Cardiac Simulator Technologies and Design for Medical Education and Auscultation Training: A Systematic Review
Abstract
1. Introduction
2. Review Methodology
2.1. Patent Search
- A.
- Inclusion criteria:
- Covers simulators that specifically incorporate a cardiac auscultation system.
- Describes mechanisms for reproducing normal or pathological heart sounds.The patent may be registered in any patent office of any country.
- Details the design or manufacturing method of simulators with defined anatomical landmarks for auscultation.
- May be registered in any national or international patent office.
- B.
- Exclusion criteria:
- Refers to general-purpose simulators without explicit mention of cardiac auscultation.
- Focused exclusively on other physiological systems.
- Duplicates across databases—only the first occurrence was retained to avoid redundancy.
- Filed before 2020, given the typically slow pace of development and dissemination.
2.2. Search for Scientific Communications
- A.
- Inclusion criteria:
- Focused on the design of patient simulators for cardiac auscultation.
- Incorporating clinical cases involving auscultation.
- Addressing testing and evaluation metrics for cardiac auscultation simulators.
- Including feedback mechanisms for auscultation techniques.
- Involving the development of patient simulators for cardiac auscultation.
- Describing fabrication methods for mannequin simulators.
- B.
- Exclusion Criteria:
- Generalist simulators without specific reference to cardiac auscultation.
- Devices are limited to sound recording with no educational component.
- Simulators dedicated solely to arrhythmia or ECG.
- Devices focus exclusively on vital sign monitoring.
- Duplicate records.
- Items published before 2020.
- Simulators targeting systems other than the cardiovascular system.
3. Results
3.1. Patentometric Analysis
3.2. Scientometric Analysis
4. Discussion
4.1. Structural Elements of the Simulation Mannequin
4.2. Types of Materials
4.3. Types of Materials for Sound Simulation
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Search Engines | Filter 1 | Filter 2 | Filter 3 | Filter 4 |
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Patentscope | 836 | 31 | 16 | 69 |
Google Patents | 432 | 27 | 21 | |
Espacenet | 6918 | 220 | 53 | |
The Lens | 14,971 | 1951 | 182 | |
Total | 23,157 | 2229 | 272 | 69 |
Search Engines | Filter 1 | Filter 2 | Filter 3 |
---|---|---|---|
The Lens | 11,680 | 19 | 52 |
ScienceDirect | 22,460 | 34 | |
PubMed | 59,902 | 53 | |
Total | 92,042 | 106 | 52 |
Cite | Title | Main Applicant | Body Part | Type | Technology |
---|---|---|---|---|---|
[12] | Auscultation Device for Cardiovascular Medicine Department | Wei Jing | Heart | Specialized stethoscope | Mechanics |
[13] | Auscultation Position Indication Method and Device | Huawei Tech | Heart | Method | Electronics |
[14] | Auscultation System | Ausculsciences | Heart | Method | Electronics |
[15] | Auscultation System for Guiding a User to Perform Auscultation on a Subject | Aria Narayan Vikram | Heart | Monitoring device | Simulation |
[16] | Auscultation Training Examination Model | Zhejiang University | Heart–Lungs | Mannequin simulator | Electromechanics |
[17] | Biofeedback Apparatus and Method | Gideon Eric | Heart–Respiratory Tract | Specialized stethoscope | Mechanics |
[18] | Biosignal Measurement Apparatus and Method | Myllylae Teemu | Heart | Monitoring device | Electronics |
[19] | Cardiac Health Assessment Systems and Methods | Cortery Ab | Heart | Monitoring device | Electronics |
[20] | Cardiopulmonary Auscultation Virtual Simulation Training System and Method | Beijing Unidraw VR Technology | Heart–Lungs | Simulation device | Simulation |
[21] | Cardiopulmonary Percussion Model for Teaching | Union Hospital Tongji Medical College Huazhong University of Science and Technology | Heart–Lungs | Mannequin simulator | Electromechanics |
[22] | Cardiopulmonary Simultaneous Multidirectional Auscultation Anthropomorphic Dummy | Shanghai Yikai Medical Tech | Heart–Lungs | Mannequin simulator | Mechanics |
[23] | Chest Wall Oscillation System with Digital Auscultation | Koninklijke Philips | Heart–Thorax | Monitoring device | Electromechanics |
[24] | Comprehensive Delivery Mother-Child First-Aid Model | Xi’an Mcneill Medical Technology | Heart–Thorax | Mannequin simulator | Electronics |
[25] | Comprehensive Skill Training Simulator | Shanghai Qize Medical | Heart–Thorax | Mannequin simulator | Electronics |
[26] | Device for Automated Screening of Congenital Heart Diseases | Capis Sprl | Heart | Monitoring device | Artificial intelligence |
[27] | Diagnostic Simulator | Seno Medical Instr | Heart–Thorax | Monitoring device | Electronics |
[28] | Digital Stethoscope for Diagnosing Cardiopulmonary Pathologies | Alsaliem Sulaiman | Heart–Lungs | Specialized stethoscope | Electronics |
[29] | Dynamic Body Part Simulator | Bioconix Pty | Heart–Thorax | Mannequin simulator | Electromechanics |
[30] | Electronic Device for Auscultation and Method of Operation Thereof | Smartsound | Heart | Specialized stethoscope | Artificial intelligence |
[31] | Electronic Standardized Human Body Model System for Emergency Training and Examination | Beijing Shengyi Zhijiao Technology | Heart–Arm | Mannequin simulator | Electronics |
[32] | Electronic Standardized Infant Model System for Emergency Training and Examination | Guangdong Medical Technology | Heart–Thorax | Mannequin simulator | Electronics |
[33] | First-Aid Skill Training Model with Airway Management Function | Second Military Medical University | Heart–Thorax | Mannequin simulator | Electronics |
[34] | Heart Sound Deep Learning Heart Disease Prediction Method and System for Auscultation Teaching | The Sixth Medical Center of Chinese Pla General Hospital | Heart | Software | Artificial intelligence |
[35] | Heart-Variable Simulation Device for Cardiopulmonary Auscultation Palpation | Shanghai Yikai Medical Technology | Heart–Lungs | Mannequin simulator | Electromechanics |
[36] | High-Simulation Multifunctional Wireless Human Body Vital Sign Examination Training Model | Yingkou Guidong medical apparatus | Heart–Lungs | Mannequin simulator | Electronics |
[37] | Human Pulse and Heartbeat Simulator | Laerdal Medical | Heart | Simulation device | Electronics |
[38] | Integrated Sensing Device for Heart Sound and ECG Signals | Decentralized Biotechnology Intelligence | Heart | Monitoring device | Electronics |
[39] | Modeling Method, Apparatus, Device, and Storage Medium of Dynamic Cardiovascular System | Beihang University | Heart | Method | Simulation |
[40] | Multi-Mic Sound Collector and System and Method for Sound Localization | Vitalchains | Heart–Thorax | Monitoring device | Electronics |
[41] | Multi-Modal Heart Diagnostic System and Method | University of Alabama | Heart | Monitoring device | Electronics |
[42] | Multi-Parameter Simulator | Contec Medical Systems Qinhuangdao | Heart–Thorax | Simulation device | Electronics |
[43] | Noninvasive Arterial Condition Detecting Method, System and Non-Transitory Computer Readable Storage Medium | National Central University | Heart | Detection system | Electronics |
[44] | Portable Heart Motion Monitor | Cardiac Motion; University of California | Heart | Monitoring device | Electronics |
[45] | PPG Pulse Wave Simulator | Hunan Cofoe Xinchi Medical Tech | Heart–Arm | Simulation device | Electronics |
[46] | Pregnant Woman four-step Palpation Simulation Teaching Model | Beijing Yimo Technology | Heart–Thorax | Mannequin simulator | Electronics |
[47] | Pulse Simulator and Simulation Method Thereof | Yantai Nanshan University | Heart–Thorax | Simulation device | Electronics |
[48] | Pulse Wave Conduction Parameter Measuring Method and Pulse Wave Conduction Parameter Processing Device | Shenzhen Darma Tech | Heart | Monitoring device | Electronics |
[49] | Real-Time Adaptation of a Personalized Heart Model | Sorin Crm | Heart | Method | Electromechanics |
[50] | Screening Device, Method and System for Structural Heart Disease | Vital Connect | Heart | Method | Electronics |
[51] | Simulating Clinical Trials Using Whole Body Digital Twin Technology | Twin Health | Heart–Thorax | Simulation device | Simulation |
[52] | Simulation Defibrillator Teaching Equipment with Cardio-Pulmonary Resuscitation Display Function | Guangdong Kangwei Technology | Heart–Thorax | Mannequin simulator | Electronics |
[53] | Simulation Device for Palpation of Variable Lungs Through Cardiopulmonary Auscultation | Shanghai Yikai Medical Tech | Heart–Lungs | Mannequin simulator | Mechanics |
[54] | Simulation Doll | ExAc | Heart | Mannequin simulator | Simulation |
[55] | Simulation of Heart Pacing for Modeling Arrhythmia | Biosense Webster Israel | Heart | Method | Simulation |
[56] | Simulation System for Abdominal Cavity Examination | Obshchestvo S Ogranichennoy Otvetstvennostyu Medviar | Heart–Abdomen | Mannequin simulator | Electromechanics |
[57] | Stethographic Device | Western Michigan University | Heart–Thorax | Monitoring device | Electronics |
[58] | Stethoscope Dummy | Qi Jingtan | Heart–Lungs | Mannequin simulator | Electronics |
[59] | System and Method for Determining An Auscultation Quality Metric | Johns Hopkins University | Heart–Thorax | Method | Artificial intelligence |
[60] | System and Method for Evaluating Effects of Antiarrhythmic Agent | Industry-Academic Cooperation Foundation Yonsei University | Heart | Software | Machine learning |
[61] | System And Method for Medical Simulation | Global Diagnostic Imaging Solutions | Heart–Thorax | Software | Simulation |
[62] | System For Recording Chest Signals and Method Using Said System | CSEM | Heart–Thorax | Monitoring device | Electronics |
[63] | System, Device and Method for Automated Auscultation | Andino Jean | Heart–Thorax | Monitoring device | Artificial intelligence |
[64] | System, Device and Method for Automated Auscultation | Arizona State University | Heart–Thorax | Monitoring device | Electronics |
[65] | Systems and Methods for Determination of Pulse Arrival Time with Wearable Electronic Devices | Nebraska University | Heart | Monitoring device | Electronics |
[66] | Systems and Methods for Determining Filtered Cardiac Output | Edwards Lifesciences | Heart | Monitoring device | Electronics |
[67] | Systems and Methods for Measuring Patient Vital Signs | Thiagarajan Arvind | Heart–Thorax | Specialized stethoscope | Electronics |
[68] | Systems and Methods for Testing a Medical Device | Zoll Medical | Heart–Thorax | Mannequin simulator | Electromechanics |
[69] | Systems, Devices, and/or Methods for Managing Health | Tegen Spencer Mckay | Heart | Monitoring device | Electronics |
[70] | Teaching Device for Learning Four Palpation and Fetal Heart Auscultation | Xiamen Lifang Huanjing Tech | Heart–Thorax | Mannequin simulator | Electronics |
[71] | Teaching is with Simulating People’s Belly Palpation Analogue Means | Shanghai Yikai Medical Tech | Heart–Abdomen | Mannequin simulator | Electronics |
[72] | Trachea Cannula Simulation Training Method and System | Beijing Unidraw VR Technology | Heart–Thorax | Mannequin simulator | Simulation |
[73] | Training Anthropomorphic Dummy of Hypothermia War Wound | General Hospital of Shenyang Military Region | Heart–Thorax | Mannequin simulator | Electronics |
[74] | Training Manikins | Simcraft Tech | Heart | Method | Simulation |
[75] | Vein Simulator System | Becton Dickinson | Heart–Arm | Mannequin simulator | Electronics |
[76] | Vital Sign Comprehensive Simulator Convenient to Install | Shenzhen Kwda | Heart–Thorax | Mannequin simulator | Mechanics |
[77] | Vital Sign Measurement Device | AMI Industries | Heart–Thorax | Monitoring device | Electronics |
[78] | Wearable Auscultation Device | Senti Tech® | Heart | Monitoring device | Electronics |
[79] | Wearable Heart Sound Detection System and Method Thereof | Decentralized Biotechnology Intelligence | Heart | Specialized stethoscope | Electronics |
[80] | Wireless Intelligent Cardiopulmonary Auscultation Anthropomorphic Dummy | Henan Yujing Technology Development | Heart–Lungs | Mannequin simulator | Electronics |
Author | Year | ||||
---|---|---|---|---|---|
2020 | 2021 | 2022 | 2023 | 2024 | |
Yutaka Kagaya | 1 | 1 | |||
Leijte E. | 1 | 1 | |||
Pinto L. | 2 | ||||
Fu Y. | 1 | 1 | |||
Qi Z. | 1 | 1 | |||
Iwata M. | 1 | ||||
Rzeźniczek P. | 1 | ||||
Kengen B. | 1 | ||||
Ock J. | 2 | 1 |
Cite | Main Author | Performance Parameters | Year |
---|---|---|---|
[81] | Bai F | Accuracy of volume measurements with both methods and reproducibility of measurements. | 2024 |
[82] | Manzanares A | Learning time to master basic simulated navigation skills and ability to transfer skills from the simulator to real situations. | 2024 |
[83] | Leijte E | Time to complete tasks, economy of motion, and appearance validity of the robotic simulator for advanced suturing tasks. | 2020 |
[84] | Huri G | Accuracy in the performance of arthroscopic procedures and time required to complete standardized surgical tasks. | 2021 |
[85] | Fu Y | Task completion time, use of the CUSUM method to analyze intracorporeal enhancement and errors made. | 2020 |
[86] | Massone C | Detailed analysis of the features that simulate Spark Nevus and their importance in differentiating between lesions. | 2023 |
[87] | Geissler ME | Object transfer, circular cut, balloon resection, and suture, measuring execution time and cognitive load using the NASA-TLX scale. | 2024 |
[88] | Lee JE | Medical students’ perceptions of patient safety before and after simulator training. | 2024 |
[89] | Suzuki H | Evaluation of ease of application and quantity used in a simulated 10.1093/europace/euae037ment. | 2022 |
[90] | Hendrickx DM | Evaluation of the accuracy of simulations and their usefulness in planning public health interventions. | 2021 |
[91] | Yoshimura T | Evaluation of anatomical accuracy by comparison of actual and modeled coordinates. | 2021 |
[92] | Bhattacharya S | Analysis of the relationship between demographic characteristics, driving history, and visuo-cognitive test results with driving simulator performance. | 2023 |
[93] | Silva VC | Assessment of motor, cognitive, and visual functions in older drivers using a simulator. | 2023 |
[94] | Larraga-García B | Evaluation of training efficacy and differences in treatment approaches between medical students and physicians. | 2021 |
[95] | Ulises Sánchez-Vásquez | Ability of the simulator to reproduce normal heart sounds and evaluation of the fidelity of the simulator compared to actual clinical practice. | 2023 |
[96] | Fu TT | Effectiveness of the virtual simulation teaching system in neonatal PICC care training. | 2024 |
[97] | Iwata M | Evaluation of simulator sensitivity in different driving scenarios and applicability of the simulator in clinical studies. | 2020 |
[98] | Yau SY | Comparison of performance between different levels of medical experience and evaluation of applied force during difficult scenarios. | 2021 |
[99] | Kliem PSC | Duration of evaluation and improvement with clinical experience and confidence of participants in their evaluations. | 2024 |
[100] | Yutaka Kagaya | Diagnostic accuracy in the identification of heart murmurs (aortic and mitral regurgitation) and correlation with student satisfaction. | 2021 |
[101] | Hilleke S | The combination of simulator training followed by clinical observation. | 2024 |
[102] | Scott-Watson M | Improvement in basic arthroscopic skills and correlation with personal characteristics. | 2024 |
[103] | von Bernstorff M | A moderate correlation was found between the simulator and a reaction timer, suggesting that simpler tools could estimate BRT in clinical practice. | 2021 |
[104] | Maita H | The use of the bladder simulator significantly improved students’ skills and confidence. | 2023 |
[105] | Rzeźniczek P | Symptoms of simulator sickness measured with the Simulator Sickness Questionnaire (SSQ) before and after simulation. | 2020 |
[106] | Liu C | Effectiveness in background exam training and willingness to use the simulator in the future. | 2024 |
[107] | Jaud C | Benchmark for competency-based training, effectively differentiating between novice and experienced surgeons. | 2021 |
[108] | Kengen B | Task duration between high- and low-impulsivity groups and number of errors made. | 2020 |
[109] | Yutaka Kagaya | Accuracy in identifying heart sounds, student satisfaction, and progress in auscultation skills. | 2022 |
[110] | Pinto L | Success rate between groups before and after simulator training. | 2024 |
[111] | Sønderup M | Accuracy of image placement, number of repetitions required to complete the task, and comparison between novice and experienced surgeons. | 2024 |
[112] | Ghazanfar S | Performance in robotic simulator tasks and transfer of skills to robotic surgery. | 2021 |
[113] | Ducloyer JB | Task execution time and incidence of complications, such as rupture of the posterior capsule. | 2024 |
[114] | Ono Y | Lowest peak forces applied to structures during direct and indirect practice in novices. | 2020 |
[115] | Ock J | Realism of the simulation, ease of use of the simulator, and applicability in the training of medical doctors. | 2020 |
[116] | Motov S | Performance on simulator tasks, progress in technical skills, and participant satisfaction. | 2024 |
[117] | Grethlein D | Correlation with test performance. | 2020 |
[118] | Jokinen E | Comparison between simulator-trained and non-simulator-trained residents. | 2020 |
[119] | Weimer JM | Accuracy in identifying cardiac structures, transfer of simulator skills to real patients, and time required to complete examinations. | 2025 |
[120] | Pinto LOAD | Procedure time, instrument manipulation accuracy, and success rate in simulated procedures. | 2024 |
[121] | Qi D | Accuracy in the execution of the procedure and errors made during the simulation. | 2020 |
[122] | Huang C | Ability to make clinical decisions in emergency situations, application of knowledge in simulated scenarios, and satisfaction and confidence of the participants. | 2020 |
[123] | Gulbakit Koshmaganbetova | Accuracy in identifying heart murmurs, improvement in auscultation skills after training, and comparison between different training durations. | 2021 |
[124] | Zhang CT | Reaction time, rate of safe responses, and impact of variables such as age and distraction. | 2020 |
[125] | Qi Z | Accuracy of navigation, ease of use of the system, and cost and accessibility of the system. | 2024 |
[126] | Uhm D | Gripping technology and sealing forces. | 2021 |
[127] | Leijte E | Time to complete basic tasks, accuracy and efficiency of instrument manipulation, and comparison between different levels of experience of participants. | 2021 |
[128] | Alvarez-Lopez F | Depth perception, ease of use, relevance as a learning tool, and feedback provided by the simulator. | 2020 |
[129] | Porto JT | Coordination, instrument navigation, and timing of procedures. | 2020 |
[130] | Tjong FVY | Percentage of respondents who believe that simulators should be part of routine training and proportion of respondents who suggest that simulation programs should be developed by EHRA. | 2024 |
[131] | Bogar PZ | Exercise evaluation time and efficacy and reliability of the artificial-intelligence-based evaluation approach compared to the standard human-based method. | 2024 |
[132] | Yaïci R | Content validity, construct validity, and criterion validity. | 2024 |
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Romero-Martínez, C.; Zúñiga-Avilés, L.A.; Cruz-Martínez, G.M.; Reyes-Lagos, J.J.; Zagoya-López, J.; Bárcenas-García, Á.E. Cardiac Simulator Technologies and Design for Medical Education and Auscultation Training: A Systematic Review. Bioengineering 2025, 12, 731. https://doi.org/10.3390/bioengineering12070731
Romero-Martínez C, Zúñiga-Avilés LA, Cruz-Martínez GM, Reyes-Lagos JJ, Zagoya-López J, Bárcenas-García ÁE. Cardiac Simulator Technologies and Design for Medical Education and Auscultation Training: A Systematic Review. Bioengineering. 2025; 12(7):731. https://doi.org/10.3390/bioengineering12070731
Chicago/Turabian StyleRomero-Martínez, Christian, Luis Adrián Zúñiga-Avilés, Giorgio M. Cruz-Martínez, José Javier Reyes-Lagos, Joel Zagoya-López, and Ángel Eduardo Bárcenas-García. 2025. "Cardiac Simulator Technologies and Design for Medical Education and Auscultation Training: A Systematic Review" Bioengineering 12, no. 7: 731. https://doi.org/10.3390/bioengineering12070731
APA StyleRomero-Martínez, C., Zúñiga-Avilés, L. A., Cruz-Martínez, G. M., Reyes-Lagos, J. J., Zagoya-López, J., & Bárcenas-García, Á. E. (2025). Cardiac Simulator Technologies and Design for Medical Education and Auscultation Training: A Systematic Review. Bioengineering, 12(7), 731. https://doi.org/10.3390/bioengineering12070731