A Novel Haptic Cardiac Simulator: Mixed Methods Pilot Evaluation in Medical Students and Educators

Cardiac auscultation is an essential component of clinical examination but is often challenging to achieve proficiency in. Self-contained, multisensory learning resources that incorporate simultaneous visual and haptic stimuli offer a unique approach to supporting learners in acquiring this core skill.

This pilot study of both medical students and clinical educators evaluated the utility of a novel iPhone app, Haptic Heart, which generates haptic vibrations to simulate heart sounds and murmurs. We aimed to explore the perceptions of students and educators when using haptics as a learning resource and the underlying reasons behind these perceptions and to gather lessons that would inform future development of the resource.

Clinical-year medical students from the Lincoln Medical School with access to an iPhone were invited to trial Haptic Heart between October 2023 and December 2024. Cardiology specialists involved in clinical education were also invited to take part. After using the app, participants were asked to complete a modified version of the 12-item Evaluation of Technology-Enhanced Learning Materials: Learner Perceptions questionnaire that included additional free-text items. Educators were also asked to comment on the resource's authenticity and perceived usefulness. Quantitative responses were analyzed using descriptive statistics; free-text responses were analyzed for common themes.

A total of 21 students and 18 educators completed the evaluation. Both cohorts returned positive responses across nearly all questionnaire items, with students showing near universal agreement that the app was of excellent quality (21/21, 100%), supported their learning needs (21/21, 100%), and would change their clinical practice (20/21, 95.2%). Educators similarly rated the resource highly for learning utility (16/18, 88.9%) and authenticity (13/18, 72.2%). Reported technical difficulties were minimal for students (1/21, 4.8%) and educators (2/18, 11.1%). Analysis of free-text responses suggested that learners valued the ability to "feel" murmurs and to vary heart rate. Educators highlighted the resource's novelty and innovation, although some noted concerns about audio quality when using a stethoscope to auscultate haptic vibrations directly.

This pilot evaluation demonstrates the potential of smartphone-based haptic technology as a tool for medical education. Haptic Heart was perceived by both students and educators as an innovative educational tool for cardiac auscultation. Further work should focus on expanding the range of haptic patterns provided and exploring the effectiveness of these resources on learning.