KEY LESSONS LEARNED: As new requirements are placed on a medical education system strained for resources and funding, creative solutions are needed that will make efficient use of existing education material, to meet the needs of the students, educators and organizations. Using current technological advances in computers and the Internet, one can create stimulating and educational material that combines tracking, feedback and evaluation and thus efficiently meet the ACGME goals. STATEMENT OF PROBLEM OR QUESTION: There is interest in using the Internet to assist in teaching medical clerks ECG reading skills, but multiple technical barriers have impeded efforts thus far. These include inability to place high quality ECG images on the Internet and failure to utilize software that allows interactivity yet is supported by most web browsers. OBJECTIVES OF PROGRAM/INTERVENTION: To develop an internet-based, comprehensive ECG tutorial that is interactive and can be viewed by standard web browsers. DESCRIPTION OF PROGRAM/INTERVENTION: We developed a new method for digitizing paper ECG files. We then digitized our complete ECG library used for our four session, clinical clerkship ECG tutorial. These high quality images were placed in web pages using multimedia development software that can be viewed with most web browsers. FINDINGS TO DATE: An online ECG tutorial is now available to all internal medicine clerks. It covers 4 chapters of material and includes over 30 ECG cases. The interactivity allows users of various skill levels to choose the amount of assistance they receive in interpreting the cases. KEY LESSONS LEARNED: A large amount of effort was required to overcome technical barriers. Once these issues were overcome, further work was very efficient. The solutions to these technical issues can be easily shared. STATEMENT OF PROBLEM OR QUESTION: Evidence-based medicine and Internet resources have become increasingly important in the organization and philosophy underlying morning report. Electronic media is easily available to house officers in real time and this often supercedes the limited, outdated content in standard textbooks. Managing that data and integrating it into an educational culture is a new challenge for residents and faculty alike. OBJECTIVES OF PROGRAM/INTERVENTION: Prior to implementation of the new paradigm, the chief resident conducted morning report and the post-call senior resident presented the case. Faculty, other senior residents, interns, and medical students were present in the room. Qualitative surveys of residents at the time revealed concerns of knowledge stratification between interns and senior residents, need for more current handouts, and a desire for more involvement by the interns and medical students in discussion. In the new model, two chief residents conduct morning report and the two-day post call intern presents the case. No senior residents or faculty are present in the room. DESCRIPTION OF PROGRAM/INTERVENTION: We describe a novel morning report format that: