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The central line dressing change is a life-critical procedure performed by nurses to provide patients with rapid infusion of fluids, such as blood and medications. Due to their complexity and the heavy workloads nurses face, dressing changes are prone to preventable errors that can result in central line-associated bloodstream infections (CLABSIs), leading to serious health complications or, in the worst cases, patient death. In the post-COVID-19 era, CLABSI rates have increased, partly due to the heightened nursing workload caused by shortages of both registered nurses and nurse educators. To address this challenge, healthcare facilities are seeking innovative nurse training solutions to complement expert nurse educators. In response, we present the design, development and evaluation of a robotic tutoring system, ASTRID: the Automated Sterile Technique Review and Instruction Device. ASTRID, which is the outcome of a two-year participatory design process, is designed to aid in the training of nursing skills essential for CLABSI prevention. First, we describe insights gained from interviews with nurse educators and nurses, which revealed the gaps of current training methods and requirements for new training tools. Based on these findings, we outline the development of our robotic tutor, which interacts with nursing students, providing real-time interventions and summary feedback to support skill acquisition. Finally, we present evaluations of the system's performance and perceived usefulness, conducted in a simulated clinical setting with nurse participants. These evaluations demonstrate the potential of our robotic tutor in nursing education. Our work highlights the importance of participatory design for robotics systems, and motivates new avenues for foundational research in robotics. 

An ongoing nurse labor shortage has the potential to impact patient care well-being in the entire healthcare system. Moreover, more complex and sophisticated nursing care is required today for patients in hospitals forcing hospital-based nurses to carry out frequent training and assessment procedures, both to onboard new nurses and to validate skills of existing staff that guarantees best practices and safety. In this paper, we recognize an opportunity for the development and integration of intelligent robot tutoring technology into nursing education to tackle the growing challenges of nurse deficit. To this end, we identify specific research problems in the area of human-robot interaction that will need to be addressed to enable robot tutors for nurse training.