Retired medical simulation manikins as a development platform for physically assistive robots: a staged roadmap

Physically assistive robots require body designs that ensure safe contact, build trust, and are cost-effective for healthcare providers. However, dedicated platforms often struggle to achieve all three simultaneously. We suggest that high-fidelity medical simulation manikins could serve as a practical development platform in this field. These manikins have an anthropomorphic shape with human-like contact surfaces, internal space for routing cables and mounting devices, and are familiar to clinical staff. Because simulation programs frequently replace their functional units, this hardware can be deployed directly within the institutions that need assistance. Based on a scoping review of 64 studies on manikin adaptation and a pilot project that transformed a retired manikin into a multilingual receptionist for about US$1,200 in additional parts, we propose a staged roadmap: social and cognitive interaction, sensory enhancement, guided physical contact, and active physical assistance, with measurable stage gates governing each transition. The pilot demonstrates only feasibility for conversational and embedded computing, not physical assistance or user acceptance. We recognize limitations, including the need for new load paths, certification under ISO 13482 and related standards, and prospective ethics approval in later stages. Additionally, the realistic appearance of the manikin may pose risks, as added motion to a static, humanlike form can cause discomfort. This roadmap aims to turn these uncertainties into testable hypotheses using an affordable platform and to encourage the assistive robotics community to view the simulation storeroom as a valuable resource.