Electrotactile, Vibrotactile, and Thermal Feedback in a Wearable CPR Training Game: Comparative Effectiveness Study (Preprint)

BACKGROUND Background: Cardiopulmonary resuscitation (CPR) is a critical skill for healthcare professionals, where the timeliness and precision of execution directly affect patient survival outcomes. Traditional CPR training methods often lack authentic haptic feedback, resulting in suboptimal skill transfer to real-world clinical scenarios. OBJECTIVE Objective: This study investigates how multimodal gamification can enhance CPR skill acquisition by integrating three distinct types of haptic feedback—vibrotactile, thermotactile, and electrotactile—into a serious game–based training system. The goal is to evaluate and compare the effectiveness of each feedback modality in supporting CPR training outcomes. METHODS Methods: We developed a serious game that provides real-time feedback on compression depth, frequency, and hand placement during training sessions. The system not only aids in guiding compression accuracy but also tracks the rate of target achievement. Three feedback modalities were individually assessed to determine their impact on improving CPR performance. RESULTS Results: Compared to conventional training methods, participants using the serious game demonstrated improved accuracy in compression depth and reported greater confidence in performing CPR. Performance improvements were observed with electrotactile, vibrotactile, and thermotactile feedback by 43.6%, 24.5%, and 17.7%, respectively. Among them, electrotactile feedback yielded the most significant performance gains, though System Usability Scale (SUS) ratings suggested a potential trade-off in user experience. CONCLUSIONS Conclusions: This work highlights the potential of serious games to bridge the gap between simulation-based training and real-life application, offering a novel approach for dynamic error correction and long-term skill retention through enhanced interactive experiences.