Satoru Shoji

Development of Airway Management training system WKA-4: Provide useful feedback of trainee performance to trainee during Airway Management

The emerging field of medical robotics is aimed at introducing intelligent tools. More recently, thanks to the innovations in robot technology (RT), advanced medical training systems have been introduced to improve the skills of trainees. The principal challenges of developing efficient medical training systems is that they must simulate real-world conditions of the task, provide objective assessments of training progress, and provide useful feedback to trainees. So far, many medical training systems have been developed; however, those training system do not fulfill the three conditions of the Active Training system. For the proof of concept of an effective Active Training system, we proposed WKA-4 (Waseda Kyotokagaku Airway No.4) which satisfies all of the requirements of the Active Training system. In this paper, we present the hardware configuration of the WKA 4 briefly, which has 11 embedded actuators and 44 embedded sensors, and simulates real-world condition of the task. In addition, in order to verify the usefulness of feedback of the WKA 4 for medical training, a set of the experiments were carried out to a doctor group and two novice groups. One novice group is provided by the feedback of the embedded sensors of the WKA-4 while the other novice group is not. From the comparisons of the results of the experiments, we verify the effectiveness of our proposed Active Training system.

Development of a novel flow sensor to acquire quantitative information on BVM operation during airway management training

Airway management is a basic skill for emergency rescue. The operation of the bag valve mask (BVM) is also a key process. The BVM is used not only to provide oxygen but also to detect if the tracheal tube is inserted in the trachea or bronchus. Currently, there are many training platforms designed for training medical staff. Most of them can provide subjective assessments. However, they are limited in providing quantitative assessments of a trainees performance, including information about the BVM operation. Therefore, we propose a novel flow sensor system that can not only provide quantitative information on the trainees BVM operation, but it can also objectively evaluate the trainees performance. Waseda Kyotokagaku Airway — No.5 (WKA-5) is the newest platform that we designed for airway management training. It is based on robot technologies. Many types of sensors are embedded in this robot. In this paper, we will introduce the mechanical structure of the flow sensor and the method of data processing. The flow sensor has superior characteristics, such as high precision, quick responsiveness, and ease of maintenance. Using this sensor, we can analyze the frequency of BVM operation and detect whether the tracheal tube is in the proper position. Finally, several preliminary experiments have been carried out to confirm the accuracy and effectiveness of the flow sensor and evaluate the trainees operation.

Development of the airway management training system WKA-4: For improved high-fidelity reproduction of real patient conditions, and improved tongue and mandible mechanisms

In recent years advanced robotic technology has seen more use in the medical field to assist in the development of efficient training systems. Such training systems must fulfill the following criteria: they must provide quantitative information, must simulate the real-world conditions of the task, and assure training effectiveness. We developed Waseda Kyotokagaku Airway series to fulfill all of those requirements. The WKA series we had developed does not consider external appearance such as patient skin, or internal appearance such as the pharynx, larynx, and esophagus. Moreover, the tongue mechanism of the previous system can not precisely measure the force applied by medical devices and cannot simulate muscle stiffness. In addition, the mandible mechanism of the previous system could not adequately reproduce various airway difficulties or apply force control. For these reasons, we propose the WKA-4, which has high-fidelity simulated human anatomy, and we have improved the mechanism over the previous system. We have also attached a lung to the proposed system to improve simulation of the real-world conditions of the task. In this paper, we present how to design several organs with various embedded sensors and actuators, for a conventional patient model with high-fidelity simulated human anatomy. We also present the control system for the WKA-4. Finally, we present a set of experiments carried out using doctors as subjects, and they gave their valuable opinions about our system.

Development of a human-like neurologic model to simulate the influences of diseases for neurologic examination training

Neurologic examination procedures require not only abundant knowledge but also prominent skills. During medical education and training, several methods will be put to use such as watching video, reading books, making use of the simulated patient (SP), and so on. These can help medical staffs, especially novices, to master the skills and accumulate experiences. To make up for the drawbacks of the above methods, such as lack of active interactions, limitation of multi-symptom reproductions, etc, the medical training simulators have been developed to improve training effectiveness. However, most of these simulators only mimic the symptoms. They have no the abilities to show the pathology of diseases. This limits the training effectiveness. In this paper, we propose an elbow robot named WKE-1(Waseda Kyotokagaku Elbow Robot No.1) for neurologic examination training as one part of the whole body patient robot named WKP (Waseda Kyotokagaku Patient). In this robot, we simulate various symptoms occurring during the examination of elbow force, biceps tendon reflex, involuntary action, and also make a physiological neurological model to simulate the pathology of the nervous system. Taking advantage of this robot, the trainee can get a systematic training on both the skills and knowledge. Finally, we take a set of experiments to verify our proposed mechanism and system. The experimental results lead to the consideration that the approach is worth following in further research.

Development of the airway Management Training System WKA-5: Improvement of mechanical designs for high-fidelity patient simulation

In recent years advanced robotic technology has seen more use in the medical field to assist in the development of Active Training systems. Such training systems must fulfill the following criteria: they must provide quantitative information, must simulate the real-world conditions of the task, and assure training effectiveness. For these reasons, we have developed WKA (Waseda Kyotokagaku Airway) series which can satisfy the above three conditions. However, the mechanical mechanisms of the previous system WKA-4 were not designed to consider internal organs and external appearance. As a result, it cannot simulate high fidelity anatomical organs including tongue, oral cavity, nasal cavity, upper airway and esophagus. Therefore, we are proposing WKA-5 (Waseda Kyotokagaku Airway No. 5), which improves those mentioned defects of the WKA-4. In this paper, we present mechanical mechanism designs such as a mandible and a tongue mechanism which consider internal organs such as upper airway, tongue, nasal cavity, esophagus and external appearance. Finally, a set of experiments was carried out to doctor subjects in order to verify the usefulness of our proposed mechanism, and discuss the doctors on the results of the experiments.

Development of airway management training system WKA-4: Control system for simulation of real world condition of patient's motion

In recent years advanced robotic technology has seen increasing use in the medical field to assist in the development of efficient training systems. Such training systems must fulfill the following criteria: they must provide quantitative information, simulate the real-world conditions of the task, and assure training effectiveness. For these reasons, we have developed the Waseda Kyotokagaku Airway series to fulfill all those requirements using actuators and sensors as the main elements. Our WKA series could not completely simulate real-world conditions of the patients such as the motions of head, mandible, and tongue, which is important for the task of human airway management. In order to simulate the motions of those parts as in a real human being, we propose Waseda Kyotokagaku Airway No. 4, which meets all requirements of effective training systems. Particularly, for realistic simulation of the motions of those parts, the WKA-4 has improved mechanisms with high-fidelity simulated human anatomy, and Virtual Compliance Control is implemented to reproduce the stiffness of the humans muscles. In this paper, we present the hardware configuration and discuss the realistic simulation of the motions of those parts using a motion control system and control system for the WKA-4. Finally, we present a set of experiments carried out using doctors to verify our proposed mechanism and control system.