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Remote operations Hermes vs Butcher

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					    Remote operations

Main activity 1:

Hermes vs Butcher

Purpose                                                                        Resources
This activity is designed as a main lesson activity. Students                  • ‘Newspaper article’
consider the ethical and moral issues associated with the                      • ‘Thinking guide’.
development of new technology. The activity offers strong
opportunities for cross-curricular work with PSHE, PSE, PSD.                   Prior knowledge required
                                                                               Students should have a basic understanding of telemedicine
Outcomes                                                                       and remote surgery. This can be covered by preceding this
By the end of this activity all students should:                               activity with the Short activities Remote control and Long
                                                                               distance. Further information on telemedicine can be found
• Understand what remote surgery is                                            in Long distance cure and the video Remote operations.
• Appreciate that different groups of people may have
  different views on the nature and benefits of scientific                     If students are unfamiliar with the concept of remote surgery
  and technological advances.                                                  or telemedicine, give them brief definitions. These could be:
                                                                               Telemedicine: The use of modern communications technology
                                                                               for medical diagnosis and patient care when the patient and
                                                                               doctor are in separate locations.
                                                                               Remote surgery: Using robots in the operating room to
                                                                               assist the surgeon in performing surgery. The surgeon views
                                                                               the patient via a terminal and manipulates robotic surgical
                                                                               instruments via a control panel.


     30–45 minutes | The activity can be extended over two lessons


Curriculum links 11-14

 England                              Scotland                                 Wales                                      Northern Ireland

 KS3 Science                         Science                                   KS3 Science                                KS3 Science
 Sc1: 1c                             5.15 Developing informed                  Skills: listen attentively in different    Educational (cross-curricular) themes
 Breadth of Study: 1a–d, 2a, b       attitudes: a commitment to learning       situations and respond appropriately;      Objective 2: Understanding conflict:
                                                                               communicate confidently one’s feelings     Pupils should develop knowledge and
 KS3 Citizenship                     Technology                                and views and maintain with conviction     understanding of conflict in a variety
 Knowledge, skills and               5.19 Knowledge and understanding:         a personal standpoint; empathise with      of contexts and of approaches to its
 understanding: 1g, 2a–c, 3a         needs and how they are met                others’ experiences and feelings; use a    resolution by non-violent means
                                     5.21 Developing informed attitudes:       range of strategies to resolve conflict;
                                     respect and care for self and others;     make decisions and choices effectively;
                                     social and environmental responsibility   make moral judgements and resolve
                                                                               moral issues and dilemmas; make
                                     PSD Interpersonal relationships:          reasoned judgements; take part in
                                     express their own views on                debates and vote on issues
                                     values which are important to the
                                     community; demonstrate respect and
                                     tolerance for those whose opinions
                                     differ from their own
                                          Remote operations




14 -16

 England                                Scotland                                  Wales                                     Northern Ireland

 KS4 Science                            Scotland                                  KS4 PSE                                   KS4 Science
 Scientific enquiry: (single) 1c, d;    Science                                   Skills: Listen attentively in different   Educational (cross-curricular) themes
 (double) 1c                            5.15 Developing informed attitudes:       situations and respond appropriately;     Objective 2: Understanding Conflict:
 Breadth of study: 1a-d, 2a, b          a commitment to learning                  appreciate, reflect on and critically     Pupils should develop knowledge and
                                                                                  evaluate another person’s point of        understanding of conflict in a variety
                                        Technology                                view; make moral judgements and           of contexts and of approaches to its
 KS4 Citizenship                        5.19 Knowledge and understanding:         resolve moral issues and dilemmas;        resolution by non-violent means
 Knowledge, skills and understanding:   needs and how they are met                be aware of the factors involved in
 1g, 2a-c, 3a                           5.21 Developing informed attitudes:       making moral judgements; make
                                        respect and care for self and others;     reasoned judgements; Take part in
                                        social and environmental responsibility   debates and vote on issues




            1. Give teams of students the following scenario:
 Activity




               A team of engineers, scientists and doctors have recently designed and built the world’s first completely
               autonomous robot surgeon. The machine uses sophisticated imaging equipment to make its own diagnoses
               and then performs any necessary surgery without any human intervention.
               Unfortunately, during its first clinical trial something went wrong and the robot malfunctioned, injuring the patient
               it was supposed to be operating on. This has led to some doctors’ unions and patients’ groups calling for the project
               to be abandoned. (ca five minutes)
            2. Explain that the teams with even numbers will be the engineers, scientists and doctors who designed the robot and
               want work to continue, and teams with odd numbers will be the patients’ groups and doctors’ unions who want
               development of the robot stopped.
               Students should put together a robust argument for their particular points of view using the ‘Newspaper article’
               and ‘Thinking guide’ to help them. (ca 15 minutes)
            3. Pair up odd and even teams. Their task now will be to debate the issue using the arguments they have
               formulated and to try to develop a way forward. (ca 15 minutes)
               You might find it helpful to insist on two simple rules:
               • Only one person per debating group speaks at a time
               • The person speaking alternates from one team to the other.
            4. Ask one person from each debating group to tell the class how their particular debate proceeded and what
               their agreed way forward was. The main points from each group can be noted on the board and these can then
               be discussed as a whole class. (ca 10 minutes)




The Institution of Engineering and Technology
   Remote operations

Main activity 1:

Hermes vs Butcher

Differentiation
Easier                                                          Harder
Instead of a debate, ask each team to present arguments to      Set up a ‘public debate’. Only one team discusses their
the whole class and then having a class vote to determine       arguments at a time while the rest of the class is the ‘audience’.
which argument is the most successful.                          Questions from the ‘audience’ to challenge what is said in the
                                                                debate are allowed.


 Teacher references
 The following websites offer some interesting background information.
 History of robotic surgery
 www.websurg.com/robotics/history.php gives an in depth look at the history of robotic surgery.
 USA Acquisition Support Centre
 www.usaasc.info/alt_online/article.cfm?iID=0607&aid=03 looks at robotic surgery from a military perspective.
 A perspective of robotic surgery
 www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1356187 gives a history of the area with a look at the
 advantages and disadvantages.
   Remote operations

Main Activity 1:

Newspaper article




            FARATRON
                                 Daily Gazette
                                       Carolyn Sargent, Chief Medical Reporter



   TROUBLE WAS BREWING                      Speaking before the accident, Dr        Some doctors’ unions and groups
   yesterday at St Swithin’s Hospital       Alison Fuller, head of the design       representing patients are less than
   in Faratron City after Mr Gary           team which developed the robot          happy and are calling for the
   Butcher, 47, came close to losing        said, ”I have full confidence in        project to be abandoned, saying
   his left leg in a botched gall-bladder   Hermes. We have conducted               that a robot could never be fully
   operation.                               extensive trials and I think Mr         trusted with such an important
                                            Butcher’s gall bladder operation will   job.
   Mr Butcher had volunteered to            present no problems at all. In fact,
   be the first patient in the world        I am so confident that I don’t even     Elsewhere, the project has been
   to undergo a completely robotic          intend to be in the hospital myself     hailed as the greatest advance in
   surgical procedure. Speaking             while the procedure is carried out.     medicine since the discovery of
   yesterday from his bed in nearby         This could revolutionise surgery        penicillin. A doctor who did not
   St David’s Hospital he said, ”I can’t    and drastically reduce the number       wish to be named said, ‘Just think
   believe this happened. I expected        of human surgeons needed in a           of what this will mean to people
   to wake up with a small keyhole          hospital.’                              who live in areas of the world
   scar near my navel and go home the                                               where there aren’t currently the
   same afternoon. Instead I have 250       Dr Fuller was unavailable for           skills or the hospital facilities for
   stitches and nerve damage caused         comment today but a source within       sophisticated surgery.’
   by the robot trying to amputate my       the design team said that although
   left leg above the knee.”                Mr Butcher’s experience was
   The operation was being carried out      regrettable it was down to an error
   by Hermes, a pioneering surgical         that had been made by the team
   robot that can diagnose conditions       that calibrated one of its scanners
   and carry out surgical procedures        while it was being installed at the
   with no human intervention.              hospital.
    Remote operations

Main Activity 1:

Thinking guide

The steps below will help you to develop an argument which you can use to support your case either for or against
continuing the development of the Hermes surgical robot.




                               1. Read the newspaper article about Mr Butcher’s unfortunate
                                  experience with Hermes.

                               2. Write a list of points from the article which support your case.
                                  If you can say that a point is a fact, put an ‘F’ next to it. If you
                                  can say that it is someone’s opinion, put an ‘O’ next to it.

                               3. Write a list of points from the article which do not support
                                  your case. If you can say that a point is a fact, put an ‘F’ next
                                  to it. If you can say that it is someone’s opinion, put an ‘O’
                                  next to it.

                               4. Now add your own ideas to these lists, again putting ‘F’ for
                                  fact and ‘O’ for opinion next to each thing you write down.

                               5. Use the points which support your position to write a very
                                  brief opening statement. This will be the first thing you say
                                  in your debate. It should tell the other side:
                                    • What you think about the situation
                                    • Why?
                                    • What should happen now?
                               6. Examine the points which do not support your position
                                  and try to think of arguments against them. This is important
                                  because these are the points which will be used to
                                  undermine you.

                               7. Think about what compromises you might be willing to make
                                  in your arguments. Think also about what compromises you
                                  would want the other side to make.
        Remote operations

Main Activity 1:

Practical activity

If time allows, the lesson can be extended with an additional            Prior knowledge required
practical session in which students work in small teams to
                                                                         Students should be familiar with the basic principles involved
investigate the necessity of developing standards and protocols
                                                                         in building an electric circuit.
for communication.

Resources required per pair                                              Pre-lesson preparation
•   One non-latching push to make switch                                 Print out slips of paper with the following questions on:
•   Two 3 metre leads and one short one                                  • Where did you go on holiday last?
•   One light bulb (3V approx) and holder                                • What is your favourite food?
•   One 3V power supply
                                                                         These questions should be printed one per slip of paper and
•   Supply of crocodile clips
                                                                         there should be enough for one copy of each slip per team.
•   Build your own communicator experiment sheet
•   Two copies of the Code word sheet
•   Morse code sheet.



            1hour


            1. Arrange students into pairs or threes so that there is an even number of teams in the class.
 Activity




                Tell the students that they are going build a simple communications device and develop a system which
                will allow them to communicate with each other. (ca three minutes)
            2. Give each pair a copy of the Build your own communicator sheet and get them to assemble their circuits.
               (ca 12 minutes)
            3. Once the circuits have been assembled and tested, each pair must form a communications link with
               another pair so that they are able to send messages back and forth between themselves.
                Care must be taken so that trailing leads do not constitute a trip hazard. (five minutes)


                                            pair A                                pair B




                                                                                                Non-latching push
                                                                                                to make switches
                                                                                                are best used here,
                                                                                                if available
                                          Remote operations




            4. Explain to the teams that they need to develop a set of rules or protocol for sending messages to and fro
 Activity




               between each other.
                The protocol can also include rules about time spacing between receiving a message and replying etc.
                This aspect is not of direct relevance to their particular activity, where they will effectively be developing a code,
                but it could be worth mentioning to higher ability groups to illustrate the fact that a communications protocol
                is more than just a way of enciphering or encoding a message.
                In order to keep the exercise short, teams can be given the Code word sheet to use for this. This sheet contains
                22 words which can be used for answering the set questions printed on the slips.
                Given the limitations of their equipment, teams will have to create a system similar to Morse code. (25 minutes)
            5. Teams should split into their original pairs or threes, with pair A being given the first question. This can be either
               of the questions printed out prior to the start of the lesson. The only communication between the pairs must now
               be via the communicator the students have constructed.
                Pair A use the code they have developed to transmit the question to the other pair, who then need to send
                a reply, also using the code.
                If any teams are particularly quick in finishing the task, Pair B can be given the second question. (five minutes)
            6. Once a few teams have completed the task ask them what would happen if they swapped around and tried
               to communicate with another pair. It should be obvious that communicating would be practically impossible.
               If time allows pairs can be swapped around and teams can each be given some Morse code sheets and asked
               to communicate using a ‘global’ protocol. It should be obvious that they can now communicate with anyone
               else in the room.
                This illustrates the need for global protocols and standards in communication and can also be used to explain
                one of the reasons why remote surgery is taking longer than some people have expected to become widespread.
                (10 minutes)




The Institution of Engineering and Technology
      Remote operations

Main Activity 1:

Practical activity: code word sheet

           Your task is to create a simple code which will allow you to send basic messages using your communicator.
Activity




           A code gives us a way of representing whole words in one go, whereas a cipher means developing a way of
           representing individual letters. As you only have a short period of time you will need to concentrate on creating
           a code for this activity.
           Bearing in mind that your communicator consists of a light bulb and a switch, the easiest way of developing a
           code is going to be by using sequences of long and short flashes like the dots and dashes in Morse code.
           To keep things even simpler you only have to create a code for the words in the table below. Fill in your code
           in the spaces next to each word.
           You should have two copies of this sheet. Make sure that you fill them both in because you will need them
           for the next part of the exercise.


              Word                        Code                       Word                              Code
              anchovies                                              liver
              cabbage                                                Milton Keynes
              did                                                    my
              favourite                                              on
              food                                                   Siberia
              go                                                     to
              holiday                                                went
              I                                                      what
              is                                                     where
              last                                                   you
              Liechtenstein                                          your
             Remote operations

Main Activity 1:

Practical activity: experiment sheet

                   Building a communications device is really quite simple. All you need is to be able to do is transmit a signal
Experiment sheet




                   over a distance. Even complex information can be transmitted and received using very simple equipment.
                   Here is an example that you can build yourself.
                   Your teacher will give you:
                   • One switch
                   • Two 3 metre leads and one short one
                   • One light bulb (3V approx) and holder
                   • One 3 volt power supply
                   • Supply of crocodile clips.
                   Now you just need to build the following circuit:




                                           Short wire                                   Long wire




                                                                                        Long wire




                   The second part of the activity is to design a method of communication that will allow you to communicate with
                   another group. To do this you will need to think about the following:
                   •   What kind of information do you want to send? It might be pictures, sound or text for example. Pictures and
                       sound would be very difficult with our set up, so really we are limited here to text which will mostly be letters
                       and perhaps some numbers from time to time.
                   •   How will you transmit your text? Probably the easiest thing to do is to use short flashes and long flashes.
                   •   Encipher or encode? Enciphering in this case means representing individual letters with sequences of short
                       flashes and long flashes. Encoding would mean having a sequence of short flashes and long flashes representing
                       whole words.
                       Encoding is faster if you only have a few possible words that you are ever going to send, but enciphering gives
                       you much more flexibility.
                   •   How could you speed things up? Communication needs to be as quick as possible, particularly in applications
                       like remote surgery, so think how you might speed things up. Think about the methods you use to speed up
                       sending a text message on your mobile, for example.
              Remote operations

Practical Activity:

Build your own communicator:
Morse code sheet
 Experiment sheet




                      A           U
                      B           V
                      C           W
                      D           X
                      E           Y
                      F           Z
                      G
                      H
                      I
                      J
                      K           1
                      L           2
                      M           3
                      N           4
                      O           5
                      P           6
                      Q           7
                      R           8
                      S           9
                      T           0

				
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