Background: The integration of medical technology in the operating room has revolutionized surgical workflows and team dynamics. However, this progress coincides with a critical global shortage of nurses and a high turnover rate within the existing nursing workforce, impacting patient care quality, nurses' well-being, and hospital finances Aim: This study investigates the impact of technological complexity on the workload and job satisfaction of intra-operative nurses, focusing on open surgery, minimally invasive surgery, and robotic-assisted surgery within the gynecology department of a Dutch academic hospital. Method: The study design follows a mixed-methods approach, combining qualitative and quantitative methods to assess nursing experiences across three surgical modalities. Specifically, we conducted 5 interviews, distributed 28 validated questionnaires, performed automated video analysis on 35 recorded surgeries, and analyzed hospital datasets encompassing 411 cases. Data collection took place in 2022 and 2023. Results: Findings show that intra-operative nurses experience varying levels of workload and job satisfaction depending on the level of technology. Open procedures showed the highest job satisfaction, characterized by continuous engagement and manageable workloads. Minimally invasive surgery procedures, while less physically demanding, were associated with reduced involvement and lower satisfaction. Robotic-assisted procedures presented the most significant challenges, with increased workload, reduced involvement, and heightened stress stemming from surgery preparation, technological complexity, and altered team dynamics. Conclusions: Advancements in medical technology improve outcomes and efficiency but often neglect their impact on intra-operative nurses. Communication issues, equipment challenges, and limited technical training contribute to burnout and turnover. This study underscores the need for supportive operating room environments that prioritize nurses’ well-being. By examining the link between technology, workload, and satisfaction, it offers strategies to retain and empower nursing staff. It also shows how automated video analysis can objectively assess nursing roles, highlighting the importance of balancing technology with human-centered care in the operating room.

This chapter discusses principles, frameworks, and steps for designing a roadmap to implement Responsible Research and Innovation (RRI) in industrial practices. It is based on invaluable experience gathered from the EU-funded PRISMA project, in which a trans-disciplinary group of experts from research, industries, and policy developed guidelines to include relevant societal values in the development strategy of innovative products. These guidelines are built on existing corporate social responsibility (CSR) and quality, risk and innovation management standards and policies. Fundamentally, they provide a management standard (Plan-Do-Check-Act cycle) that could help companies to introduce structural changes in their usual business practices toward more anticipatory, inclusive, and RRI practices (responsibility-by-design). The guidelines can be used by researchers, businesses, and innovators to develop long-term strategies (roadmaps) for Responsible Innovation, which, in turn, help organizations identify and achieve technologies geared toward ethically and socially desirable outcomes.

Literature proposes numerous initiatives for optimization of the Operating Room (OR). Despite multiple suggested strategies for the optimization of workflow on the OR, its patients and (medical) staff, no uniform description of ‘optimization’ has been adopted. This makes it difficult to evaluate the proposed optimization strategies. In particular, the metrics used to quantify OR performance are diverse so that assessing the impact of suggested approaches is complex or even impossible. To secure a higher implementation success rate of optimisation strategies in practice we believe OR optimisation and its quantification should be further investigated. We aim to provide an inventory of the metrics and methods used to optimise the OR by the means of a structured literature study. We observe that several aspects of OR performance are unaddressed in literature, and no studies account for possible interactions between metrics of quality and efficiency. We conclude that a systems approach is needed to align metrics across different elements of OR performance, and that the wellbeing of healthcare professionals is underrepresented in current optimisation approaches.

There is now almost a decade of experience with RRI (Responsible Research and Innovation), including a growing emphasis on RRI in industry. Based on our experiences in the EU-funded project PRISMA, we find that the companies we engaged could be motivated to do RRI, but often only after we first shifted initial assumptions and strategies. Accordingly, we formulate six lessons we learned in the expectation that they will be relevant both for RRI in industry as well as for the future of RRI more broadly. These lessons are: (1) Strategize for stakeholder engagement; (2) Broaden current assessments; (3) Place values center stage; (4) Experiment for responsiveness; (5) Monitor RRI progress; and (6) Aim for shared value.

The concept of Responsible Research & Innovation (RRI) seems to gain initial momentum. The lack of collective meaning however, results in a plethora of publications, which describe RRI from ad hoc perspectives. To provide a robust foundation for scholars and practitioners seeking to implement RRI, we aim to integrate those perspectives through a literature review. We develop a practical framework for RRI, synthesized from earlier frameworks and ideas, that can be operationalized in research and innovation practice to help make RRI more tangible for scientists and engineers. We analyze policy papers, EU project proposals, and academic articles on RRI that appeared between 2011 and 2016 to identify common qualifiers of RRI. The resulting framework integrates a set of qualifiers that are central to the concept of ‘responsive’ research and innovation. The framework also allows identification of ‘RRI shortcuts’ to be avoided. We invite scholars to investigate the applicability of this framework as a means of shifting RRI from concept to practice.

Responsible innovation requires, among other things, that innovators reflect on the broader socio-ethical and socio-economic context of their work. This may be done by reflecting on innovation project complexity. However, tools and methods enabling relevant reflection are not abundant. In this explorative study, we investigated the effect of explicitly stimulating reflection about complexity during innovation project front-end development, using Midstream Modulation (MM) in combination with a complexity framework that distinguishes technical, organizational and external (TOE) aspects. Three project leaders in engineering and construction within the Dutch process industry interacted regularly with a critical outsider, following MM protocols, while also discussing relevant TOE aspects. Our method proves useful in supporting deliberations, and helps to broaden and deepen considerations regarding TOE aspects. The findings show the possibility and utility of enhancing reflection during early phases of innovation project management, in a way that advances both ongoing projects and responsible innovation objectives.

Senior pre-university education (SPE) students experience difficulties applying mathematics to physics. This paper reports the outcome of an online explorative quantitative study of teachers' belief systems about improving transfer of algebraic skills from mathematics into physics, conducted among 503 mathematics and physics teachers working in SPE. We used a questionnaire with 16 beliefs about improving transfer, and asked teachers to select a top 5 and distribute 50 points among them. We used agglomerative hierarchical clustering to cluster qualified SPE teachers with more than 10 years of teaching experience. We found 3 large clusters, each containing naïve and desirable beliefs about transfer. These clusters turned out to be rather coherent sets of beliefs. Hence, these clusters can be interpreted as belief systems, to a certain extent justifying Ernest's [(1991). The philosophy of mathematics education. London: Falmer.] idea to cluster teachers based on their belief systems. We found relations between our groups and those of Ernest. Since naïve beliefs turn out to be weak in each cluster, science teacher educators can help science teachers to change their harmful naïve beliefs, into desirable transfer enhancing beliefs. Furthermore, we discuss some implications of our results for science teacher educators, curricula, teachers and textbooks.

Following societal and policy pressures for responsible innovation, innovators are more and more expected to consider the broader socio-ethical context of their work, and more importantly, to integrate such considerations into their daily practices. This may require the involvement of ‘outsiders’ in innovation trajectories, including e.g. societal and governmental actors. However, methods on how to functionally organize such integration in light of responsible innovation have only recently started to emerge. We present an approach to do just that, in which we first develop value profiles of the involved actors, and second, design a workshop setting that allows innovators to develop design requirements in collaboration with representatives of parties that are not usually involved in such innovation design practices. Using a case study in automated vehicle development, we positively demonstrate the possibility and utility of our approach. We stress that in this study we wish to demonstrate the functionality of our developed method, and did not search for scientifically valid outcomes regarding this technical field.

Recently, the notion of responsible research and innovation (RRI) has been gaining momentum in policy and practice. The main claim of RRI is that social, ethical and environmental aspects should be taken into consideration in scientific research and innovation activities. Socio-Technical Integration Research (STIR) is one of the first tools emerging from RRI research that is designed to help research, development and innovation actors practically implement key aspects of RRI in their daily work. Since its inception in 2006, results from multiple international studies have demonstrated the possibility and utility of STIR, albeit in developed countries. In 2015, a STIR pilot study was conducted in the developing region of Szeged, Hungary. Its results are similar, but far from those achieved in developed countries. In this paper we explore what, if any, role the innovation environment plays in the outcomes of the implementation of RRI practices such as STIR. We analyze STIR results and effectiveness in the wider context of the national innovation environments of Hungary and the Netherlands. Our findings suggest that the innovation environment can affect the success and effectiveness of approaches such as STIR. As a policy recommendation, we therefore recommend that RRI approaches such as STIR be adapted to the innovation environment of the country concerned.

Responsible research and innovation (RRI) has become an important topic in the academic community and in policy circles, but it has not yet been systematically included in the innovation process of companies. We discuss how companies can integrate RRI into their corporate social responsibility (CSR) policies and business strategy. To this end, we developed a conceptual model that links a company's RRI strategy to its context, and that helps to translate the RRI strategy into activities that result in RRI outcomes. We also propose a process for developing company-specific RRI key performance indicators (KPIs) that can support companies to measure RRI outcomes.

Students in senior pre-university education encounter difficulties in the application of mathematics into physics. This paper presents the outcome of an explorative qualitative study of teachers’ beliefs about improving the transfer of algebraic skills from mathematics into physics. We interviewed 10 mathematics and 10 physics teachers using a semi-structured questionnaire that was based on an algebraic transfer problem. Almost all teachers acknowledged this transfer problem and considered it to be important. We found a continuum of teachers’ beliefs about aspects influencing transfer, including beliefs on improving this transfer. Together with identified improvement aspects about coherent mathematics education, these may help reduce physics teachers’ frustrations who spend extra time on re-teaching mathematics. Teachers think that transfer does not happen, because students see both subjects as separate disciplines. Contrary to most physics teachers, most mathematics teachers do not feel the need to collaborate with physics teachers. We found two extreme, opposite beliefs about the transfer of algebraic skills into physics. An intermediate group believes that only an integrated approach can solve the transfer problem. Some of the teachers’ beliefs could be organised into a beliefs system. Further research could investigate to which extent such beliefs systems exist and which beliefs these contain.