Editor:
Michael J. Barrett, MD, FACC

Nurse Planner:
Chris Owen, MS, ACNP-BC, RNFA, AACC

Peer Reviewers:
Michelle M. Kittleson, MD, FACC
Ralph J. Verdino, MD, FACC

Date of Release: 3/15/2019
Date of Last Review: 3/26/2025
Date of Expiration: 3/25/2028

Target Audience:
The target audience includes any healthcare professional interested in improving their cardiac auscultation skills.

Learning Objectives:
Upon completion of Heart Songs 5, members of the cardiovascular care team including, but not limited to, physicians, nurses, nurse practitioners, and PAs will be able to demonstrate improved recognition and differentiation of:

• Basic heart sounds including third, fourth sounds, summation gallops and pericardial rubs.
• Essential diagnostic heart sounds/murmurs including hypertrophic cardiomyopathy and mitral valve prolapse.
• Expert heart murmurs including aortic/mitral stenosis and regurgitation.
• Heart sounds associated with congenital disorders including atrial and ventricular septal defects.

This program is available online and includes the following:

• Streaming Video of Each Heart Sound
• Downloadable Versions of Each Video
• Interactive Pre- and Posttests

Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the American College of Cardiology Foundation (ACCF). ACCF is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians
The ACCF designates this enduring material for a maximum of 13 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM Maintenance of Certification
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 13 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Once your MOC claim is submitted to the ACCME no modifications can be made to your overall credit claim. Participants can claim credit only once.

Nurses
The ACCF designates this activity for 13 CNE contact hours. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

Interprofessional Continuing Education (ICPE) Credit
This activity was planned by and for the healthcare team, and learners will receive 13 credits provided by ACCF Interprofessional Continuing Education (IPCE) credits for learning and change.

While offering the credits noted above, this activity is not intended to provide extensive training or certification in the field.

"Research demonstrates that practice makes perfect when trying to master cardiac auscultation. Listening to these "Heart Songs" at the computer...can help clinicians at every level refine their auscultation skills."

– Michael J. Barrett, MD, FACC

Cardiac auscultation has traditionally been taught as if it were an intellectual skill, with a didactic lecture followed by a brief demonstration of heart sounds. This approach has yielded disappointing results, with most clinicians able to recognize only about 40% of abnormal heart sounds.

Heart Songs, on the other hand, is based on psychoacoustic research demonstrating that intensive repetition (400 to 600 times) is required for the human brain to master a new sound. This degree of repetition is necessary for the formation of an auditory template of each new sound. Once each new sound is mastered, it is reinforced each time you hear it in a patient.

By using this learning principle from psychoacoustic research, Heart Songs produces a significant improvement in cardiac auscultation in a relatively short time. Two controlled trials1,2 have shown that proficiency in cardiac auscultation routinely exceeds 80% using this approach.

Heart Songs 5 provides you with high-quality heart sounds that you can listen to at your convenience so you can improve your cardiac auscultation skills.

Heart Songs in the News

August 31, 2015
Cardiologists at Medical Meeting Fail to Identify Basic and Advanced Murmurs (ESC Abstract)

June 4, 2007
Capitalizing on a Craze: Medicine on an MP3 (AMA News)

Mar 14, 2006
A Virtual Classroom Is Superior to Traditional Training in Teaching Cardiac Auscultation (ACC 06)

Jan 30, 2006
Heart Songs: Young doctors are losing their stethoscope skills (Time)

Jan 2006
The power of repetition in mastering cardiac auscultation (Am J Med)

References:

1. Barrett MJ, Lacey CS, Sekara AE, Linden EA, Gracely EJ. Mastering cardiac murmurs: the power of repetition. Chest 2004;126:470-5.
2. Barrett MJ, Kuzma MA, Seto TC, et al. The power of repetition in mastering cardiac auscultation. Amer J Med 2006;119:73-5.
3. Barrett MJ, Martinez MW, Scott M, O'Gara PT. How accurate are cardiologists at detecting aortic and mitral murmurs? A reality check on auscultation skills in the era of transcatheter interventions. Eur Heart J 2015;36;792.
4. Chizner MA. Cardiac auscultation: rediscovering the lost art. Curr Probl Cardiol. 2008;33:326-408.