Hands-on Activity: Future Hospitals: Robotics and Automated Patient Care Engineering

Contributed by: Inquiry-Based Bioengineering Research and Design Experiences for Middle-School Teachers RET Program, Department of Biomedical Engineering, Worcester Polytechnic Institute

A female nurse checks on a young male patient in a hospital bed by holding a stethoscope on his chest.
copyright
Copyright © 2007 Kelly E. Barnes, U.S. Navy, Wikimedia Commons http://commons.wikimedia.org/wiki/File:US_Navy_070731-N-4238B-007_Lt._Megan_Zeller,_an_intensive_care_unit_nurse,_checks_the_vital_signs_of_patient,_while_he_recovers_after_surgery_aboard_the_hospital_ship_USNS_Comfort_(T-AH_20).jpg

Summary

Students further their understanding of the engineering design process while combining mechanical engineering and bioengineering to create an automated medical device. During the activity, students are given a fictional client statement and are required to follow the steps of the design process to create medical devices that help reduce the workload for hospital workers and increase the quality of patient care.
This engineering curriculum meets Next Generation Science Standards (NGSS).

Engineering Connection

The engineering design process (EDP) is a widely accepted way of arriving at an optimized solution to an identified problem. This activity guides students through the EDP as they apply basic engineering concepts to design automated medical devices. Medical devices are health care products used to diagnose, care for, treat or prevent medical conditions. Examples of medical devices include pacemakers, heart monitors, dialysis machines and physical therapy devices. This project's real-world problem is to design an automated medical device for the hospital of the future. By combining mechanical engineering and bioengineering, students design and construct classroom prototypes of their medical devices.

Pre-Req Knowledge

Prior to the start of the activity, students should have been introduced to the steps of the engineering design process and recognize that the process works in a circular fashion, rather than a linear process with a beginning and an end. Students should be familiar with the creation of multi-view drawings.

Students should also have a working knowledge of programming with the LEGO MINDSTORMS robot kit. Students who are not familiar with programming LEGO can build prototypes without the robotic components or learn the program as they go. See the STEMcentric web page (http://www.stemcentric.com/ev3-tutorial/) for good quality EV3 tutorial videos for students.

Learning Objectives

After this activity, students should be able to:

  • Utilize the engineering design process to develop a solution to a given problem.
  • Explain the reasons for their selected design.
  • Summarize the problem, solution and future recommendations in an oral presentation.

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Middle School Lesson

Educational Standards

Each TeachEngineering lesson or activity is correlated to one or more K-12 science, technology, engineering or math (STEM) educational standards.

All 100,000+ K-12 STEM standards covered in TeachEngineering are collected, maintained and packaged by the Achievement Standards Network (ASN), a project of D2L (www.achievementstandards.org).

In the ASN, standards are hierarchically structured: first by source; e.g., by state; within source by type; e.g., science or mathematics; within type by subtype, then by grade, etc.

  • Define the criteria and constraints of a design problem with sufficient precision to ensure a successful solution, taking into account relevant scientific principles and potential impacts on people and the natural environment that may limit possible solutions. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Evaluate competing design solutions using a systematic process to determine how well they meet the criteria and constraints of the problem. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Develop a model to generate data for iterative testing and modification of a proposed object, tool, or process such that an optimal design can be achieved. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • New products and systems can be developed to solve problems or to help do things that could not be done without the help of technology. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • The use of technology affects humans in various ways, including their safety, comfort, choices, and attitudes about technology's development and use. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Design is a creative planning process that leads to useful products and systems. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • There is no perfect design. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Requirements for design are made up of criteria and constraints. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Design involves a set of steps, which can be performed in different sequences and repeated as needed. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Brainstorming is a group problem-solving design process in which each person in the group presents his or her ideas in an open forum. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Modeling, testing, evaluating, and modifying are used to transform ideas into practical solutions. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Identify and explain the steps of the engineering design process, i.e., identify the need or problem, research the problem, develop possible solutions, select the best possible solution(s), construct a prototype, test and evaluate, communicate the solution(s), and redesign. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Demonstrate methods of representing solutions to a design problem, e.g., sketches, orthographic projections, multiview drawings. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
  • Explain examples of adaptive or assistive devices, e.g., prosthetic devices, wheelchairs, eyeglasses, grab bars, hearing aids, lifts, braces. (Grades 6 - 8) Details... View more aligned curriculum... Do you agree with this alignment?
Suggest an alignment not listed above

Materials List

Each group needs:

Note: This activity can also be conducted with the older (and no longer sold) LEGO MINDSTORMS NXT set instead of EV3; see below for those supplies:

  • LEGO MINDSTORMS NXT robot, such as the NXT Base Set
  • computer loaded with the NXT 2.1 software


To share with the entire class:

  • extra LEGO parts (bricks, beams, bars, etc.), as available

Introduction/Motivation

Client Statement for Students

Hello fellow engineers and welcome to the annual DaVinci Engineering team meeting. Due to recent events, the board of directors has decided to change the direction of our company. We are no longer in the business of food processing; instead, we will focus on developing automated medical devices. Together, we will create the hospital of the future!

The board of directors has identified two medical devices that, if automated, would help increase the quality of treatment for hospital patients. Many patients in today's hospitals are confined to hospital beds or wheelchairs. When patients spend extended amounts of time in one position, certain health conditions may develop, with deep vein thrombosis and pressure ulcers being the most common. Currently, prevention is the best treatment for these conditions. Unfortunately preventing these health issues from occurring is very time consuming and labor intensive for healthcare workers.

How can we help? If healthcare facilities had robotic wheelchairs and hospital beds that would automatically reposition the patients, healthcare workers would be able to dedicate more time to other pressing issues and the quality of healthcare would be improved. As a member of our elite engineering team, your challenge is to design and build the first-generation prototype for either an automated wheelchair or an automated hospital bed.

Vocabulary/Definitions

bioengineering: The application of engineering skills to solve problems in the life science fields.

biomedical engineering: The application of engineering skills to solve problems in the medical field.

constraints: The aspects of the design that must be met to be determined successful.

engineering design process: An iterative decision making process to optimize resources in meeting stated objectives. The major elements of the engineering design process are; identify the problem, research the problem, develop possible solutions, select the best solution, create a prototype, test and evaluate, communicate the solution, and redesign.

functions: What the design/product will do regardless of the chosen solution.

mechanical engineering: The application of engineering, physics and material science to the design of a mechanical system.

medical device: A device designed to help diagnose, care for, treat or prevent a disease or a condition in a patient.

objectives: What the design/product will "be" regardless of the chosen solution.

problem statement: A detailed description of the needs that will be met.

prototype: A first attempt or early model of a new product or creation. May be revised many times.

robot: An automated device capable of carrying out complex and/or repetitive tasks.

Procedure

Background

Bioengineering is the systematic application of the engineering design process to the fields of medicine and biology. A bioengineer must have a solid understanding of biology as well as the ability to draw upon electrical, chemical, mechanical and other engineering disciplines. Bioengineers work in a wide range of areas, including medical instrument design, pharmaceutical delivery systems and medical procedure design and, as demonstrated in this activity, the design of medical devices.

A medical device is a device specifically designed to help diagnose, care for, treat or prevent a disease or a condition in a patient. These devices fall into one of three classifications: Class I is the least dangerous and Class III is the most dangerous.

Class I devices require the least amount of regulatory control, such as tongue depressors, arm slings and hand-held surgical instruments. Class II devices must comply with special control procedures. X-ray systems, gas analyzers and surgical drapes are examples of Class II medical devices. Class III medical devices have the highest level of regulatory controls. Replacement heart valves, pacemakers and breast implants are considered Class III devices.

The field of robotics has the potential to revolutionize the medical field. Currently, robots have been integrated into the medical world in limited areas. Robots are currently used for remote control surgery as well as drug delivery systems. This limited implementation is just the beginning of unlimited possibilities. Medical staff eagerly await further implementation because robots are very precise and do not tire, which has the potential to alleviate many of the monotonous and time consuming tasks that healthcare workers deal with daily.

Bedsores, also known as pressure sores or pressure ulcers, are caused when pressure is applied to localized regions of the skin for extended periods of time. Pressure ulcers often form on skin that cover bony regions of the body, such as elbows, ankles and hips. Pressure ulcers can be very problematic for people who have a medical condition that requires the extended use of a wheelchair or restricts the patient to a bed. Pressure ulcers can develop quickly and are often difficult to treat. Preventing the formation of pressure ulcers is difficult and requires a great deal of time and effort from healthcare workers to move the patient's body position every two hours. To do this, a patient needs to be physically moved in order to change their position on the bed or in the wheelchair.

Deep vein thrombosis (DVT) is another serious medical condition associated with a lack of movement. With this condition, blood pools in the patient's veins and begins to clot. The clots can break free and travel to the lungs where they can cause a pulmonary embolism. To prevent deep vein thrombosis, doctors often prescribe pharmaceutical treatments to thin the blood. Unfortunately blood thinners have unwanted side effects, such as excessive bleeding.

Both pressure ulcers and deep vein thrombosis are conditions that are preventable by limiting a patient's time in any one position. Unfortunately, this is a very laborious task for healthcare workers. In both hospitals and nursing homes, both of these conditions are far more common than desired. Robots have the potential to provide an ideal solution for both health issues. By developing a robotic medical device that can reposition the patient automatically every two hours, healthcare workers become available to address other concerns while the patient is receiving the regular movements necessary to avoid the formation of DVT and pressure ulcers.

Before the Activity

Activity Schedule

Day 1: Administer pre-activity test, introduce the project and complete guided background research.

Day 2: Define the problem, further background research and develop possible solutions.

Day 3: Discuss possible solutions, complete pro/con list for each design, and select best possible solution.

Days 4-8: Create multi-view drawings of the selected design, construct classroom prototype.

Day 9: Evaluate designs, complete EDP packet and organize presentation.

Day 10: Student groups develop design presentations.

Day 11: Group presentation, class debriefing, administer post-activity test.

With the Students

Day 1

  1. Before beginning the activity, administer the pre-activity test.
  2. As a class, discuss medical devices and the ways in which robots could be used as medical devices.
  • Define a medical device as: A device that is designed to help diagnose, care for, treat or prevent a disease or a condition in a patient.
  • Define a robot as: An automated device capable of carrying out complex and/or repetitive tasks.
  • Discuss different robotic devices that are used in hospitals today and provide the following examples: robotic disinfection systems for highly contagious germs, robotic avatars for specialists in distant locations and drug delivery robots.
  • Students discuss some of the difficulties for people confined to beds and wheelchairs.
  • As a class, discuss how robots could help people confined to beds and wheelchairs.
  1. Introduce students to the Hospital of the Future project.
  • Introduce pressure ulcers and deep vein thrombosis to students.
  • Instill a sense of importance to the project by emphasizing its real-world impact.
  1. Divide the class into groups of two students each.
  2. Direct students to use the internet to complete the Hospital of the Future Guided Research Packet.

Day 2

  1. Students start to work on the design project by defining the problem. The EDP packet guides them to define the problem based on the provided client statement. They they identify the functions, objectives and constraints of a successful solution.
  • Read to the class the project introduction and client statement from the EDP packet.
  • Add any additional limitations or requirements for the design teams to address that are beyond those included in the client statement.
  • Each group chooses either a wheelchair or a hospital bed as its project.
  1. Groups conduct additional research into the selected condition and medical device.

Day 3

  1. Student groups brainstorm a minimum of three possible solutions to the problem. They sketch their ideas in the Design Solutions table in the packet. Require the sketches to be detailed enough to get their ideas across to their partners.
  2. Student groups select the best solution.
  • Group members share their ideas with each other.
  • The group identifies which functions, objectives and constraints each design solution meets. Record this information in the Design Solutions table. The team identifies the best solution—the one that meets the functions, objectives and constraints most effectively.

Days 4-8

  1. Students create multi-view drawings for their group's selected design. Multi-view drawings are drawn on graph paper using a ruler and a consistent scale. Require each set of drawings to include at least three different views.
  2. Following the creation of the multi-view drawings, teams construct their prototypes from the provided EV3 kits. Students may use extra LEGO pieces if available.

Day 9

  1. Each group develops four survey questions that are used to evaluate the hospital bed or wheelchair design. Evaluate each team's design by no fewer than five students. Use the data collected to determine the success of the design.
  2. Students evaluate the success of their designs based on the test results. Record the evaluation in the EDP packet and shared it in the design presentations at project end.
  3. In the Future Recommendations portion of the EDP packet, students explain any potential changes to their designs that would help improve the success of the prototypes. Require a detailed sketch of the improved design.

Day 10

  1. Students turn in the completed packet, along with the unselected design solution, which serve as an instructor assessment tool.
  2. Give teams time to prepare design presentations about their design projects. Require them to discuss the design solutions, any challenges encountered, constraints, future improvement ideas, etc. If desired, provide a PowerPoint template for students to use. The presentation serves as one post-activity assessment tool for the design projects.

Day 11

  1. Students present their design, test results, evaluation of the results and future recommendations to the class during a brief design presentation.
  2. Administer the post-activity test.
    A photograph shows what looks like a chair on wheels with gears and sensors, made from a LEGO robot kit and LEGO pieces.
    Figure 1. A student-made robotic wheelchair designed to prevent DVT in hospital patients.
    copyright
    Copyright © 2015 Jared R. Quinn, Worcester Polytechnic Institute

Attachments

Assessment

Pre-Activity Assessment

Quick Test: Before beginning the activity, administer the seven-question EDP Pre-Activity Test to evaluate students' base understanding of the engineering design process.

Activity Embedded Assessment

EDP Packet: Completion of the Hospital of the Future EDP Packet serves as a formative assessment for each student's ability to follow the engineering design process while creating a prototype medical device.

Drawings/Prototypes: Students create multi-view drawings and prototypes of their wheelchair or hospital bed designs. Review their drawings and prototypes to assess their ability to demonstrate methods of representing solutions to a design problem.

Post-Activity Assessment

Student Design Presentations: Following the completion of the EDP packet, each team is responsible for sharing its project with the class. Limit presentations to 3-5 minutes and require them to focus on the students' work within the design process. Also make sure students include their own evaluations of the test results and at least one future recommendation to improve their medical device designs. Assess students on their ability to follow the steps of design process and clearly communicate their design logic and concepts.

Quick Re-Test: Administer the EDP Post-Activity Test, which is the same as the pre-test, to evaluate students' growth in their understanding of the engineering design process.

Additional Multimedia Support

To prepare the EV3 robot for the activity, follow the Five Minute Bot Building Instructions online tutorial, which provides excellent guidance through the building process due to its many images: https://www.youtube.com/watch?v=Dhe2jXi3Fc4.

If you prepare and purchase an Arduino kit in order to ready the robot, make use of a great tutorial guide at http://makezine.com/projects/build-your-own-arduino-controlled-robot/. Additionally, Maker Shed sells all the parts listed throughout the steps (although finding some on alternative sites such as Amazon or www.Sparkfun.com may be less expensive). For example, the 4WD platform they use is listed at https://www.makershed.com/collections/arduino. Maker Shed sells the other integrated circuits needed, and the Arduino Uno can be purchased directly from the company at http://arduino.cc/en/Main/ArduinoBoardUno or from SparkFun Electronics at https://www.sparkfun.com/.

References

Bioengineering. Encyclopedia Britanica Online Academic Edition. Accessed July 1, 2014. http://www.britannica.com/EBchecked/topic/65846/bioengineering

Diseases and Conditions: Bedsores. Mayo Foundation for Medical Education and Research. Accessed July 2, 2014. http://www.mayoclinic.org/diseases-conditions/bedsores/basics/definition/con-20030848

FDA Device Classification. 2008-04. LEEDer Group, Inc. Accessed July 1, 2014. http://leedergroup.com/bulletins/fda-device-classification

Mechanical Engineering. 2014. Merriam-Webster Inc. Accessed July 1, 2014. http://www.merriam-webster.com/dictionary/mechanical%20engineering

Medical Device. McGraw-Hill Concise Dictionary of Modern Medicine, The Free Dictionary. Accessed June 1, 2014. http://medical-dictionary.thefreedictionary.com/medical+device

Your Guide to Preventing and Treating Blood Clots. Agency for Healthcare Research and Quality. Accessed July 2, 2014. http://www.ahrq.gov/patients-consumers/prevention/disease/bloodclots.html

Contributors

Jared R. Quinn, Kristen Billiar, Terri Camesano, Jeanne Hubelbank

Copyright

© 2015 by Regents of the University of Colorado; original © 2014 Worcester Polytechnic Institute

Supporting Program

Inquiry-Based Bioengineering Research and Design Experiences for Middle-School Teachers RET Program, Department of Biomedical Engineering, Worcester Polytechnic Institute

Acknowledgements

This activity was developed under National Science Foundation RET grant no. EEC 1132628. However, these contents do not necessarily represent the policies of the National Science Foundation, and you should not assume endorsement by the federal government.

Last modified: October 30, 2018

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