Since publication of the 2011 print edition and the open access 2015 online version (including heart sound recordings), reception of the book and associated material has been gratifying. International access to the website has been steady and a number of Canadian and international medical schools use the recordings for group and individual teaching. With the 200th anniversary of the invention of the stethoscope by Laennec in 2016 there has been a renewed focus on physical examination. A number of articles have appeared strongly urging better teaching and emphasizing the importance of careful examination before imaging. New teaching resources and apps for mobile devices continue to proliferate, although many are not field tested before marketing. Finally the availability and promotion of inexpensive cardiac ultrasound devices has led to their widespread use, often without evidence based recommendations.
In this revised online edition much has been added or updated. In Chapter 6 the conclusions of the Canadian-Australian study on heart murmur recognition have been added, with a late reinforcement module which is available through the website. Chapter 8 on technical aspects of teaching is completely revised to reflect web-based teaching using recordings accessed on this website. Similarly Chapter 10 on curricula and Chapter 12 on teaching devices have been updated. The potential of hand held ultrasound in teaching is reviewed in Chapter 2.