"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

Margaret Mead

A Virtual Simulation for Cardiac Auscultation training.


Cardiac auscultation requires skills that are hard to acquire and currently in decline given insufficient practice and the shift to the use of techniques that place a greater emphasis on technology (e.g., echocardiography).
Although the use of these newer techniques can provide an objective view of the auscultated heart, they also distance the medical professional from practice with the cost‐effective stethoscope which is available in every medical examination scenario (Bank, Vliegen, & Bruschke, 2016). Traditional auscultation education and training focuses on memorizing heart sounds (associated with both healthy and diseased hearts), and their corresponding diagnosis. A variety of sound‐based libraries, websites and mobile apps that help familiarize trainees with the sounds of the heart under normal and diseased conditions are available. More recently, virtual reality and manikin‐based simulators have become widely used for training as they allow trainees to practice in controlled scenarios where several procedures can be configured. However, there is a gap between memorizing sounds and manikin‐based practices as simulated scenarios provide context required to diagnose a patient. To address this gap, we leverage the engaging, motivational, and interactive nature of virtual reality and video games along with the ubiquitous nature of mobile computing through the development of a mobile‐based virtual simulation app that employs game elements and low fidelity multi‐modal cues (visual, auditory, and haptic) as a tool to promote analytic thinking and decision making while performing a virtual cardiac auscultation. The goal of the app is for the user (taking on the role of a medical professional) to auscultate the virtual patient by identifying heart rate, rhythm, and sound location, and determine whether the sounds are part of a normal or diseased heart. A video outlining the cardiac auscultation app is available on Youtube via the following link: https://youtu.be/LIRL7EjETi4.

Related content


A Virtual Simulation for Cardiac Auscultation training.

Author Information

Alvaro Joffre Uribe Quevedo Corresponding Author

The Games Institute, University of Waterloo

David Rojas

Institute of Medical Science, University of Toronto, Toronto, CAN

Bill Kapralos

Faculty of Information Technology/Health Education Technology Research Unit, Ontario Institute of Technology, Oshawa, CAN

Fuad Moussa

Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook Health Science Centre

Adam Dubrowski

Health Sciences, University of Ontario Institute of Technology, Oshawa, CAN

Norman James

Faculty of Medicine, Mil. Nueva Granada University

PDF Share