Nursing Perceptions of Robotic Technology in Healthcare: A Pretest–Posttest Survey Analysis Using an Educational Video

Figures & data

Figure 1. Robotic technology in healthcare definitions and examples. Three categories of healthcare robotic technology (Medical, Care, and Healthcare service) are represented by eight subcategories: (a) Surgical—da Vinci https://www.intuitive.com, (b) Robotic diagnostic systems—Nasal Swab Collecting Robot https://brainnavi.com, (c) Companion—Aibo https://us.aibo.com, (d) Assistive—EksoNR https://eksobionics.com, (e) Medication delivery and dispensing—E3 https://www.omnicell.com, (f) Cleaning and disinfecting—LightStrike https://xenex.com, (g) Telepresence and remote monitoring—Ava Mobile Telepresence https://www.avarobotics.com, (h) Delivery—Fetch https://fetchrobotics.com.

Table 1. Likert items question prompts.

Item	Question	Response format (1–5)
Impact	How would you describe the impact of {robotic technology subcategory} if introduced in clinical areas?	Very detrimental, Slightly detrimental, Neither detrimental nor beneficial, Slightly beneficial, Very beneficial
Acceptance	What level of acceptance do you think {robotic technology subcategory} would have if introduced in clinical workplaces?	Very unwelcomed, Slightly unwelcomed, Neither unwelcomed nor welcomed, Slightly welcomed, Very welcomed
Environment	How conducive is your physical layout of your clinical workplace to having {robotic technology subcategory}?	Very unfavorable, Slightly unfavorable, Neither unfavorable nor favorable, Slightly favorable, Very favorable
Use	How helpful do you think {robotic technology subcategory} will be when doing your job?	Very unhelpful, Slightly unhelpful, Neither unhelpful nor helpful, Slightly helpful, Very helpful
Pre video open response (optional)	Please provide any information you’d like to include for your decision	N/A
Post video open response (optional)	Please provide any information you’d like to include for your decision and comments on ways you think {robotic technology subcategory} should or should not be used.	N/A
End of survey open response (required)	Please provide any information you’d like to include before the end of the survey	N/A

Table 2. Demographic information (n = 88).

Characteristic	Sample count	Characteristic	Sample count
Age		Background
18–29	33 (38%)	Advance practice registered nurse	4 (5%)
30–39	18 (20%)	Certified nurse’s aid	6 (7%)
40–49	17 (19%)	No professional background	7 (8%)
50–59	11 (12%)	Other	7 (8%)
60+	8 (9%)	Patient care assistant	11 (12%)
N/A	1 (1%)	Registered nurse	53 (60%)
Gender		Experience
Female	79 (90%)	<1	14 (16%)
Male	6 (7%)	1–2	6 (7%)
Non-binary/third gender	2 (2%)	3–5	14 (16%)
Prefer not to say	1 (1%)	6–10	8 (9%)
		10–20	15 (17%)
Education		20+	20 (23%)
Associate’s degree	6 (7%)	N/A	11 (12%)
Baccalaureate degree	39 (44%)
Current graduate	12 (14%)	Clinical
Current undergraduate	22 (25%)	Acute care/critical care	22 (25%)
Diploma	1 (1%)	Adult health	13 (15%)
Doctoral degree: DNP	1 (1%)	Anesthesia	3 (3%)
Doctoral degree: PhD	5 (6%)	Cardiology	6 (7%)
Master’s degree	13 (15%)	Community	4 (5%)
		Emergency/trauma	9 (10%)
Place of employment		Family health	6 (7%)
Academia	8 (9%)	Geriatric/gerontology	6 (7%)
Acute care facility	14 (16%)	Home health	5 (6%)
Ambulatory care setting	13 (15%)	Maternal-child health/obstetrics	3 (3%)
Assisted living facility	2 (2%)	Medical surgical	21 (24%)
Federal government hospital	2 (2%)	Neonatal	2 (2%)
Home health	6 (7%)	Oncology	2 (2%)
Industry	2 (2%)	Other	9 (10%)
Investor-owned (for-profit) community hospital	3 (3%)	Palliative care/hospice	3 (3%)
Nongovernment Not-for-Profit Community Hospital	28 (32%)	Pediatrics	5 (6%)
Nursing home/extended care	3 (3%)	Perioperative	4 (5%)
Other	5 (6%)	Psychiatric/mental health/substance abuse	2 (2%)
Physician practice clinic—both PCP and specialty	1 (1%)	Public health	2 (2%)
Physician practice clinic—primary care physician (PCP)	3 (3%)	Rehabilitation	6 (7%)
Physician practice clinic—specialty care	3 (3%)	School health	1 (1%)
School health service	1 (1%)	Women’s health	6 (7%)
School of nursing	9 (10%)
State/local government community hospital	5 (6%)

Table 3. Descriptive statistics and pre-post-video comparison of nursing perceptions of robotic technology in healthcare (Wilcoxon test for paired samples).

	Means (SD)		Median		Mode		Wilcoxon
Robot	Pre-video	Post-video	Pre-video	Post-video	Pre-video	Post-video	p value
Surgical	14.8 (3.7)	16.2 (3.2)	15.5	16	16	16	<0.001
Diagnostic	14.3 (3.7)	15.8 (3.5)	15	16	16	16	<0.001
Dispensing	15.3 (3.6)	16.2 (3.7)	16	16	20	20	0.002
Cleaning	16.8 (3.0)	18.0 (2.7)	17	19	20	20	<0.001
Telepresence	14.8 (3.9)	16.9 (3.3)	15	17	15, 20	20	<0.001
Delivery	15.1 (3.6)	16.7 (3.0)	16	17	16	20	<0.001
Companion	13.2 (4.4)	16.1 (3.8)	14	16	16, 20	20	<0.001
Assistive	14.9 (3.5)	16.4 (3.0)	15	16	15, 18, 19	20	<0.001

Table 4. Themes categories for the end of survey, open-ended exit question.

Themes category	Themes sub-category	Themes	Frequency (n)	Representative quote
Research study	Positive	Good, interesting, and/or important	9	Overall a great and innovative idea to help the healthcare facilities flourish.
Research study	Positive	Educational	11	I wasn’t too sure about robotics in the healthcare setting due to not having any background knowledge or experiences. After watching the video, it was very informative and insightful. I think the idea is innovative and can also provide the warm/comforting companionship as well as reducing any medical errors.
Research study	Mixed	Categories are confusing but collecting opinions of practicing and student nurses is important	1	I was a little confused when answering the questions vs. the video. The video broke the technology into 4 different categories, so it was a little hard keeping track of which one [robotic technology category] I was answering for in the questionnaire. Otherwise, I really appreciate that this was focused on collecting the opinions of nurses/future nurses. So important!
Research study	Negative	Technical difficulties	1	[T]he video was very hard to hear.
Quality of Care	Improvement	Efficiency and safety	5	I think there are a lot of things to consider with using robotic technology. I do not think they should replace the jobs of anyone, but make it be clear that they are to aid and make the jobs of healthcare workers more efficient. There are just somethings that us, humans must do on our own.
Quality of care	Improvement	Patient satisfaction	2	In my opinion it is very welcome to use robots in nursing area, help patients to have better feeling in their life also it will give them better feeling about hospitalization and so on.
Quality of care	Concerns	Error and safety	5	I believe this technology has a place in healthcare, but my particular perception is based exclusively in the population I care for. My experience with mobile robots has been that they are large, cumbersome and slow moving, which is the direct antithesis of a nurse who needs to be nimble, quicky moving and quick thinking. My fear is that a robot would be between me and my patient, causing a delay in emergent care.
Work performance	Improvement	Workload and workflow	3	With technology becoming increasingly involved in everyday life, it can be beneficial to see more technological involvement in healthcare. Tedious, small tasks can easily be fulfilled by robots which can allow nurses and other healthcare workers to better prioritize their mandated tasks to provide the best care possible.
Work performance	Improvement	Short staffing	1	Robotic technology is the wave of the future. With short staff at most hospitals the robots will be in more demand. [sic]
Work performance	Improvement	Burnout	1	This is a necessary technology to reduce nursing burnout
Work performance	Improvement	Specific robotic technology	5	I have worked in facilities that use robots for late food tray delivery and that works well. Also, the VNA in the area I work, uses a telemonitoring system for CHF patients that works very well. The [da Vinci] is used by many surgeons at the hospital I work at. I don’t have personal experience with it. It would not offer much improvement for my job. I don’t see how the med robot would help in hospitals- seems better for outpatient pharmacies or in settings where patients don’t need a lot of supervision/monitoring.
Work performance	Concerns	Job security	4	I think the use of robots is a great help. I do feel the “older” generation of nurses will perceive robots as a way of taking away their jobs/skills
Work performance	Concerns	Personal touch and empathy	6	I found this survey and the education about robotics use in healthcare intriguing. I think there is a place for robotics in health care and their use could lead to improved accuracy, efficiency and quality of patient care, but there is still work to be done to define the appropriate devices within settings. I think it is important to understand the patient’s perspective on use of robotics. I still believe that human touch is part of the art and science of healing and feeling cared for.
Work performance	Concerns	Specific robotic technology	3	I feel as though the robotic companions would negatively impact patients, as they are unable to provide empathy/emotions that patients often need
Nursing in the healthcare system	Improvement	Specific workplace	5	I would be interested in learning more about robotic devices and how they could assist in the ICU setting
Nursing in the healthcare system	Improvement	Nondescriptive	5	I think all in all it will be the most beneficial. It will be hard to sway some people due to their [sic] lack of knowledge when it comes to technology, the possibility of malfunctioning, and the possibility of decreasing job opportunities. However, the beauty of technology can do outstanding things within the healthcare field, it just has to gain the trust of the people.
Nursing in the healthcare system	Concerns	Adoption and implementation	3	very informative video. I do think that the current culture in healthcare may be resistant in adopting new technology such as robotics, in regards to performing such things as testing(nasal swabs…) Although helpful, it reduces facetime between provider and patient.
Nursing in the healthcare system	Concerns	Appropriate technology selection	4	Would be curious how much time it takes to get the robots working and the person who needs to service them compared to an actual person doing the job.
Nursing in the healthcare system	Concerns	Funding and accessibility	1	I think in theory robotic technology would be great but most of the hospitals or health care facilities that would benefit from this are places that can fund such technology. If this technology can be used in smaller, low-income healthcare facilities, that is where it would be most beneficial.