It looks and feels like a real person. It can cough, has a gag reflex and will even cry “ouch!” if handled roughly.

Meet mikoto, a next-generation medical simulation robot developed for students, young doctors and emergency care workers so they can get hands-on training without the risk of harming actual patients.

Medical venture Tmsuk R&D Inc. and Tottori University Hospital, both based in Yonago, Tottori Prefecture, have jointly developed mikoto, the name of which means “life.”

The mannequin-like robot is specifically designed for three tasks: endotracheal intubation (an emergency procedure whereby a patient’s airway is opened by inserting a tube into the windpipe through the mouth or nose); gastrointestinal endoscopy (checking the stomach and other internal organs via a flexible fiber-optic tube with a tiny TV camera attached to its end); and sputum suctioning.

“Due to rapid advances in medicine and medical technologies, the skills and tasks medical professionals need to learn have diversified,” Dr. Toshiya Nakano, a neurologist at the university’s faculty of medicine, said last month at a news conference in Tokyo as the developers unveiled the new simulator.

The move comes at a time when simulation is taking on an increasingly bigger role in training medical students in Japan where textbook learning still accounts for a majority of the curriculum.

Many medical schools and hospitals have simulation centers where such training devices are already in use. But the dolls are often sturdily built, meaning their mouths are difficult to open, causing many young medical professionals to develop bad habits such as handling patients too forcefully, experts say.

That is why simulation robots need to look and feel as real as an actual human, mikoto’s developers said.

“Young doctors used to learn the ropes gradually by observing senior doctors at work and then trying their hand at operating on actual patients,” Nakano said. “Such styles of training are no longer acceptable. Ensuring patient safety is a top concern.”

The inner workings of the robot look real too.

The developers took digital images of the tongue, esophagus and windpipe of an actual patient who went through a check-up at the university hospital and re-created the organs using a 3-D printer.

Mikoto is programmed to respond using a sensor attached in its throat. When the pressure is too strong, it will cry out, itai! (ouch!).

It also provides feedback. Each user gets a score at the end of a practice session based on data recorded by sensors and the amount of time it took to complete a procedure.

Mikoto is one of 30 medical devices currently under development in Tottori Prefecture that also include easy-to-wear mouthpieces for dental surgeries and a laryngoscope that allows doctors to adjust blade sizes.

The prefecture has helped set up brainstorming sessions between local manufacturers and university hospital doctors, offering seed capital for new products that are considered worth pursuing.

Tottori, one of the fastest-aging and depopulating prefectures, wants to rebrand itself as a medical technology hub, and eventually export its products overseas, officials said.

“The stereotypical views of Tottori have been that it’s a place of hot springs, sand dunes and crabs — a remote place,” Hiroya Kitano, a Tottori University director, told the news conference. “Many people think it has nothing to do with cutting-edge medical technology.”

He said, however, that the prefecture can present a new model for industry-academia collaboration.

“We think we can create good products by breaking down the walls of sectionalism and closed-mindedness.”

A Matter of Health is a new weekly series on the latest health research, technology or policy issue in Japan. It appears on Thursdays.

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