Translating Touch: Investigating the Communication and Structure of Haptic Mental Models in Medical Simulation

Medical education has historically relied heavily on the traditional apprenticeship model of ‘see one, do one, teach one’ – the transition from observation to active engagement. However, as technical challenges have grown ever more sophisticated and patient tolerance for error has decreased, junior doctors face reduced training time in clinic. This has driven a transition towards simulation-based teaching methods. Instructional videos (Dong & Goh, 2015), interactive tablet and computer apps (Kowalewski et al., 2017), and even mental rehearsal (Arora et al., 2011) are widely used and well-documented tools. Yet, these cognitive exercises are overwhelmingly dominated by visual imagery. Medical students memorise the steps involved in a procedure, mentally rehearse the trajectory of an instrument, or learn to recognise the visual appearance of an anatomical structure. The lack of tactile information in these tools is striking. The physical sensation of touch is an essential component of surgical skill, necessary for assessing tissue compliance and making precise movements.

Despite its importance, the sensation of touch is notoriously difficult to articulate (Buono et al., 2025). We lack a clear understanding of how experts build and maintain cognitive representations (mental models) of these physical sensations. While visual learning benefits from shared objective reference points, haptic experiences are inherently subjective, deeply embedded as tacit knowledge, and rarely communicated systematically in surgical curricula. This project, situated at the dynamic intersection of psychology, educational research, medicine, and haptics, seeks to address this gap by investigating the cognitive storage and communication of touch as relevant to medicine.

Our primary aim is to systematically investigate how elite, experienced surgeons conceptualise and communicate their mental models of touch during specific medical procedures. To achieve this, the project will employ robust qualitative methodologies, specifically conducting in-depth, cognitive-elicitation interviews with expert practitioners, followed by rigorous thematic analysis. By formalising this tacit knowledge through these qualitative psychological approaches we intend to map these internal haptic representations. By understanding how experts understand the sense of touch, we can build a ‘haptic lexicon’ to better communicate these complex sensory expectations to medical students and surgical trainees.

To evaluate the efficacy of this cognitive framework, the internship will culminate in a comparative pilot study using an established simulation platform. The student will adapt a standard visual training modul – such as an interactive Touch Surgery routine or a clinical skills video modelled on widely used resources like Geeky Medics – into two distinct training conditions. The first condition will augment the visual module purely through cognitive instruction, integrating our newly developed ‘haptic lexicon’ to guide the trainee’s mental rehearsal of the physical sensations. The second condition will serve as a tactile benchmark, pairing the same visual module with actual physical haptic feedback, delivered via synthetic tissue models or a controllable robotic tactile display. By comparing trainees’ subsequent performance, knowledge transfer and skill acquisition across these two groups, we aim to establish how effectively a linguistically communicated mental model can approximate the learning benefits of direct physical simulation.

The anticipated contributions of this research span both theoretical and applied domains. For the academic team in experimental psychology, this project offers a novel pathway to study embodied cognition, cross-modal mental imagery, and the interpersonal communication of sensory mental models, with high impact potential. For the medical haptics and robotics team, it offers a framework for aligning subjective human cognitive models with digital simulation tools being developed for use in medical training. Ultimately, this interdisciplinary endeavour promises to advance our fundamental understanding of how the human brain processes, stores, and shares the sensation of touch with the long-term aim of enhancing human health.