John Hay
John Hay Biomedical
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Physical exam listening library

Hear it. Describe it. Explain it.

Today's Lesson · Fri 10/16 · Wk8 · The physical exam: Listen and test, then choose Charlie's exam tests

Open today's complete lesson in Schoology (opens in a new tab)

Follow that lesson for today's required work and what to turn in. Use the downloads below when its steps ask you to analyze sounds.

Download the named heart, lung and blood-pressure sounds, then use the illustrated guide to connect what you hear to its source in the body and what a physician would investigate. These 25 synthesized teaching simulations have not been clinically validated. They support comparison practice and cannot establish a diagnosis.

Download all heart, lung and blood-pressure sounds (ZIP) Download the illustrated listening guide (PDF)

For Listen and Test: compare normal S1 and S2 with the holosystolic murmur. Then compare normal vesicular breath sounds with expiratory wheeze, fine late inspiratory crackles, rhonchi and inspiratory stridor. Open the named MP3s below and use the guide for each comparison.

Listen at a comfortable volume with headphones if available. Replay the same example before comparing it. Describe timing, pitch and sound quality before interpreting it. If the classroom stethoscope gives a faint or unclear sound, record "not clearly heard" and use the simulation for the assigned comparison. Do not invent an observation.

Open all 25 named MP3s: preview or download

Lung sounds

Heart sounds

Blood-pressure sounds

Earlier portal reference material (before the class was repaced)

Use the Schoology lesson above for today's required work; this older reference follows an earlier schedule.

Period 1-2 calendar
I am in Period 6A-7B, show me this day

Ethics of monitoring

This page has four parts, in the order you use them. Part 1 is what you need to know. Part 2 says what to do, in plain English. Part 3 shows the work done once on a case that is not yours. Part 4 is your own work and where to turn it in.

Open your materials, follow the steps, then turn in your work.

Debate whether wearables and continuous monitoring help or harm patients, and defend your view.

Need help getting started?Help: worked exampleMissed class?
Print or open for todayActivity 2.1.5 Telehealth
Student sheet: Telehealth, day 1Remote monitoring and the glucose feedback loop. Today is the science and the ethics; the data day follows.PDF · 4 pages · 200 KBOpen

Check you have the right sheet: the top of it prints today's portal day, Ethics of monitoring. The PLTW activity itself is in myPLTW and is not posted here.

Unit 4 extra creditNine items open when we finish Unit 2. Read the cover sheet now so you know what is coming.Cover sheet (6 pages)See all nine
Optional: listen or watch a unit review▸
Optional unit study notebook
Bloodwork and reference ranges: what lab panels measure and how they flag chronic disease.
Open the notebook
Optional review video
Audio overviewVideo overviewMind mapStudy guideFlashcardsQuizData table
Part 1 of 4 · Background and definitions▸

💡 Big idea: Continuous monitoring produces more data, but that data improves health only when someone interprets and acts on it correctly, so the benefit depends on interpretation, not on the amount of data collected.

Know by the end
  • • Patient autonomy is the right of a competent individual to make informed decisions about their own healthcare, including the decision to be monitored or not.
  • • Wearable data can detect early warning signs, improve chronic disease management, and reduce emergency visits, but it can also generate false alarms and increase health anxiety.
  • • Data from wearables is collected by skin sensors and interpreted by an algorithm, which introduces accuracy limitations not present in clinically validated instruments.
Carry forward

Should terminally ill patients be offered medical aid in dying in order to decrease use?

Daily take-home

Continuous monitoring produces more data, but that data improves health only when someone interprets and acts on it correctly, so the benefit depends on interpretation, not on the amount of data collected.

Read this first

Driving question: If a smartwatch pings you at 2 a.m. saying your heart rhythm looks off, has it saved your life or robbed you of sleep, and who gets to decide whether you keep wearing it?

New idea: Continuous monitoring produces more data, but that data improves health only when someone interprets and acts on it correctly, so the benefit depends on interpretation, not on the amount of data collected.

Visual or model: No figure is attached to this lesson. The readings, the worked example and E1 to E3 carry the evidence.

  1. Observe or measure the relevant feature in ethics of monitoring.
  2. Organize the observation with a stable evidence ID.
  3. Apply this rule: Use science to estimate consequences, then state the value judgment and tradeoff that determine the decision.
  4. Choose the option the evidence supports and state the limit of the conclusion.

Real biomedical example: If a smartwatch pings you at 2 a.m. saying your heart rhythm looks off, has it saved your life or robbed you of sleep, and who gets to decide whether you keep wearing it?

What the evidence supports: E1 to E3 support the daily take-home when the response meets the stated success criteria.

What it cannot prove: The package does not support claims beyond this lesson's or any real patient diagnosis.

Vocabulary:
  • • : The amount of sugar dissolved in the blood, the body's main fuel, normally about 70 to 99 mg/dL when fasting and tightly controlled by .
  • • : A waxy, fat-like substance that the body uses to build cell membranes and make hormones, but too much in the blood can clog arteries.
  • • : Anything that raises a person's chance of developing a disease, such as smoking, family history, or high , without guaranteeing it.
  • • telehealth: Delivering healthcare remotely using video calls, phone, or digital tools so patients and providers can connect without being in the same place.
  • • wearable: A small electronic device worn on the body that continuously senses and records health data such as heart rate, steps, or oxygen level.
  • • monitoring: The ongoing measurement of a patient's vital signs or condition over time to track changes and catch problems early.
  • • : The span of values for a lab test or measurement seen in healthy people, used as a reference to flag results that may signal a problem.

Use it now: Choose one decision option. Cite E1 and E3, then explain how the rule connects the evidence to your choice. This is thinking practice for the one turn-in named under Turn in, not a second submission.

Go further, optional: The source links below are optional enrichment. Every fact required for today's local evidence decision appears in this lesson package.

Evidence set and decision
E1 · Source fact

A defensible biomedical decision separates scientific evidence from value judgments, identifies who may benefit or be burdened, and states the uncertainty and tradeoffs that remain.

Limit: Scientific evidence can inform the options and likely consequences, but it cannot choose a single value-neutral answer.

E2 · Teaching model

Use science to estimate consequences, then state the value judgment and tradeoff that determine the decision.

Limit: A review-board model organizes reasoning but does not make one ethical principle automatically outweigh every other principle.

E3 · Task criterion

You can weigh benefits and harms of health monitoring.

Limit: E3 defines the classroom product or success criterion. It is not independent scientific evidence and cannot justify a clinical or causal claim.

Today's decision · Simulated classroom evidence scenario

Your role: biomedical investigator

Decision: Your team must decide what the evidence from ethics of monitoring supports before submitting the claim-evidence-reasoning response named on today's page.

  • • Act on the 2 a.m. alert immediately, since the watch measured your rhythm and gave you a real number.
  • • Pause the decision until we know whether this watch's rhythm alerts were ever checked against a validated clinical test.
  • • Keep the watch but let a clinician read the alert, because data helps only when someone acts correctly.

Response: State one choice, cite at least two evidence IDs, explain the rule that connects them, and add one limitation. Use it inside the one turn-in named under Turn in; it is not a separate submission.

Claim ceiling: Today's evidence supports a classroom claim about ethics of monitoring. It cannot prove causation, diagnose a real patient, or justify action outside this room.

Composite case file

Reason for review: Your team must decide what the evidence from ethics of monitoring supports before submitting the claim-evidence-reasoning response named on today's page.

Context: More data is not the same as better care; data only helps when someone interprets it correctly and acts on it, and the patient always has the right to decide whether to be monitored at all.

Timeline:
  • • T1: Read the question on your Telehealth day-1 sheet: should a clinic recommend continuous remote monitoring, and what has to be true for that recommendation to be responsible?
  • • T2: Draw the on your sheet and mark in a second color where it breaks in type 1 diabetes.
  • • T3: List one benefit and one harm of continuous monitoring, and connect them to patient autonomy.
  • • T4: Argue your claim in your group with one reason and one example.
  • • T5: Write your CER and submit it with your feedback-loop diagram as one PDF to the Schoology assignment for this lesson in Schoology.
Evidence records:
  • • E1: A defensible biomedical decision separates scientific evidence from value judgments, identifies who may benefit or be burdened, and states the uncertainty and tradeoffs that remain.
  • • E2: Use science to estimate consequences, then state the value judgment and tradeoff that determine the decision.
  • • E3: You can weigh benefits and harms of health monitoring.

Measurements: Use only the measurements, units, graph, or counts supplied in today's task. No additional patient measurement is implied.

Uncertainty: This is a composite classroom scenario. Missing history, measurements, or confirmation tests remain unknown and limit the conclusion.

Watch the trap

Students often think because a wearable produces a number, that number is as trustworthy as a hospital lab test. The trap: Wearable data is estimated by an algorithm from sensors on your skin, not measured in a validated lab, so it can be wrong; treating a watch reading as clinical truth can lead to false alarms or false comfort.

Portal terms
CER:
Claim, Evidence, Reasoning: make a claim, back it with evidence, explain your reasoning.
SOP:
Standard Operating Procedure, the exact steps to follow (especially in a lab).
Tracker:
Your PLTW progress log where you record completed evidence.
myPLTW:
The PLTW course site where you do the online activities. Find it in Clever with your Microsoft sign-in, right next to Schoology.
This unit's vocabulary

Tap the speaker to hear a term. Add two of these to your notebook glossary with a definition and an example in your own words.

Build your vocabulary · optional, for extra credit

Pick just 2 or 3 words from today and make them yours: write what each one means in your own words, name the context clue or evidence that helped, then give one example from what you actually did in Ethics of monitoring. Try your own words first; the glossary is there if you get stuck. This is voluntary and counts as extra credit, so keep it short.

blood glucose
cholesterol
risk factor
telehealth
wearable
monitoring

Saved on this device. Show Mr. Mendoza or add these to your notebook glossary to claim the extra credit.

Part 2 of 4 · Directions in plain English▸

2.2 Start the work

Read the question on your Telehealth day-1 sheet: should a clinic recommend continuous remote monitoring, and what has to be true for that recommendation to be responsible?

Show all 5 required steps
  1. Read the question on your Telehealth day-1 sheet: should a clinic recommend continuous remote monitoring, and what has to be true for that recommendation to be responsible?
  2. Draw the blood glucose feedback loop on your sheet and mark in a second color where it breaks in type 1 diabetes.
  3. List one benefit and one harm of continuous monitoring, and connect them to patient autonomy.
  4. Argue your claim in your group with one reason and one example.
  5. Write your CER and submit it with your feedback-loop diagram as one PDF to the Schoology assignment for this lesson in Schoology.

Lost your place? Check that your feedback-loop diagram is drawn and marked for type 1 diabetes (step 2) and that you have one benefit and one harm tied to patient autonomy (step 3). Then write your CER and submit it with the diagram (step 5).

  1. 0:00Hook: show a real smartwatch alert that turned out to be a false alarm vs. one that caught a real arrhythmia
  2. 0:10Introduce patient autonomy concept; contrast with beneficence (what the doctor thinks is best)
  3. 0:20Read the ethics prompt; list one benefit and one harm of continuous monitoring
  4. 0:32Small-group debate: connect position to patient autonomy
  5. 0:54Individual CER writing: position, evidence, reasoning
  6. 1:10Share two CERs; preview the bloodwork lesson that follows
Mr. Mendoza's 5-minute intro
  • • Smartwatches can now detect atrial fibrillation, track blood oxygen, and estimate sleep quality. Does that make people healthier? Or does it make them obsess over numbers that do not actually mean much?
  • • This is the ethics of data. The technology exists. The question is whether using it improves patient outcomes or whether it creates anxiety, drives unnecessary medical visits, and shifts decision-making from doctors to algorithms.
  • • Patient autonomy means you have the right to choose whether you are monitored. But does a patient who opts out of monitoring get worse care? That is where the tension is.
  • • Pick a side and defend it. Next week we chart simulated bloodwork over time and see what a trend looks like.

PLTW connection and today's work

In myPLTW, open Lesson 2.1 Talk to Your Doc and go to Activity 2.1.5 Telehealth. Read the whole activity before you pick a side in today's debate.

Today's stopping point: You finished the vital-signs analysis last class. Today starts the clinical-data half of Lesson 2.1 Talk to Your Doc with Activity 2.1.5 Telehealth. Read it and take a position by the end of today.

PLTW activity titles identify the course connection. If your account will not open, use the posted materials for today and tell Mr. Mendoza. Do not mark an online activity complete unless you completed it.

Course connection

  • Activity 2.1.5 Telehealth
Open Activity 2.1.5 Telehealth in myPLTW

Use the turn-in directions in Part 4 of this page. Do not create a second submission unless your teacher asks for one.

Show another explanation or a smaller first step

Need help? Choose a starting point

Need a running start
Warm up by listing two ways a doctor could use daily heart-rate data, and two ways a person might feel if their watch buzzed every hour, so you have raw material for both sides of the debate.
On track
Take a clear side on whether constant monitoring helps or harms, back it with one benefit and one harm, and connect your position to a patient's right to choose being monitored.
Stuck? Get unstuck
If you are catching up, draw the feedback loop first, then write a short CER on the sheet's question with one reason and one real example, such as a smartwatch alert or a glucose monitor.
Push me further
Argue the harder middle position: monitoring helps some patients and harms others. Name what makes the difference (the condition, whether a clinician reviews the data, the patient's anxiety level) instead of picking a simple yes or no.
Part 3 of 4 · Worked example▸

This is a parallel case, not your own. Read it for the order of the work, then do your own in Part 4.

Worked example · a parallel case (guides, does not reveal)
Worked CER on a parallel case
Completes: A short written argument on a parallel case, a pharmacy app that texts refill reminders naming the medication, taking a side on whether the convenience is worth the privacy cost, with the reasoning grounded in informed consent and data privacy. It is not the remote-monitoring question on your sheet.

Parallel case, not the question on your sheet: a pharmacy app that texts refill reminders naming the medication.

Claim: The app helps patients more than it harms them, but only if the patient chooses what the text may say and who else can see the phone.

Evidence: Reminder texts raise the share of prescriptions picked up on time, which matters for drugs that stop working when doses are missed. A text that names the medication can also reveal a diagnosis to anyone who reads the screen, which is a disclosure the patient never agreed to.

Reasoning: The deciding factor is informed consent: the patient should be told what the text will contain and be able to choose a reminder that does not name the drug. With that choice, the benefit of doses taken on time outweighs the privacy cost; without it, the app makes a disclosure decision that belongs to the patient. A limitation is that a reminder is only a nudge, so the app cannot tell whether a dose was actually taken.

Why this matters

This model shows the level of evidence and organization needed to complete: A short written argument on a parallel case, a pharmacy app that texts refill reminders naming the medication, taking a side on whether the convenience is worth the privacy cost, with the reasoning grounded in informed consent and data privacy. It is not the remote-monitoring question on your sheet.

Build yours step by step
  1. Write one defensible claim.
  2. Choose specific evidence that supports the claim.
  3. Explain the scientific rule that connects the evidence to the claim.
Change it for a new task

Keep the structure. Replace the question, facts, measurements, and evidence. Then recheck units, vocabulary, and whether the conclusion goes beyond the evidence.

Also due today: Submit the diagram and the CER as one PDF to Schoology assignment for this lesson in Schoology.

See the full worked example
Inspect the analogy

A review board sorts scientific evidence, stakeholder needs, possible benefits, possible burdens, and uncertainty before choosing a policy.

  1. Which statements are scientific evidence?
  2. Which statements express a value or priority?
  3. Who receives the benefit and who carries the burden?
Rule

Use science to estimate consequences, then state the value judgment and tradeoff that determine the decision.

Where it breaks

A review-board model organizes reasoning but does not make one ethical principle automatically outweigh every other principle.

Map the analogy to biology
  • • Evidence cards map to source-backed findings.
  • • Stakeholder cards map to affected people and priorities.
  • • The recommendation maps to an explicit tradeoff with a named uncertainty.
Part 4 of 4 · Your work▸

Check your work before submitting

  • I can weigh benefits and harms of health monitoring.
  • I can defend a position with reasoning.

4.1 Turn in your work

DueCheck the Schoology assignment for this day
Hand in
Your glucose feedback-loop diagram, annotated for type 1 diabetes, plus one CER (3-5 sentences) answering the sheet's question: should a clinic recommend continuous remote monitoring, and what has to be true for that recommendation to be responsible? Name patient autonomy in your reasoning.
How to submit and name your file

Submit the diagram and the CER as one PDF to the Schoology assignment for this lesson in Schoology.

In Schoology, open your course and the assignment for this lesson. Attach your file, select Submit, and check that it appears in the submission.

PDF upload help

You get two school days for every day you were absent, so this deadline moves with you.

Open Schoology I was absent
Today's lesson is in Schoology

Each school day has one lesson page in Schoology that holds everything for the day: the goal, the story so far, every table and data value, the numbered steps, and what to turn in. Open it first and work from it. The other rows for this day, if any, are the score line for a paper quiz or test and the John Carroll debate item; they do not add work. Check Schoology for each deadline.

Link will not open? Open Schoology, choose your course and section, and find the title shown above.

How this is graded
For: CER: Your glucose feedback-loop diagram, annotated for type 1 diabetes, plus one CER (3-5 sentences) answering the sheet's question: should a clinic recommend continuous remote monitoring, and what has to be true for that recommendation to be responsible? Name patient autonomy in your reasoning.
  • Complete
    Every required part of the artifact is present, nothing left blank.
  • Accurate
    The science and the data are correct and match the evidence.
  • Scientific reasoning
    You explain your claim with evidence and reasoning (CER), not just an answer.
  • Professional communication
    Clear, organized, labeled, and written the way a clinician or scientist would.
  • Submitted
    Go to Schoology to turn this in. Submit one PDF. Schoology attaches your name to your upload; on the page itself, write your period and code. Name the file: FirstName LastName - Assignment Title - YYYY-MM-DD.pdf. If you cannot get in, see Mr. Mendoza. Do not skip the work.
How this lesson connects

Keep using what you learned last class: Should terminally ill patients be offered medical aid in dying in order to decrease antibiotic use? Today: Continuous monitoring produces more data, but that data improves health only when someone interprets and acts on it correctly, so the benefit depends on interpretation, not on the amount of data collected.

Practice: try a question, then check your answer▸

Claim ceiling for this check: Today's evidence supports a classroom claim about ethics of monitoring. It cannot prove causation, diagnose a real patient, or justify action outside this room.

Quick self-check · commit, then reveal

A smartwatch says your resting heart rhythm looks abnormal, but your doctor's EKG comes back completely normal. Why might the watch and the EKG disagree?

How sure are you?

Write an answer and pick a confidence to unlock the key.

Cumulative WebXam review · flash practice

Fast retrieval with instant answers, not the commit-then-reveal check above. Try each from memory first: write what you remember about the earlier units, then check yourself here.

Tap an answer to check it · nothing is recorded or graded
[Review: Master the Morgue: body systems, tissues, and toxicology evidence] Before handling a specimen under the microscope, which practice best maintains a contamination-free workspace?
[Review: Open Investigation: building the evidence board and the report] A company finds a drug lowers cholesterol. What must they do before selling it?
[Review: Talk to Your Doc: clinical communication and vital signs] What is the purpose of an experiment measuring blood glucose after a drug or a placebo?
In the blood glucose drug-versus-placebo experiment, what is the dependent variable?
Missed class or ready for more?▸
Where this leads: careers

What today's skills lead to. These are real health-science careers this course builds toward. Tap one to see, on the US Department of Labor's O*NET site, what the job actually involves, what it pays, and how fast it is growing.

Forensic Science TechnicianCollect and analyze physical evidence to answer medical and legal questions.Medical ExaminerDetermine cause of death using autopsy, lab work, and case evidence.Clinical Laboratory TechnologistRun the lab tests that diagnose disease from blood and tissue samples.EpidemiologistTrack how diseases spread and design ways to stop outbreaks.
What to do if you were absent
Today was a debate: do this instead

Draw the glucose from your student sheet, then write a CER on the sheet's question and submit both as one PDF to the Schoology assignment for this lesson.

John Carroll Philosophy for Children

Submit the diagram and the CER as one PDF to the Schoology assignment for this lesson in Schoology.

If MR. MENDOZA is absent

Class still runs. Complete today's work as this page describes (it is self-guided). Need the concept taught without a teacher? Use this authoritative explainer:

MedlinePlus: Laboratory Tests
Sources: slides, readings, and resources▸
Socratic teaching slide deck

The deck carries the prior idea forward, lets you inspect an analogy, maps the rule to biology, and ends with the same evidence decision and exit ticket used on this page.

Download PPTX
Resources & readings

Hand-picked readings and interactives for this lesson, from authoritative open organizations and PLTW's own public course outline.

Complete blood count (CBC), reading bloodworkReadingMedlinePlus (NIH)Open Sickle cell disease, patient-facing overviewReadingMedlinePlus (NIH)Open

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