On systolic murmurs and cardiovascular physiological maneuvers.

Physiological principles that directly apply to physical diagnosis provide opportune occasions to bring basic science to the bedside. In this article, we describe the effect of cardiac maneuvers on systolic murmurs and how physiological principles apply to the explanation of the changes noted at the bedside. We discuss the effect of Valsalva, squatting, and hand grip maneuvers on different physiological parameters influencing preload, afterload, chamber dimensions, and pressure gradients. The clinical manifestations noted during the aforementioned maneuvers are described in common cardiac conditions responsible for the production of certain systolic murmurs.

Insights gained from the analysis of performance and participation in online formative assessment.

BACKGROUND: Online quizzes are simple, cost-effective methods to provide formative assessment, but their effectiveness in enhancing learning and performance in medical education is unclear. PURPOSE: The purpose of this article is to determine the extent to which online quiz performance and participation enhances students' performance on summative examinations. METHODS: A retrospective case study investigating relationships between formative and summative assessment in terms of use and outcomes. RESULTS: Online quiz scores and the rates of quiz participation were significantly correlated with corresponding performance on summative examinations. However, correlations were not dependent on the specific quiz content, and changes in patterns of quiz use were not reflected in corresponding changes in summative examination performance. CONCLUSIONS: The voluntary use of online quizzes, as well as the score attained, provides a useful general indicator of student performance but is unlikely to be sensitive enough to direct an individual student's learning plan.