May 7, 2012By Lance Baily

Voice Changer Solutions for Your Medical Simulation Lab

Did you know you can quickly and dramatically increase realism to your medical simulation program through the addition of a voice-changer? Consider the benefits of transforming the sound of a facilitator’s voice into the age and gender of the patient they are simulating.

Imagine creating a more realistic patient presentation for your medical simulation learners by changing an adult male clinical instructor’s voice into that of a child’s for your pediatrics cases, or even morphing a female educator’s voice into that of an elderly adult male patient for your geriatrics cases!

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I have done several hours of research and testing to find the best software and hardware based voice changing solutions for your medical simulation labs.

Before purchasing a voice changing solution for your medical simulation program, you must be sure to investigate the current capabilities of your lab’s technology.  Will you be able to utilize the software solution recommended below, or will the technological specifications of your current video capture systems require you to use the hardware solution.

For example, at the Clinical Simulation Center of Las Vegas we had hard-lined XLR based microphones which ran straight to the “audio inputs” for our recording/debriefing software.  In order to use a software solution we would have needed to purchase an additional laptop for each of the five control room stations as well as a mixer to convert the XLR signals to & from the computer.  Instead, purchasing a hardware solution was as easy and pulling out the microphone XLR from the wall, plugging it into the input side of the new system, and then running another XLR audio-outbound cable back into the debriefing systems audio-input.

On the other hand, if your sim lab has the microphone going directly into your recording system, the software solution below may be your best bet!  Either way, please consider your technology needs before making a purchase.  If you are not sure, have a healthcare simulation technology specialist, IT specialist or your lab’s A/V integrator help you recommend the best route to take. Then, check out these solutions below:

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 Screaming Bee – MorphVOX Pro Voice Changer Software Solution ($39.95):

Changing voices for sim lab

MorphVox Pro is a great solution for voice-changing in your medical simulation lab.  Screaming Bee sells their software for about $40, and provides hundreds of free pre- designed “add-on” voices that can be used with the full program. Some of the content packs like “Personality Voices” were perfect for immediately starting to transform facilitator voices in your simulation lab.  If you have a bit of time to get creative, you can customize and edit the free addons and save those filter settings for future use. In other words you can change the pitch, tone and delay as well as other key controls to modify the outputted voice for your exact patient needs.  Then, save the voices onto specific hotkeys to make switching between voices quick and efficient.  I was successfully able to utilize this software on a PC to make my voice sound like a child’s voice, a female’s voice, and an elderly male’s voice among others.

As well, you can also record your voice onto a saved file and then apply filters to that file at a later date in-order to save time.  For instance, say you had five different patients for your clinical skills learners to all engage with who all needed to have the same speech but were different characters.  With MorphVox Pro you could make one recording and then export that audio file with five different filters to create five very differently sounding patients.

To hear an example download these files I recorded through the MorphVox Pro software.  First play the audio file called “original” and then listen to the various voice “applied filters” with character names created by Screaming Bee.  Take note that I did NOT re-record this audio file but rather applied and rendered various “voice” filters to the original sound file.  What this means is that none of the tone changes or character inflictions you may hear in the changed voice files are of my doing, but rather all effects of the software itself. Just imagine how realistic your patient simulators will sound with even the most minimal amount of “character presentation” by your clinical educators or healthcare simulation staff.  Pretty remarkable if you ask me!

The pros of the MorphVox Pro healthcare simulation lab voice-changing software are many.  First, you can download a “junior version” of the software to try out some basic voice-changing for your simulation lab for FREE.  Second, the MorphVox software is really affordable considering all the additional benefits it will bring your simulation program (not to mention the cost of the hardware solution found below). Third, hundreds of voices are provided for free which are each customizable for your exact needs.  And finally, MorphVox Pro is really easy to install and learn on your PC desktop or laptop.  Furthermore, the software has a loop “background” noise option which could potentially be used to add environment sounds to your lab.

The cons of the MorphVox Pro software is that it only works on a Windows based operating system.  And again as I said above, if your simulation lab is using only hardware for its audio solution – you would have to invest in a laptop.

The Voice Box from Electro-Harmonix Voice-Changing Hardware Solution ($220):

The Clinical Simulation Center of Las Vegas loved the Voice Box from ElectroHarmonix so much we bought one unit for every one of the five high-fidelity simulation lab rooms.  Clinical instructors really appreciated how they could easily change the sound of their voice to reflect opposite genders or ages more closely aligned with that of the patient being presented in the medical simulation lab room.

Simulation Lab voice changer

Installation was easy as all we had to do with take our microphone XLR cord and plug it into the input side of the device.  From there we ran another cable from the output side of the voice-changing box to our inputs for the lab’s audio speakers and recording systems.  Changing the tone from a deep voice to a high-pitched voice was as simple as rotating the knobs for “gender” and “voice mix” with all other knobs left and full-left, while selecting the mode of “Low-” or “High-” Harmony.  Of course, playing around with the settings on the voice box will lead to your best results.  Turning off the voice-changer is as simple as bypassing any changes on the box by pushing the “mic bypass” button.

The pro’s of this hardware solution include:

  • High Quality.  Successfully integrating this box into your lab’s systems will create a very professional sound.
  • Durable design.  These types of voice-changing boxes are intended for use by bands which will have them on stage near their feet.
  • Immediate voice changing capabilities without having to install, load or learn software.
  • Capable of working with almost any microphone regardless of your audio/video recording system or operating system software.

The cons are the increased price difference from the software solution of course and also the lack of any pre-designed “voices” which come with the software solution mentioned above.  As well, there is no way to record your voice and change it later without other systems in place.

I recommend buying the Voice Box through Amazon because of the 25% discount. And don’t forget you may need to buy an additional XLR cable to make this system work.

Final thoughts: 

Better healthcare simulation learning can stem from a more authentic and realistic patient engagement. During my fire academy, we could only pretend the building was on fire for so long before we actually had to start a real live fire to practice our drills on.  Thus, the closer your simulated healthcare environment is to the real healthcare environment the better your learning outcomes will be. By investing in some additional infrastructure you can quickly and dramatically increase the realism of your medical simulation labs.

As for which solution to go with, I would first recommend exploring the voice-changing software solution if your labs already utilize a computer for audio capture. You can always download the free trial version of the MorphVox Pro (called MorphVox Junior) and try it on your systems to ensure compatibility. But even with the additional costs involved, know that the Voice Box hardware is also a great solution for changing your simulated patient voice.

Check out the comments below for answers to technical questions and other recommendations.

*Updated Community Comments from SimGHOSTS community in 2018:

Glenn James Simulation Lab Supervisor Douglas College, Faculty of Health Sciences”

I piloted the MorphVOX Pro software and found there were latency issues from the control room to our patient room due to the heavy audio input signal processing load on the CPU.  I did some research and ended up implementing multiple Roland VT-3 hardware units to adjust the Pitch and Formant (tone) in real-time. These relatively inexpensive units are designed for DJs, so they have a lot of features you don’t necessarily need in simulation (reverb, vocoder, etc.) The instantaneous, real-time audio processing is fantastic for disguising/augmenting patient voices and works especially well in our pediatric simulations! The Bypass feature also allows the user to switch between the raw, unaltered signal to the transformed one.

Colleen Tingey Nursing Learning Center Supervisor Brigham Young University College of Nursing: We use the Voice Box harmony machine and vocoder by Electro-Hamonix.




Do you have another solution worth exploring?  Leave a comment below!

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  • Avatar
    May 9, 2012 at 10:10 am

    We are using the Boss VE-20 vocal performer. It works pretty good. We have created various pre-sets that can be stored and recalled by simply going to the numbered position that you stored it in.

  • Avatar
    Lance Baily
    May 9, 2012 at 3:04 pm

    Andy Currivan RN, Simulation Specialist from the University of Hawaii Manoa emailed me this question:

    Hi Lance,

    I just read your article on Voice Changer Solutions and was hoping you could help me with a few questions. We are trying to incorporate some type of voice changer with our Laerdal SimMan3Gs and coincidentally we have been exploring the same solutions that you have mentioned. We ran into a couple of dead ends though.

    Vocoder – we aren’t really able to change gender without it sounding robotic

    Software – we would really like to go this route but we’re having difficulty incorporating it into the 3G software/computer setup, how did you accomplish this? We’ve even tried using an attenuator to go from one computer to another but we couldn’t get the attenuator to work right.

    Any help would be appreciated.


    ————- Here is my reply: ———-

    Hi Andy,

    Lets see. First with the vocoder voice box – what I remember setting all the dials to the extreme left except for mix and gender which I would play with once the MODE had been set to either High Harmony or Low Harmony. I think those are really the only controls we messed with and were able to get things to sound more realistic. I think replicating a child’s voice or a women’s voice were easier – and a man’s was the only one that sounded a bit robotic-like.

    Second with regards to the Laerdal 3G software, my initial thought is to recommend having an outside audio system for patient voice other than the one on the manikin. With a larger audio speaker system in the sim lab room, you will be can get a louder and higher quality signal from some professional speakers as opposed to being limited to the power of the ones installed inside the 3G. This would also alleviate the need to mess with audio through the Laerdal software. If, however, that is not an option my first questions is to ask if you are using an external microphone that is plugged into the laptop or an “on-board” audio microphone which is on the laptop itself. Having an external mic can provide better control and higher quality as you will be able to speak into from anywhere in the sim control room. Test your external microphone to make sure it works on the Laerdal system. Do this by first plugging in a microphone other than the “on-board” microphone and making sure you are able to hear your voice through the laerdal software. You may need to mess with the preferences either on the laerdal software or the device manager of the PC itself to ensure that your audio in is now set to an external microphone as opposed to the onboard audio.

    Regardless of if you are using an onboard or external based microphone, you may need to make either the on-board or the external (which would by my choice) the default microphone device. Then, to get the audio playback of morphvox to be the input sound for Laerdal’s simman software, you may need to change the recording playback options. Otherwise, Laerdal may just try to use your microphone and not your transformed MorphVox audio. Learn how to do that here:

    If that still doesn’t work, I would try to take the software itself off the laerdal laptop and onto another computer. I would try adding an additional laptop to the mix just to ensure you can get the kind of quality you want with regards of the software use. Plug the microphone input into the new laptop, and run the software. Then have a line-out cable from the headphone jack of the ‘voice-changer’ laptop go into the microphone input of the laerdal laptop. While this is a lot of extra steps, this could quickly solve the problem of testing if the system can work to your liking.

    Hope this helps!


  • Avatar
    Cathy Eden
    May 17, 2012 at 8:42 am

    Thanks for creating this website! I used a test drive version of the Screaming Bee program about a year ago and found that there was a slight delay in the audio transmission. Did you find that with this version? Was there any delay with the hardware solution?
    Thanks, Cathy

  • Avatar
    Lance Baily
    May 17, 2012 at 6:02 pm

    Hi Cathy,

    I did not notice a delay myself with the Screaming Bee software, nor the hardware solution. How much RAM did your computer have when you were running the Screaming Bee software?

    The PC I tried the software on was fairly new so that might have had something to do with your delay.

  • Avatar
    Cathy Eden
    May 18, 2012 at 8:03 am

    That’s a good point. This computer is 9 years old (time really flies!) and only has 512MB. This article was very helpful — thanks again!

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