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Any acquired skill, no matter the specific field, needs practice. Although practicing is rather easy in some areas, the medical field remains, no doubt, one of the most difficult in which to practice the skills and procedures needed for success in the profession.
Dealing with life and death doesn’t leave much room for error, so medical schools and teaching hospitals have had to come up with ways to ensure their apprentices acquire enough experience to learn procedures well, without putting anyone’s life at risk while doing so.
Assisting when physicians diagnose patients, or nurses draw blood, can only get you so far. In order to react in difficult, life threatening circumstances, one needs a more hands-on approach. This is where medical mannequins (and soon) robots came into the picture.
The newest member of this one-of-a-kind family is HAL, the robot that looks like a 5-year-old boy and is used by medical students to better understand how young patients react when treated.
According to wired.com, the robot can cry, bleed, talk and go into anaphylactic shock. It has a pulse, and medical students can perform a wide variety of tests on it.
Gaumard Scientific, a company creating teaching simulators for hospitals and schools since the 1940s, created the device, which is far beyond the first synthetic human skeleton the company long ago produced for medical schools.
Other similar robots have been created for learning purposes before HAL. Victoria, a woman robot who gives birth to a baby robot and a newborn baby robot Super Tory, were built to help train nurses about infant health issues.
Hal is much more than a simple test mannequin, and the starting price of $48,000 says it all.
“Participants can perform a full range of emergency procedures including surgical airway, needle decompression, and chest tube thoracostomy with the highest degree of realism,” John Eggers, Gaumard’s Executive Vice President, said in a statement. “It’s the closest experience to real world pediatric emergency care available today.”
HAL can follow a finger with its eyes, and answer some questions, even including the degree of pain it “feels”, as shown in a demonstration video. The robot can move his head from side to side, cry real tears and call for his mother when “feeling” distressed.
HAL is able to replicate many of the medical situations a physician or nurse might encounter when treating a 5-year-old child.
It can go into cardiac arrest or anaphylactic shock, including the swelling of its tongue and throat, as happens in the case of severe allergies, for instance. Students can draw blood from it and measure sugar, oxygen and carbon dioxide levels. Also, it is equipped with the ability to dilate and shrink its pupils when a light is directed into them.
Using HAL is as close as possible to treating a real person, a human volunteer, so the students can obtain necessary knowledge and practice some procedures. The robot can even be controlled by teachers from another room, or be “told” to react certain ways, making diagnose more difficult.
When looking at HAL, one can see its appearance is not too human; its face lacks some features. The robot was built to be realistic enough to help with teaching, but not so realistic as to make students extremely emotional when they have to slit its throat to insert a tracheal tube.
HAL is a real piece of engineering, having mechanical and pneumatic systems which make it breathe, provide fake blood and tears, and even exhale CO2. Motors pull his face from inside to provide the necessary expressions that make HAL appear angry or scared, but also to give it the ability to simulate certain medical symptoms. Although it does not have certain facial features, to prevent an emotional response from students, HAL has a functioning nose and mouth. He can even yell at students not to touch him.
This actually helps with achieving one of the goals builders had when creating HAL. Since children are not always willing to or even capable of describing how they feel or to interact with medical staff, a teaching tool was needed to help students adjust.
What children don’t say with words, they usually transmit through facial expressions. In order to get those exactly right, the company worked closely with pediatricians to reproduce as closely as possible how a child’s face moves when angry or scared. Muscle movements, brow movements, all were fine-tuned.
The teachers can tell the robot to go into cardiac arrest, making it necessary for students to hook it up to an EKG to monitor its “heart.” He even has a pulse, which can be monitored with a blood pressure cuff.
What HAL brings to the examining table is realism and interactivity. Old rubber dummies, as training mannequins are usually called, could not provide that. Trainees had to check with their instructors to get feedback and know whether they were performing the right protocol or to find out critical readings. Instructors responded from another room, through a microphone known as the Voice of God: “You do not feel a pulse.”
HAL automatically gives students a wide range of readings, and things happen to it in real time.“For so many years, the mannequins were really just rubber human likenesses with basically no interactivity at all,” says Marc Berg, a medical director at the Revive Initiative for Resuscitation Excellence at Stanford. “They’re finally increasing exponentially in their realism.”
Therefore, it is difficult to predict how students will react to HAL, and especially when teachers will decide to complicate matters.
“We can amp the stress level up so high for the participants that people will cry, essentially have to drop out of the scenario,” says Berg. “I do think there’s a good potential that we’ll see more of that emotional type response when the mannequin is so realistic.”
Even if it makes students cry, HAL has the opportunity to better train generations of new doctors and nurses. Since there already is a shortage of medical staff everywhere, this can only be good news.