Improving the hospital experience for children using a social robot

In this interview, News-Medical talks to Dr. Justin Wagner about Robin, the social companion robot, and how he improves children’s hospital experiences.

Can you tell us about your work and tell us what led you to carry out this study?

Robin is a social companion robot designed to help children in healthcare settings. In Armenia, where it was developed, it was previously studied in outpatient clinics and has shown promise in reducing anxiety levels in children.

Before the pandemic, we were already interested in bringing the most engaging technologies to support our pediatric patients. Our team met the creators of Robin and we were struck by the robot’s capabilities, which seemed to represent the most advanced social support robotics we’ve heard.

We designed a study to introduce Robin into a pediatric inpatient setting, and we assembled a team of scientists, behavioral health experts, and child life specialists. The timing of the pandemic was fortuitous and accelerated the research plan.

As restrictions for visitors were put in place and emotional support services were limited during a time of uncertainty surrounding the transmission of COVID-19, we figured Robin could provide a crucial service by ramping up the already incredible work. of our specialists in the life of the child.

Image Credit: UCLA Health

Your study found that communicating with children via a social robot improved their hospital experience. How was this study designed?

Under the circumstances of the pandemic, personal visits were restricted and remote interactions were becoming the new normal. We designed our study to compare the type of emotional support that Child Life specialists could provide through two types of interactions: video chat with a Child Life specialist via a tablet versus telepresence with Child Life specialists projecting via Robin the Robot.

Children and their parents participated in surveys on the positive and negative affect of the child (conscious manifestations of emotion). Specialists from Child Life also participated in a focus group to discuss their perceptions of the benefits or challenges of using Robin with their patients in the hospital.

How did you analyze your data and determine that the robot was having a positive effect on children’s experiences?

The questions in our survey of children and their parents consisted of the validated Positive and Negative Affect Scale (PANAS), which we assessed before and after each visit. We compared the changes in each child’s positive and negative affect between those who received a tablet encounter and those who received a visit from Robin.

The PANAS scale was valuable in that we could assess the effects of each type of visit on positive and negative emotional states. While an increase in positive affect is a great result, a simultaneous decrease in negative affect is even better.

Why do you think the presence of the robot has improved the children’s hospital experience so much?

The way we designed the study allowed us to see the effectiveness with which the specialists at Child Life provide emotional support. When they operated the robot, their effects were magnified. While we are unfortunately unable to conclude from our data the exact reasons for these effects, there are a few that I suspect.

On the one hand, I think the children were more involved with the physical presence of a life-size being in the room rather than the 2-dimensional projection of a video chat. Robin also has a whimsy factor. The smooth frame, glossy white surface and soft animated facial features are enchanting.

Robin the robot on Fox11

How did this method allow children to have more control over their hospital experience?

I have to thank the Child Life specialists for developing an entire character for the robot, a naive being from an alien planet who is here to learn more about Earth. The kids taught Robin where they live, the songs they love, and their favorite dance moves.

I think the children felt comfortable sharing and confiding in this curious companion. They were the experts in this relationship, a role they rarely get to experience in the hospital.

How did the positive effects spread to families and healthcare workers?

Our most statistically compelling finding was that patients’ parents perceived a 75% reduction in negative affect after a visit with Robin and no change in negative affect after a visit with a tablet. For me, this is an incredibly significant discovery.

For my patients, a reassured parent is just as important as any surgery I perform. In Child Life focus groups, specialists identified that Robin gave them a greater sense of engagement, intimacy with their patients, patient-centered care and ease of infection control measures. while they were providing their services.

Can you give us some information about the robot, Robin, and how it was developed? How difficult is the operation of the robot?

Robin was developed in Armenia by Expper Technologies, Inc. Its creators intended Robin to provide companionship and entertainment for pediatric patients who may be anxious in healthcare settings. They designed the robot to be 4 feet tall with a curved frame to allow for easy hugging. They designed his face to have big, sympathetic eyes and fitted him with a voice modulator so that Robin would talk to his mate with a child’s voice.

The robot comes with a remote-controlled software suite that allows its operator to move its wheelbase, or project different emotional expressions, show videos or move its face panel. Specialists at Child Life found that the biggest challenges included a learning curve and time commitment required to develop the robot character and control it remotely in real time.

Expper hopes to develop future iterations of Robin driven by an artificial intelligence engine capable of fully autonomous conversation. Robin currently has the ability to recognize and calculate the emotional state projected by his mate’s facial expression, although we chose not to study this characteristic in our pilot study.

The world has undergone a big change to use remote interaction more often in the wake of the pandemic. How could this study impact the future of doctor-patient interaction?

I see Robin as a creative way to break down barriers to sensitive communication during the pandemic and beyond. Social robots like Robin can be deployed in any healthcare facility to improve access to care through telepresence, or to provide emotional support to those who need it most. As a pilot, our study was the first of what will hopefully be many next steps to demonstrate how social robotics benefits healthcare.

Importantly, we have shown that, even under the dramatic circumstances of the COVID-19 pandemic, Robin the robot is increasing and improving the hard work of people who treat families at Mattel Children’s Hospital. This can and should be replicated and studied further in other centers.

How could these robots become an integral part of hospital pediatric care and do you think this type of practice will become commonplace in our future?

Robin made it possible for our Child Life Specialists to engage with children who were otherwise unreachable, either due to emotional factors such as fear, anxiety and prior trauma, or due to physical barriers. such as strict infection control measures. Even in our well-endowed hospital, child life specialists are in great demand.

I suspect we’ll see robots like Robin providing telepresence visits to children in contexts like these where resources for emotional support are otherwise limited or cumbersome.

Robot in hospital

Image Credit: Phonlamai Photo /

How does robotics, in general, improve and help the medical industry? How will their influence evolve over the next few years?

The fantasy factor is applicable in several aspects of medical care. Robots are used in some settings for the intelligent transport of materials in hospitals, to augment a surgeon’s hands and instruments during difficult operations, and like Robin for emotional support. Those who receive emotional support are in their infancy, providing rudimentary functions and physical presence.

As artificial intelligence evolves over the next few years, its integration with robotics will lead to an explosion of innovative ways to increase the experience of providing and receiving medical care. Robots can help us educate us about the effectiveness of our care, provide us with more sophisticated assistance in surgical procedures, and extend the reach of our highest quality healthcare to those in remote areas with less access.

What is the next step in this study?

Now that we have demonstrated the feasibility of introducing Robin as a component of pediatric inpatient care, we are looking to broaden our scope. We aim to determine how Robin’s enhanced facial expression recognition features can be used to improve emotional support.

We intend to increase the number of interactions with patients so that we can draw more detailed conclusions about the extent to which robots increase emotional support. We will also be looking at other environments within our healthcare system to determine which ones need it most, such as infusion centers, x-ray rooms, and even adult and geriatric care facilities.

Where can readers find more information?

About Dr Justin Wagner

I’m a pediatric surgeon at Mattel Children’s Hospital at UCLA. I am board certified in Pediatric Surgery and Surgery by the American Board of Surgery and a member of the American Academy of Pediatrics.Dr Justin Wagner

I am an assistant professor and co-chair of the surgical clerkship at the David Geffen School of Medicine at UCLA. My academic interests are in multimodal and comprehensive pediatric surgical care, national and international surgical training, and innovation and multimedia in medical education.

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