Future-proof medical training with AR - Part 2: Heart & ECG



September 28, 2023

The heart, often regarded as a simple muscular pump, is, in reality, a testament to nature's ingenuity, orchestrating intricate chemical processes and electrical potentials. In our fast-paced world, where health and well-being are paramount, understanding the heart's functioning has become increasingly vital. Both in consumer electronics and clinical medicine, there's a growing need for comprehensive knowledge of heart activity and diagnostics. This is where the innovative Awake platform steps in, harnessing immersive technologies to bridge the gap between medical knowledge and technological solutions, offering a unique educational experience that brings the heart's complexities to life in ways previously unimaginable.

The future of medical training (©Adobe Stock)

The future of medical training (©Adobe Stock)

The heart serves as the central organ within the human body, ensuring the seamless distribution of oxygen-enriched blood to even the most remote parts of our anatomy. At first glance, it may appear as a simple muscular pump, but closer scrutiny reveals that the heart is nothing short of an evolutionary marvel. Within it, intricate chemical processes occur, translating into electrical potential. The release of this electrical energy leads to a spontaneous yet coordinated muscle contraction, guaranteeing the smooth circulation of blood through the intricate network of pulmonary and systemic circulation. Undoubtedly, the heart stands as a symbol of life and a reflection of our overall well-being.

The heart holds a central role not only within our bodies but also within the realm of consumer electronics.

In today's world, all so-called 'smart' devices are dedicated to monitoring various aspects of heart activity, including heart rate (HR), resting heart rate (RHR), heart rate variability (HRV), detection of potential rhythm disorders (Arrhythmia detection), and more. The fast-paced modern lifestyle, characterized by both stress and an unhealthy way of living, as well as the pursuit of peak sports and recreational performance, demands a comprehensive understanding of the heart's functionality and its associated aspects. 

Contemporary individuals seek to comprehend the true messages their hearts convey. The same applies to the clinical sphere, where the comprehension of the heart, particularly through the lens of fundamental electrocardiogram (ECG) examinations, constitutes a central component of cardiological diagnostics.

As is the case in other domains, solutions to fundamental challenges do not solely lie in the capacity or precision of perception but, above all, in the depth of understanding what is perceived.

Despite the rapid advancements in consumer electronics, which have in certain aspects reached a level of precision comparable to clinical data, the fundamental comprehension of the data collected by consumers remains relatively basic. Consequently, the majority of users often find themselves susceptible to conflicting lay interpretations, which can at times be contradictory and even detrimental to their health.

Interestingly, a similar situation can be observed within the field of clinical medicine, particularly in general clinics, where knowledge regarding the interpretation of electrocardiograms (ECGs) is often rudimentary. Here, clinicians frequently perform ECG examinations as routine procedures, leaving intricate interpretations to specialist cardiology services. The reasons behind this are undoubtedly complex and understandable.

However, it is far from accurate to assert that there are no means to bridge the gap between the availability of diagnostic data and the proficiency to interpret it.

On the contrary, the rapid evolution of immersive digital experiences within the realm of augmented or mixed reality presents a landscape of boundless opportunities for enhancing pedagogical approaches. These advancements, due to their increased accessibility and ease of repetition, hold the potential to accelerate the learning process, contribute to a deeper understanding of the subject matter, and facilitate the retention of acquired knowledge.

The birthplace of interactive platform Awake

At 3fs, we firmly believe that the essence of technological progress lies in its ability to address practical societal challenges, and we recognize the enhancement of healthcare education as a pivotal endeavor. In fact, the healthcare sector is grappling with increasing demands, most notably reflected in the challenges of acquiring new knowledge and sustaining existing expertise. 

As novel technologies continually deepen our understanding of the human body's functions and expand the scope of identifiable pathologies, diagnostics are becoming increasingly sophisticated. Unfortunately, educational approaches are not keeping pace with these advancements, thereby presenting an ever-mounting challenge in medical training.

To address these challenges and translate our technological expertise into tangible solutions, we established the 'Awake' product group within our organization. This dedicated team was wholly committed to the development of solutions in the realm of medical education and training.

With the advent of technologies enabling virtual and mixed reality experiences, particularly with the introduction of Microsoft's Hololens I, the Awake team embarked on a pilot project aimed at training medical personnel to respond to allergic reactions known as anaphylactic shock. This project was executed in collaboration with the Simulation Center at Ljubljana Medical Center and was entirely funded by our company. You can read more about it in Awake Part 1: Anaphylactic shock.

Bridge between medicine and software development

The recognized potential for practical application of this solution prompted our company to expand the project's scope to encompass fundamental knowledge concerning the functioning of the heart and related diagnostic procedures, notably ECG. To realize our broader ambitions, we invited partner companies Troia d.o.o. and Mips d.o.o. to join us.

Together, we formulated a comprehensive shared vision centered on the integration of clinically verified sensor data coming from proprietary devices, seamless connectivity through cutting-edge cloud technologies, and content distribution within the context of immersive experiences. This ambitious endeavor also received financial support from the European Union through regional development funds.

In this context, we conceived the Awake platform, built upon three fundamental pillars dedicated to advancing medical education, training, and diagnostics. We called these three pillars learning, training, and doing. To effectively address the interdisciplinary nature of the core challenges, we recognized the need to structure the Awake team differently from the traditional software development approach. While we incorporated established agile methodologies into our development processes, it became essential to establish protocols facilitating the seamless translation of medical knowledge into technological solutions.

Interdisciplinary team was a must.

At the team level, this entailed the critical inclusion of a qualified medical professional responsible for creating professional content and overseeing user experience. Our experience has demonstrated that to remain at the forefront of medical science through innovative solutions, bridging the gap between medical practitioners and software development is indispensable. Unfortunately, in this context, such collaboration is often more attainable with younger generations, as the boundaries between these fields may appear insurmountable to others.

Medical training with Awake Heart (©Adobe Stock and 3fs Awake)

Furthermore, having a medical expert within the production team plays a pivotal role in assessing the suitability and usability of solutions with active clients. Throughout the development of Awake solutions, we consistently sought feedback from the medical community, including paramedics, technicians, doctors, and professors. Their insights proved invaluable, and without a medical professional on the team, much of this input might have been lost in translation.

It's worth noting that the spherical experience necessitates a revision of conventional approaches to UX/UI. Principles distilled from the 2D world have proven to be incomplete and non-functional in this context. We had to set grounds for the totally new gramatics of structuring and conveying information. The same approach was followed by established giants a bit later and is today known as spatial UI.

From life-size heart model to ECG mastery

In the context of developing solutions pertaining to heart function, the Awake team has introduced two applications, each catering to distinct target audiences.

Awake Heart is tailored for the general populace, specifically targeting high school students who are in the process of learning about the anatomy and fundamental operation of the heart. On the other hand, Awake EKG is designed for medical students, technicians, paramedics, and general practitioners.

Awake Heart is meticulously crafted to enable students to explore the heart's intricacies at its true, life-size scale, as opposed to the conventional two-dimensional representations found in textbooks. It comprehensively covers topics ranging from the heart's basic structure to its conduction system and physiology. The module is thoughtfully designed to facilitate interactive learning, equipping students with the knowledge needed to interpret information accurately when using smart devices.

Awake Heart model (©Awake 3fs)

Awake ECG serves as an interactive supplement to the educational curriculum, introducing students to the fundamental concepts of heart function and essential techniques in ECG examination. Particular emphasis is placed on the interpretation of the two-dimensional representation of the heart's electrical activity, a task known to be a significant challenge in education. Within the sphere of immersive experiences, abstract concepts can be presented in a completely naturalistic manner. Awake ECG, therefore, elucidates the intricacies of cardiac electrical activity, the fundamental components of ECG readings (including parameters, waveforms, and leads), various interpretation methodologies, central rhythm irregularities, and their morphological aspects as observed in ECGs. 

The solution is thoughtfully designed to provide healthcare professionals, including those outside the field of cardiology, with the means to swiftly refresh their fundamental knowledge.

ECG readings in 3D space (©Awake 3fs)

Tangible impact on education

Both Awake Heart and Awake ECG have found practical applications in various educational institutions.

Eindhoven University of Technology in the Netherlands has successfully incorporated Awake Heart and ECG into its Bachelor's program in Biomedical Engineering. Their feedback underscores the significance of increased accessibility and ease of repetition and enabling ‘physical’ interaction with the content, transforming student’s learning journey into an exciting and fun exploration of the topic.

“The Awake platform proves to be an exceptional educational tool due to its interactive nature. It offers students the unique opportunity to physically engage with heart components, comprehending their functions, with emphasis on dynamic aspects of blood circulation. Conversely, the ECG program delivers valuable insights into the heart's electrical potential. The program also fosters healthy competition among peers through its timed quizzes and sparks their curiosity and enthusiasm to learn.“

- Suzanne E. Koch, Ph.D. in Bioengineering and Biomedical Engineering and Project Manager at Education Innovation Pilot at Eindhoven University

Awake platform in the classroom (©Eindhoven University)

“Studying with AWAKE feels like a futuristic Grey's Anatomy episode. Learning through interactive exams and timed challenges not only boosts your knowledge but also ignites your competitive spirit. The ECG application has certain sections which are offering even more in-depth content than what's required for our studies.”

- Students of the Bachelor program of Biomedical Engineering at the Eindhoven University

Excelling in knowledge starts with a comprehensive understanding of foundational concepts during middle and high school education. Notably, Awake has also been integrated into VR Futuclass lessons, an innovative educational platform that gamifies lessons for secondary school students across Europe.

“Awake Heart truly embodies the essence of immersive, engaging, and instructive VR education. We, as educational VR vendors, have enthusiastically recommended Awake Heart to numerous schools, and the feedback has been overwhelmingly positive. All of the schools we’ve introduced to Awake Heart have lauded its exceptional educational value and high student engagement. This app sets a gold standard for interactive biology education.”

-Märt Lume, Co-Founder of Futuclass

Transforming learning experiences

The Awake product team was established in 2016, during a period when there were only a handful of mixed-reality display devices available in the market. In the span of seven years, the market has witnessed a significant surge in activity, with prominent players like Apple, renowned for its expertise in smart devices, entering the arena.

Our initial prediction has been affirmed—immersive experiences are gradually superseding traditional ones, smart devices are converging into interpretive ecosystems, and education is poised for a transformative boost. We are now on the brink of living the future we sought to usher in with this post.


AWAKE is also available for personal use. If you have a VR device and you would like to experience Awake Heart and ECG, you can get them in the Oculus store.

For further information about AWAKE, please visit their official website:

AWAKE was co-financed (1.073.532,41 €) by the Slovenian Ministry of Economic Development and Technology & the European Union, from the European Regional Development Fund (

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