WKA-1R Robot assisted quantitative assessment of airway management

Object  The emerging field of medical robotics aims tointroduce intelligent tools for physician support. The main challenges for developing efficient medical robotic training systems are simulating real-world conditions of the task and assuring training effectiveness. High anatomic fidelity has been achieved in current systems, but they are limited to provide merely subjective assessments of the training progress. We simulated airway intubation using a unique medical robot and developed objective performance criteria to assess task performance. Materials and methods  A patient simulation robot was designed to mimic real-world task conditions and provide objective assessments of training progress. The Waseda– Kyotokagaku Airway No. 1R (WKA-1R) includes a human patient model with embedded sensors. An evaluation function was developed for the WKA-1R to quantitatively assess task performance. The evaluation includes performance indices and coefficient weighting. The performance indices were defined based on experiments carried out with medical doctors and from information found in the medical literature. The performance indices are: intubation time, jaw opening, incisor teeth force, cuff pressure, tongue force and tube position. To determine the weighting of coefficients, we used discriminant analysis. Results  Experiments were carried out with volunteers to determine the effectiveness of the WKA-1R to quantitatively evaluate their performance while performing airway management. We asked subjects from different levels of expertise (from anesthetists to unskilled) to perform the task. From the experimental results, we determined operator effectiveness using the proposed performance indices. We found a significant difference between the experimental groups by evaluating their performances using the proposed evaluation function (P < 0.05). Conclusions  The WKA-1R robot was designed to quantitatively acquire information on the performances of trainees during intubation procedures. From the experimental results, we could objectively determine operator effectiveness while providing quantitative task assessments.