Using patient simulators to teach cardiac examination remotely: the good, the bad and the Harvey

How do you teach students to recognise the potential symptoms of cardiac disease, during a pandemic, with limited access to patients? Flo Mouy (Cardiac Teaching Fellow) responded to this challenge by introducing the students to Harvey, a specialist mannequin developed for teaching. Flo created videos demonstrating how to, and how not to, examine a patient for cardiac symptoms.

Tools: Harvey, video and microphone

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Harvey can simulate almost any cardiovascular disease at the touch of a button by varying blood pressure, pulses, heart sounds, murmurs and breath sounds. Flo found setting up these sessions to require less administration than the virtual and hybrid ward rounds. (See case studies for virtual ward rounds and hybrid ward rounds.) First Flo needed to be trained by Nick Turner on how to use Harvey. She had to organise the sessions in advance; pre-recording the videos and ensuring the technology worked well. She made some adaptations, such as linking a stethoscope to a microphone so that the heart sounds were clearly audible. Flo ensured that she knew the case well in advance and put a presentation together to aid the students’ understanding. Overall, she found these sessions to be relatively low effort once the videos were completed. Whilst creating the videos was time-consuming, they are at least a reusable resource. 

For the teaching sessions, Flo and the students were at home appearing via Zoom. Flo maintained the same basic structure that she uses for real life teaching sessions. Flo carried out two examinations – one very flawed, where the students highlighted mistakes and offered recommendations for what she should have done instead.


Student feedback was positive. Students reported that it was useful to have a model video, and to compare and contrast the two sessions and see what is expected of them. They also appreciated the facility to hear the heart sounds and discuss what they had heard. Technically, there were no problems. Everyone’s Internet worked smoothly, and as the videos had been pre-recorded Flo knew they worked well. On a practical note, she could teach all the students at once. Students found they could learn from each other more, as they heard a multitude of different history taking techniques and all the resulting feedback.

The downside of the Harvey sessions was the lack of proper practice of clinical examination skills. Flo stated that ideally students would be examining a patient and listening to heart sounds in real life. As with the Virtual ward round and Hybrid ward round, students are missing the active experience of physically doing something, rather than more passively receiving information. These practical skills are a vital part of medical education and will have to be built in later in the student journey.

The Harvey videos were sufficiently popular for Flo to plan to retain then for post-pandemic teaching. Students loved Harvey, and a patient simulator offers the opportunity to cover a number of different cases. Flo felt these sessions introduced a light-hearted touch, and a much appreciated element of fun to teaching during the pandemic.  


  • Flo took advice from colleagues and the Health Sciences TEL Team on how to use the technology.
  • It was harder to shoot the video of the poor examination than the good one.
  • Once the video materials were created, the session with students is efficient to run.