49. IMPLEMENTATION AND UTILITY OF A PHONE-BASED APPLICATION FOR TEACHING AUSCULTATION SKILLS TO INCOMING PEDIATRIC CARDIOLOGY FELLOWS

Background Mastery of cardiac auscultation is a core component of cardiology training. New computer-based auscultation teaching tools have been developed to help teach this skill to trainees. OBJECTIVE: To assess incoming pediatric cardiology fellows’ auscultation skills and evaluate a phone-based application (app) to teach auscultation. Methods At the annual national Pediatric Cardiology Fellows’ Boot Camp at Stanford, the eMurmur© app was utilized to teach core auscultation skills to incoming pediatric cardiology fellows. In groups of 5 trainees each, attendees were taught basic auscultation skills in 30-minute blocks. Auscultation teaching centered around distinguishing innocent (INN) vs pathological murmurs (PATH) and focused on key diagnoses and murmurs most frequently encountered by pediatric cardiologists. Pre- and post-training assessments and surveys [Likert scoring 1-5] were administered to all attendees and were analyzed via paired t-test and sign rank test. Results A total of 40 incoming cardiology fellows from 35 training programs attended the Boot Camp at Stanford University in Palo Alto, CA from June 1-3, 2019. All trainees completed the pre- and post-training assessments. Prior to the course, trainees were less likely to correctly distinguish innocent murmurs vs. pathologic murmurs (INN 77 ± 26 % vs. PATH 92 ± 11%; p = 0.001). 73% of trainees reported the auscultation session improved their auscultation skills. Though there was no difference in overall test scores (PRE 82 ± 16% vs. POST 85 ± 17%; p = 0.13), after the training the trainees’ self-reported comfort in identifying the auscultatory findings for the most common lesions seen in pediatric cardiology were higher (PRE 3.3 ± 0.9 vs. POST 3.8 ± 0.8; p = 0.03). Comfort scores improved most for distinguishing systolic vs. diastolic murmurs (PRE 3.7 ± 0.7 vs. POST 4.1 ± 0.6 POST; p = 0.05) and gallops (PRE 3.3 ± 0.09 POST 3.8 ± 0.7; p = 0.005). Conclusions The use of an app-based teaching tool is an effective method to teach auscultation skills to incoming pediatric cardiology fellows. The app can improve fellows’ comfort with identifying the most common lesions seen in pediatric cardiology.