easier to perceive the different components of a sound. We also make it possible to swiftly compare pathological sounds chosen for their apparent similarity.
On a different section of the app, we provide the ability to switch between variants of the same pathology, as recorded from different patients, satisfying more advanced users.
Learning can be initiated with the help of a concise and deeply interactive tutorial and the knowledge attained throughout the app can be put to the test with 3 different types of quizzes.

The app has impressive production values and is presented in a minimal, clean and easy to use interface.

A degree of interaction and visual immersion like this one has no precedents in the teaching of cardiac auscultation and can be the paradigm shift needed to revive this so important physical exam technique.