Abstract:

Cardiac auscultation is a medical procedure where a medical practitioner diagnoses a patient´s heart condition using a stethoscope. Currently, cardiac auscultation skills are declining, thus causing major concerns amongst medical educators as the procedure is cost-effective and allows for the early detection of various conditions. Traditionally, cardiac auscultation training involves trainees listening to pre-recorded heart sounds (diseased and non-diseased), with accompanying pictures, diagrams, and sketches to enhance the understanding the changes across various cardiac conditions. Thanks, in part to the gaming and computer graphics “revolution” (hardware and software), multimedia tools were developed to provide 2D and 3D animations, visualizations and simulations of the heart, providing enriched context to better complement the cognitive development around the auscultation procedure. However, such scenarios become repetitive and in most cases, they are simply digital representations of the content found in traditional books. A recent approach that has been gaining momentum is the use of games in education in the form of serious games (games whose main objective is education, training or learning in scenarios other than entertainment). Serious games have been widely used in medical education although greater work remains before they become more widespread. Heart-related serious games involve cognitive and skill-based interactive scenarios where the learner engages in diagnosis and treatment activities.

In addition to the analog and digital cardiac auscultation tools and contents currently available, medical simulation manikins provide a more realistic approach to cardiac auscultation training. The use of manikins with wireless stethoscopes and audio processing units for controlling how the pre-recorded sounds are presented to the learner are available. However, such advanced simulation manikins pose challenges in terms of costs, training, availability, and curriculum implementation.

Our previous work has focused on the development and study of serious games that employed immersive technologies including virtual reality and haptics, for cardiac auscultation training. In this work, we focus on the development of a cardiac auscultation app for mobile devices. Our goal is i) to obtain a greater understanding of how the use of the (serious game) app can impact auscultation learning and diagnosis, and ii) examine the effects of multimodality when incorporating the sense of touch (haptics) to the experience. To date, we have implemented a serious game prototype that involves instructor and learner activities with follow-up and a reward system based on increasing difficulty scenarios.