How a Pediatric Robot is Making Education Real for Nursing Students

Robotic simulators help train medical students face real-life scenarios without endangering patients.
For nursing students at Bunker Hill Community College in Boston, it’s one thing to learn from an instructor or from written material, but it’s far more valuable to interact with a live patient, particularly when it comes to pediatrics, where the patient might not be able to articulate their symptoms as well as an adult can.
But with so many nursing programs in Boston and so few clinical placement slots, getting students face-to-face with pediatric patients was becoming more and more difficult. Then, Bunker Hill found a better way; they switched to a robotic simulator named Pediatric HAL from Gaumard Scientific.
Andrew Camerato, Instructional Technology Coordinator for the nursing program. Camerato says Pediatric HAL delivers several benefits, the main one being that instructors have control. They can program Pediatric HAL to simulate whatever scenario they choose in order to provide a standardized, consistent and repeatable learning experience for all students.
Pediatric HAL, which simulates a 5-year-old boy, is typically deployed in a six-hour-long class that enables six to eight nursing students to each interact with the robot. Students observe symptoms, take vital signs, connect HAL to diagnostic equipment, administer medications and observe how the patient responds to treatment.
HAL is battery operated, so he is wireless, tetherless and can be used in any setting, according to Jim Archetto, vice president of corporate planning at Gaumard Scientific, which has a lineup of other robotic simulators for medical training. HAL is controlled with a tablet, so the instructor can easily switch things up, change scenarios or repeat a process with a mouse click
HAL is capable of facial expressions and eye movements. He cries real tears, his pupils can dilate, his eyes track movement, and he can sweat. The robot can appear lethargic, worried, or in pain. His airway is capable of being intubated, he simulates heart, lung and bowel sounds, produces a pulse and nurses can conduct a variety of activities on HAL, including taking blood via a finger prick or administering an IV.
HAL has a lifelike appearance, but under the skin he’s a mass of complex circuitry, sensors, pumps, compressors, liquids, and more. Archetto says that as the technology improves, Gaumand will continue to refine and improve HAL, as well as introduce new products, some of which will deploy mixed reality.
For example, Gaumard already has an obstetrics robot named Victoria, which simulates difficult delivery scenarios. The next step is adding mixed reality, which will let nurses equipped with a VR headset to literally see into Victoria’s womb, which can help nurses determine whether a baby is in a breech position or has other medical issues.
Archetto says there are four growing markets today for Pediatric HAL: hospitals with pediatric residency programs, nursing and medical schools, training for EMTs and EMS, and medical centers. At a cost in the $50,000 range, HAL entails a serious investment, so he’s typically targeted at life-threatening or trauma-related scenarios such as head injury, asthma attack and seizure.
Of course, when hospitals and medical centers are looking at ROI, it should be noted that one in 20 patients in harmed by medical errors, which are the third leading cause of death in the U.S. An estimated 15% of all health care costs end up covering medical errors. As the population ages, there will be even more call for nurses, EMTs and other medical personnel who are training to respond to emergency situations, which is the Gaumard sweet spot.
Archetto says the company is constantly adding new scenarios and features to its existing lineup of robotic simulators, as well as coming up with entirely new products and employing new production methods, such as 3D printing.  For example, Gaumard has a robotic simulator called Trauma HAL, a ruggedized version of HAL that can be used to train civilian and military medical personnel to treat traumatic injuries that requires the use of tourniquets. And it has robots that simulate a premature baby; the Premie HAL series can simulate 24-week, 28-week or 30-week-old infants.

Simulating childhood seizures

At Bunker Hill, one important application of Pediatric HAL is to train nurses to respond to seizures, says Camerato. HAL can simulate a seizure with body movements and facial expressions. And he responds when nurses administer acetaminophen or other drugs.
Camerato says HAL has a natural appearance that avoids the “uncanny valley effect”, which “makes it easy for students to buy in.” Camerato adds that Gaumard excels at making more realistic skin, facial features, and fingers and toes than other robotic simulator companies. HAL also comes in a variety of skin tones and languages.Camerato says HAL has a natural appearance that avoids the “uncanny valley effect”, which “makes it easy for students to buy in.” Camerato adds that Gaumard
It should be noted that HAL is typically laid down flat on an examining table and doesn’t have the capacity to stand or move its limbs. HAL also doesn’t attempt to be a “social robot,” in terms of interacting with people via natural language.
But HAL can speak – a common scenario would be using a voice app to enable HAL to answer prerecorded questions or to answer questions on the fly, with the instructor speaking into a microphone.
Camerato says he selected Pediatric HAL because he had experience with other Gaumard products at his prior job, and found Pediatric HAL to be “more lifelike” and to be easier to deploy and operate than other robotic simulators.
Because the tablet connects via short-range wireless to the robotic simulator, Camerato says he doesn’t have to “do something crazy with the network.”  His plan going forward is to phase out some older simulators from other companies that are part of the Bunker Hill teaching repertoire, and purchase additional Gaumard models.