Project MARCH takes new steps based on interdisciplinary approach

Usually, you don't realise a simple walk through the city is full of obstacles. Steps, slanted inclines, going up and down a pavement: our brains constantly estimate, consciously and unconsciously, what it takes to walk without falling. A team of students worked on an exoskeleton that can also make these kinds of estimates. It should enable the regular pilot of Project MARCH - a man with a spinal cord injury - to go for a walk on a regular pedestrian route. 

The Project MARCH team consists of 26 students. Partly with the support of Medical Delta, they have been working full-time for a year on the new version of an exoskeleton that earlier teams developed. At August19, they unveiled the latest version.

We spoke with three team members - each studying at a different educational institute - about innovation, about working together outside of their own discipline and about their vision of the future of healthcare and technology.

Carlijn van Osch studied medicine at Erasmus MC and is one of the PR coordinators within the team. She signed up because she wanted to learn more social skills instead of just 'facts' and wanted to get out of the 'medicine bubble'. "What I like most about Project MARCH is that you learn to work with so many people who think differently from you. I will need that in my future work." Tom Rijnsburger studied healthcare technology at the Hogeschool van Rotterdam and would like to go into software. As a data analyst at Project MARCH, he combines and visualises data from various sensors, for example to measure the joint moment, but also data from depth cameras and algorithms for walking patterns. Janna Meijer is project manager within the team. She has a bachelor's degree in clinical technology (Leiden University, TU Delft, Erasmus Rotterdam). As a clinical technologist, she will be working with healthcare professionals and technicians. "Project MARCH is a great way to get to know people from different backgrounds and to experience how such a collaboration works in practice."

The student teams of Project MARCH are always very diverse. What is the added value of that?

Janna: "In order to build an exoskeleton, a lot of different knowledge is needed. Our team consists of students from mechanical engineering, electrical engineering, computer science, but also from medicine, movement sciences, neuroscience & AI, industrial design and so on. You can learn a lot within Project MARCH, but at the same time you need real specialist knowledge in some areas," she says. "People with different backgrounds have different ways of thinking. With people from the same educational background you don't get a lot of new input anymore, because everyone has the same knowledge and the same way of thinking." Carlijn adds: "We started the project with brainstorming. You notice, for example, that the Industrial Design students are very good at it. They came up with the most bizarre ideas, thought very much out-of-the-box, while others only thought in practical terms."

What did your teammates gain from you?

Tom: "This year, we wanted to focus on dynamic walking. One of the first questions that came up was: how does walking actually work? Because of my background in physiology and anatomy, I could contribute to that."  Janna: "As a clinical technologist, you are trained broadly and understand a bit about everything, but not in all the details. That's why I have a good overview of the various projects.  Carlijn: "Our medical education teaches us to get to the heart of the matter and to keep asking questions. Mastering these conversational skills has also proved useful here."  

What are the biggest differences in the way of thinking and acting?

Tom: "Our Electrical Engineers tend to be punctual and detail oriented. Our IO students are less so, they are often very broad-minded, extravagant and free. Medical students, on the other hand, are often overachievers, caring and focus on the person, e.g. 'how is the pilot doing'. The backgrounds also differ in their working methods. Software engineers are all about doing, just building, looking at where things go wrong and putting out fires until it works. While our Human Machine Interaction Engineer first read a lot of scientific articles and extracted the right architecture from them to develop an EEG system." Carlijn: "Another funny fact that struck us was the differences between Delft and Rotterdam. We were once at a trade fair in Rotterdam and there we got questions like: 'Can you buy it?' 'What colours do you have?', while in Delft we got questions like 'What engine is in it?' and 'What 3D printer were the hoods printed with?'"

Did the differences in background sometimes lead to miscommunication?

Janna: "Actually, the cooperation has always gone well and there have never been any major issues. In the beginning, people had to realise that their choices would influence others. For example, there was an idea to make the input device (a kind of remote control) in the stool wireless, so that the wire was no longer in the way for the pilot. However, this meant that a router had to be added to the backpack, which meant that the group that was working on this suddenly had to change their design again. Another example is the cooperation between team 'joint' and team 'bone'. As soon as an improvement was made in the knee joint, for example, the bones had to be adjusted accordingly, making them less optimal and vice versa. That was sometimes a challenge."

All in all, what is the recipe for a successful collaboration?

Carlijn: "I mainly learned that people can really think in different ways, and that everyone therefore has to adapt continuously. Adapting is really more important than I thought before". Janna: "I mainly learned that it is important to manage each other’s expectations. Even if it's a bit of a search in the beginning. If expectations are not in line with each other, you get friction and frustration. I also learned how to approach different personalities. One of them you just have to tackle if you need something, otherwise it won't happen. The other you just send an e-mail."

What is your vision of the future (of healthcare)?

Janna: "The vision of Project MARCH is to show what is possible and to inspire. In the long term, we also want to make a social impact through this." "What we develop for one person, may eventually have an impact on many more." Carlijn adds. Tom: "I hope that in five years' time we will have created a scalable exoskeleton or that our open source software will be adopted by the market. It would be nice if project MARCH were to continue as a company one day.  Carlijn: "As far as healthcare is concerned, I think the medical curriculum could focus more on technology. That is what is being done more and more. There is so much that can be done and for some processes the solution is very easy. Just knowing that things can be solved, without knowing the solution itself, would be very helpful. We' (healthcare staff) do not know what is possible, 'they' (technologists) do not know what is needed. It takes someone to build this bridge and healthcare staff/specialists are not the people to do it." Tom: "In my education, a lot of emphasis was placed on 'bridging' this gap. For example, I was doing an internship at a care hotel in Rotterdam. The staff there had telephones through which they received reports from residents. They found the notifications irritating and didn't know how to use them, so they put the phones aside and just went around all the rooms. So there really are still some bridges to build...".

After the interview, Tom, Carlijn and Janna get back to work. They walk effortlessly from the meeting room on the first floor to the office on the ground floor of the Dream Hall at TU Delft - something they also hope to achieve for the exoskeleton, with the help of the diverse student team.