Impact of Audio Feedback on User Experience in Haptic-Visual Mixed Reality Pulse Palpation Training Environments

Background: Mixed Reality (MR) environments rely on multimodal feedback to enrich sensory integration and realism, which enhances User Experience (UX). Prior studies have shown the benefits of haptic feedback in audio–visual MR medical training environments, but researchers have not fully examined how audio cues influence Haptic–Visual (HV) training environments. Methods: We built a high-fidelity MR medical training environment that synchronized visual, haptic, and audio of the human pulse. We conducted a between-subjects study with thirty novice participants who performed pulse palpation tasks in HV and Haptic–Audio–Visual (HAV) modalities. We employ a multidimensional UX evaluation by measuring task performance, presence, usability, and task workload to assess the impact of adding audio feedback in MR pulse palpation training environments. Results: Participants in the HAV modality performed tasks more accurately and reported stronger presence and higher usability. They did not report any significant increase in workload compared to the HV modality. Conclusions: Audio feedback improved perceptual coherence and enhanced UX in pulse palpation tasks. Our findings highlight the training value of integrating multimodal feedback in MR pulse palpation training systems and provide practical guidelines for designing more immersive and effective MR environments.