The use of robot-based skill training systems is an emerging topic in nursing education, as many innovative robotic systems have been developed to simulate real patients, offering a safe and self-directed platform for nursing students to learn and practice their skills. Among these training systems, several human patient simulators (HPS) have been proposed to simulate the patients performance during patient transfer; however, without an entire motion model and control strategy, most HPS show limited effectiveness in simulating actual patient behavior. Herein, this work presents a novel patient transfer training system that has the potential of improving the practical skills of nursing students. First, we propose a simplified force model for patient transfer motion to estimate the contact force in the absence of wearable sensors. We then reveal the correlation between the nurses force and patients motion during the transfer through the utilization of the variable admittance model. Finally, we demonstrate the feasibility of the proposed patient transfer training system by performing several experiments on a UR10e robot. To the best of our knowledge, this system is the first patient transfer skills training system that simulates force interaction between nurse and patient using a collaborative robot.

To explore the role of pilot tests in developing gender policies, this study investigates their use of policy‐making for the introduction of male midwives in the United Kingdom. A literature review was performed, and data that contradicted the statements of researchers studying male midwives or male midwives who had participated in the pilots were excluded. Any uncertainties were clarified through consultation with nursing and midwifery associations. The United Kingdom's Midwives Act 1902 initially restricted midwifery to women. However, the Sex Discrimination Act 1973 debates led to the consideration of introducing male midwives. While professional associations resisted, public bodies supported it, on the condition that it guaranteed women's right to select the gender of their attendant midwives. The government decided to conduct pilots to assess the acceptability of male midwives and the financial implications of having chaperones with male midwives. Despite pressure from the European Commission, the decision to permit male midwives across the United Kingdom, made in 1984, was withheld until the results of the pilots were available. However, substantive gender equality issues, such as the working conditions for male midwives, remain largely unexplored. To ensure gender inclusivity in midwifery, scientific pilot tests focusing on both formative and substantive equality are recommended.

This paper introduces the development of a VR program of interview scenes for nurse managers. The contents include four scenarios which nurse managers often encounter. Twenty-two nurse managers participated in its verification. Ninety percent of the participants answered “agree” or “strongly agree” regarding “helpful,” “useful for the future,” and “interesting.” Due to COVID-19, the participants watched the VR program either at their home or work places. All the discussions were held online. Even during the state of emergency, it is confirmed that a VR program can be useful tool for training and education.

Recently, human patient simulators have been widely developed as substitutes for real patients with the objective of applying them as training tools in nursing education. Such simulated training is perceived as beneficial for imparting the required practical skills to students. Considering the aging world population, this study aimed to develop a robot patient for training nursing students in the sit-to-stand (STS) transfer skill, which is indispensable in caring for elderly people. To assess a student’s skill, the robot patient should be able to access the skill correctness and behave according to whether the skill is correctly or incorrectly implemented. Accordingly, an STS control method was proposed to reproduce the different STS movements during correct and incorrect applications of the skill by the nurses. The lower limbs of a prototype robot were redesigned to provide an active joint with a compliant unit, which enables the measurement of external torque and flexibility of the human joint to be reproduced. An experiment was conducted with four nurse teachers, each of whom was asked to demonstrate both correct and incorrect STS transfer skills. The results of the external torque and joint torque measured in robot’s lower limbs revealed that a significant difference (p < 0.05) between correct and incorrect skills. It also indicates the introduction of the proposed control method for the robot can satisfy the requirement of the assessment of STS skill. Among the various measurements conducted, the external torque of the hip joint exhibited the most significant difference and therefore represented the most robust measure for assessing whether the STS transfer skill was correctly applied.

The development of body sensor networks (BSNs) with rich multimodal signals has enabled highly accurate fine-grained action detection, which is the cornerstone of many human–computer interaction applications. However, in the case of consecutive fine-grained actions, most existing wearable sensor-based detection methods are constrained by sliding windows because of their limited temporal receptive fields, and existing sequence-to-sequence detection methods cannot effectively leverage the potential of multimodal information of wearable sensors. Herein, to give multimodal signals full play in fine-grained action detection, we propose a novel temporal convolutional network by designing a channel attention-based multistream structure. We apply it to a promising application for correct and incorrect patient transfer nursing action detection. A data set is collected from a BSN on a patient when nurses perform patient transfer. Extensive experiments on our data set and public data set (C-MHAD) demonstrate that the proposed method is superior to the state-of-the-art methods, because it can strengthen the utilization of prediction features from the more convincing modal stream at each time frame. The source code is available at https://github.com/zzh-tech/Continuous-Action-Detection.

Objective: This study aims to clarify the degree of discrepancy between nurse managers’ intended leadership and staff nurses’ perceptions of leadership. Methods: An anonymous self-administered questionnaire examining leadership recognized by nurse managers and staff nurses was distributed, and data from 41 nurse managers and 592 staff nurses in 41 wards were analyzed through a multi-level structural equation modeling analysis. Results: There was a curvilinear relationship between nurse managers’ intended leadership and the perception of leadership by staff nurses. When the intended leadership score was higher than medium, the staff’s perception score decreased as the intended leadership score increased. Conclusion: There is a discrepancy between nurse managers’ intended leadership and staff nurses’ leadership perception, suggesting that this gap may increase as the nurse manager perceives his or her leadership as superior, particularly when they recognize it as better than medium.

Background: Nurses must make accurate decisions when caring for patients, even when multitasking. A wrong decision may endanger life. Student nurses are responsible only for single patients during their clinical practice. New graduates have minimal experience with multitasking. We developed a virtual reality (VR) multitasking simulation and evaluated its effectiveness. Methods: Student nurses prioritized tasks when caring for patients. We performed a randomized control trial enrolling senior nursing students who were randomly divided into two groups; thus, an interventional group (13 students) and a control group (performing a paper-based exercise; 14 students). The educational outcomes were measured by asking multiple-choice questions. Subjective confidence was assessed using a Visual Analog Scale. Results and Discussion: The educational outcomes did not differ significantly between the two groups. Subjective confidence was significantly higher in the intervention than in the control group. Conclusion: Although the VR simulation did not improve education, it significantly increased subjective confidence.

To more efficiently enhance the patient transfer skills of nursing students, this study aims to integrate a transfer skills evaluation system and a robot patient. The evaluation parameters, namely, the translational acceleration of the waist, rotational speed of the chest, and joint angles of the shoulder, hip, and knee, were selected on the basis of the pre-experimental results obtained with a simulated patient acted by the human individuals. To measure these parameters, inertial measurement unit (IMU) and angular position sensors were installed on the robot patient. An experiment was conducted with four nursing teachers to verify whether the robot patient could distinguish the incorrect methods of the transfer skills, determined to be a common mistake made by the nurses. According to the results, most transfer steps had the same effect on the simulated patient and the robot patient, which demonstrates that the robot patient is a suitable substitute for an actual patient. However, in certain steps, the robot patient was not able to distinguish between the correct and incorrect methods using the chosen parameters owing to the differences being insignificant. These insignificant differences were mostly attributed to the passive joint design of the robot patient.

With the number of hospital stays increasing, nurses require more training to handle a variety of patients. However, time for training in nursing schools is limited, and students lack the opportunity to practice on a diverse variety of patients. Using a robot to simulate actual patients, this study observes the learning transfer effect of practice on practice-similar and practice-dissimilar skills from one patient to another, and investigates which types of practice suit which kinds of training. An experiment was conducted by administering a pre-test, practice, a post-test, and a transfer test to two groups (N = 8), each with different practice-related skills. The evaluation used a checklist covering required skills that were either similar or dissimilar across groups, depending on their practice. The effect of practice can be observed through a comparison of skills similar to one group but dissimilar to the other. The results show that practice facilitates learning transfer on similar skills but not, or to a lesser degree, on dissimilar skills. Furthermore, if skills needed to handle given symptoms are unfamiliar or inaccessible to students, practice related to those symptoms should be emphasized through simulated training with robots.

Currently, due to shortages in the nursing faculty and low access to actual patients, it is difficult for students to receive feedback from teachers and practice with actual patients to obtain clinic experience. Thus, both evaluation systems and simulated patients have become urgent requirements. Accordingly, this study proposes a method to evaluate the nurse's transfer skill through observation from the patient. After verifying the proposed method, it will be integrated with a robotic patient as a future work. To verify if such an evaluation is practical, a checklist comprising 16 steps with correct and incorrect methods was proposed by the nursing teachers. Further, the evaluation parameters were determined as translational acceleration, rotational speed, and joint angle of patient. Inertial sensors and motion capture were employed to measure the translational acceleration, rotational speed, and joint angle. An experiment was conducted with two nursing teachers, who were asked to carry out both correct and incorrect methods. According to the results, three parameters reveal the difference for a patient under correct/incorrect methods and can further be used to evaluate the nurse's skill once the thresholds are determined. In addition, the applicability of inertial sensors is confirmed for the use of robot development.

Nowadays with the advancement of technology, many evaluation systems have been developed for skill learning. However, those systems are inevitable to set the sensors on trainees or environment (e.g. camera). Therefore this study aims to propose a method to indirectly evaluate the patient transfer skill through only measuring the patient, instead of the nurse. Based on the observation of the patient’s movements during transfer, joint angle and acceleration of patient are determined as two parameters to evaluate the nurse’s skill. Incorrect ways of transfer skill were added into a checklist, proposed in our pre-work, based on clinical experience of nursing teachers. An experiment was conducted by two nursing teachers, and they were asked to carry out the patient transfer skill through both correct and incorrect ways as proposed in the checklist. The results exhibit those two parameters enable to show the difference while the nurses carried out the incorrect way. The angles of hip and knee joints enable to reveal the difference in the steps related to standing up and sitting down; while the acceleration of patient can exhibit the difference of patient’s dynamic movement. According to such results, the indirect evaluation became practical for the future works.

To avoid back injuries, caregivers are advised to use transfer-aid equipment while transferring a patient from a bed to a wheelchair. Although the usage of such equipment has been recommended for several decades, it remains unpopular in several countries, including Japan. The current study investigates the feelings of caregivers regarding the usage of transfer-aid equipment, the cause of their feelings, and the measures that can be considered in order to increase the acceptance of transfer-aid equipment by the extensive caregiver community. The relations among the movements of users (caregivers and patients) and impressions of the caregivers regarding the equipment, while monitoring the usage of the equipment, were analyzed using Kansei engineering. The relations revealed six distinct feelings that are related to users' movements while using the equipment.

This research aims to develop a robot to help nursing students learn how to physically transfer paralyzed patients. Our prior robotic prototype had only been designed to imitate a patient with weak lower limbs; it was unable to imitate the imbalance and instability of the trunk. Therefore, we developed and waist joint on the prototype robot and also the control system in order to emulate quadriplegic and hemiplegic patients' tendency to fall over. The waist was designed with 2 DOF compliant joints. Evaluation of the robot showed that the robot was able to properly imitate the unstable waist movements of paralyzed patients.

In this research we conducted experiments for the purpose of clarifying the learning effectiveness of self-study by nursing students using the robot patient and the effect of more "patient-like" robot on the self-study of nursing students. The robot patient are 160 cm height, 40 kg weight. A motor is installed into the shoulder and elbow joints of both upper limbs, and a thermo-brake is installed in both knee joints. Triggered by the vocal greeting of the nurse, the motor and thermo-brake can be respectively controlled and can reproduce the paralysis of the upper and lower limbs and express pain via audio. We conducted an experiment targeting 12 nursing students at a nursing university. We conduct self-study of wheelchair transfer 6 times using the robot patient and we graded the students' skills using a wheelchair transfer scoring checklist drafted in advance by nursing teachers. Because the score clearly rises, showing that the robot patient is effective for self-studying wheelchair transfer. Also, by conducting self-study using robots which reproduce the entire human body of patients, students who had never interacted with patients were able to be cognizant of patients closer to reality. It was clarified in our questionnaire survey that the students felt the weight of patients, the difficulty of assisting the limbs of patients with paralysis and pain, the difficulty of keeping the patients safe, etc.

In the past few decades, simulation training has been used to help nurses improve their patient-transfer skills. However, the effectiveness of such training remains limited because it lacks effective ways of simulating patients' actions realistically. It is difficult for nurses to use the skills learned from simulation training to transfer an actual patient. Therefore, we developed a robot patient that could simulate the behavior of patients' limbs for patient-transfer training. This study examined the performance of the robot used in training and evaluated its training effectiveness. Four nursing teachers individually transferred the robot patient and then scored the robot patient's ability to simulate patients' actions and its suitability for skill training. An experiment using pre-post control group design was carried out to examine the robot patient's training effectiveness compared with the human simulated patient. The participants were 20 nursing students and one nursing teacher who was responsible for scoring the students' skills in the pre-test and post-test. All of the students were assigned to train with either the proposed robot patient or a healthy person simulating the patient. The results show that all four nursing teachers regarded the robot patient's actions as realistic. In addition, all four teachers agreed that the robot patient was suitable for skill training. The results also show that the proposed robot patient is more challenging than the current method, which employs a healthy person to simulate the patient. Significant skill improvement (p <; 0.01) was observed in the experimental group when transferring the robot patient.

To improve the patient transfer skill of nursing education students, we developed a robot patient that can simulate three categories of patients: 1) patients whose movements are affected by paralysis; 2) patients whose movements are sensitive to pain with painful expression; and 3) patients whose movements are constrained by medical devices. By practicing with the robot patient, nursing students can learn the skills required for interacting with various patients. To simulate trunk movements of these different patients, novel waist and hip joints with hardware-inherent compliance and force-sensing capability were proposed. In addition, control methods were developed and the parameters were tuned based on actual patient videos. To evaluate the developed robot, nursing teachers performed trials of transferring the robot patient as they would transfer an actual patient. The nursing teachers scored the robot patients based on a checklist. Moreover, subjective evaluations of a questionnaire were performed by the nursing teachers. The results showed that the nursing teachers performed most of the required skills of the checklist and agreed regarding the learning effectiveness of the robot. They recommended training nursing students using the robot patient in the questionnaire. Finally, hugging speed comparison showed that the nurses slow down the speed when dealing with a robot patient with painful expression.

Purpose – For self-training of nursing students, this paper developed a mannequin to simulate and measure the movement of a patient’s arms while nurses changed the patient’s clothes on a bed. In addition, using the mannequin the purpose of this paper is to determine the difference in the handling of a patient’s arms between nursing teachers and students. Design/methodology/approach – The target patient was an old man with complete paralysis. Three-degrees-of-freedom (DOF) shoulder joints and one-DOF elbow joints were applied to the mannequin. The angles of all joints were measured using a potentiometer, and those angles were transmitted to a computer via Bluetooth. Findings – In a preliminary experiment, the two nursing teachers confirmed that the mannequin arms simulated the motion of the arms of a paralyzed patient. In the experiment, two teachers and six students changed the clothes of the mannequin. The average joint angle of the left elbow and the moving frequency of the left elbow, right shoulder adduction/abduction and right shoulder internal/external rotation were lower in the case of teachers dressing the mannequin than when students were dressing it. Originality/value – The proposed system can simulate a completely paralyzed patient that nursing students would normally be almost unable to train with. Additionally, the proposed approach can reveal differences between skilled and non-skilled people in the treatment of a patient’s body.

The purposes of this study are (1) To develop a chest auscultation self-learning system for nursing students with which both a self-learning tool and an evaluation tool are integrated, and (2) To evaluate the system whether nursing students are able to acquire the chest ausculation skills. We have developed a system using RFID tags and RFID reader (TECCO). Six nursing students used this system for 15 min, and received feedback after each performance from this system. The students’ performance was evaluated. The highest score was 85, and the lowest score was 10. The range of practice time was between 5 and 13. The differences between highest score and lowest score for each examinee ranged from 63 to 25. The results indicated that nursing students can learn the chest auscultation skills using this system even they spend a limited time for practice if they use repeatedly.