Robots, cyborgs and humans. A model of consumer behavior in servicesa study in healthcare service sector

Résumé

Even though there is a wide range of studies on the acceptance of robot technologies in different fields, there is a lack of empirical researches that focuses on the use of them in healthcare services if compared to the services offered by human-beings. Meanwhile, the perception of humans to the proposed services that could be offered by cyborg is unknown. This gap or lack in studies can be understood because the proposed use of these technologies is still under the development stage. Which in turn, formulates the motivation for performing this research. The main aim of this research is to develop a model that can be used to identify the choice criteria among robot, cyborg, and human services. In addition, the proposed model could be considered as a starting point and a milestone for future researches and researchers who are interested in this domain. The first objective is related to the factors that influence cyborg acceptance as an entity in society. In fact, not much is known about the moral attitude of people toward the ratio between risk and benefits of using such technology and about their preferences, expectations, and needs. Meanwhile, the acceptance may be shifted from positive to a negative state, as the use of cyborg technologies will be shifted from therapy to enhancement purposes. The second objective of this research is to investigate the robot acceptance. In this context, despite there are different previous studies regarding the acceptance of service robots. However, the actual response of customers toward service robots is still under investigation and little attention has been paid to this context.The third objective is to investigate the intention to use human services. The decision-making process in choosing, purchasing, and using the services is important not only to the customers but also to the organizations to understand how customers will choose a specific product, especially when different alternatives are available. The fifth objective of current research is to to suggest some of the recommendations to the technology developers and services providers concerning consumer expectations toward the proposed services, such as expected features and abilities of robots and cyborg capabilities. Furthermore, the discussion of human services drawbacks will help the service providers to improve their services to meet consumers' expectations. The sixth objective will be related to giving directions to future researches, especially for the researchers who are interested in investigating the proposed services of robot and cyborg technologies. Accordingly, the research developed a model that can be used to identify the choice criteria among robot, cyborg, and human services, analyzing in the healthcare service sector. The research proposes a futuristic use of robot and cyborg as surgeons in an eye surgery. Thereafter, the developed model has been applied to investigate the intention to use each surgeon (i.e. robot surgeon, cyborg surgeon, and human surgeon). A quantitative methodology was used in this thesis. In addition to that, the measurement scale was developed based on the literature review using the 11-point scale (0 to 10). Also, an online survey was developed using google forms to test this research hypotheses. The data had been collected among students in different Jordanian universities between May and September 2019. Several visits had been conducted to the universities in different times and locations (e.g. Cafeterias, Libraries, and Classes) to reach the acceptable number of valid surveys. The participants were requested to answer the online survey questions after inviting them in person through universities professors, employees, and friends. The survey hyperlink had been sent to the participants via email, Facebook messenger, and WhatsApp. And the participants used their smartphones, laptops, or tablets to answer the survey questions. As a result, the data has been collected from 379 individuals from different universities in Jordan. 92% of the respondents are Jordanians and 8% were students from different Arabian countries, who are studying in the Jordanian universities. The partial least-square structural equation modeling (PLS-SEM) technique was used to examine this research model. This technique utilizes a component-based approach and gives a simultaneous examination of the measurement model and the structural model. Furthermore, it is a suitable technique to handle various relationships at the same time, doesn’t need a normal distribution and it is recommended for investigating complex frameworks. Before applying the PLS-SEM on the collected data, the research performed ANOVA t-test in order to examine if there is a variance in the intention to use between the three models. The significant differences in the intention to use the proposed services have been confirmed. Moreover, the results showed that human surgeons are the preferred choice followed by cyborg and robot surgeons. These results were consistent with the open questions results, which have been used in the survey while collecting this research data. Also, the participants have been asked to justify their answers by mentioning the advantages and disadvantages of their first choice. Regarding the human surgeon choice, most of the participants’ answers were related to the personal and professional traits of humans over the other choices. For instance, some of the participants believed that the accumulated experience of the human surgeons will make them better than proposed options in terms of skills and ability to act better in risky and unexpected situations during the surgery. Additionally, most of the participants believed that it will be easy for them to interact and communicate with the human surgeon. On the other side, participants mentioned a variety of drawbacks associated with the human surgeon, such as medical mistakes, surgeries time, availability, unexpected changes in the human mood, and aging. Most of the participants in this group chose the cyborg as a second option (i.e. 57%) and 23% chose robot as the third option, while the rest (20%) preferred human surgeons only. For the participants of the second group who considered cyborg surgeons as the preferred option, most of them mentioned the proposed ability of cyborg to avoid human mistakes as the main advantage of cyborg surgeons over human and robot surgeons. Likewise, they believed that the enhanced human will be able to overcome human drawbacks, such as speed, memory, mood, aging, and physical capabilities. Some of the participants confirmed that cyborg surgeons will be their preferred choice because they expect these surgeons will be more accurate and efficient than human and robot surgeons. They believe the combination of technology and the human body will be a superior product. However, their concerns were related to the technological side of the cyborg. They considered the risk of unexpected failure in the technological parts of the cyborg could affect their safety. Also, some of them pointed to the high cost that could be associated with choosing this option. Meanwhile, the majority of this group considered human surgeons as their second preferred choice. Finally, the majority of participants who chose the robot surgeon over the other two options considered robot accuracy and mood stability as the main advantages of machines over human-being. However, the drawbacks of this option were about social interaction and technology failure risks. Most of the participants in the third group prioritized human surgeons as the second priority and the least priority were cyborgs. Based on PLS-SEM results, the robot services model explained 73.8% of the variance in the intention to use robot healthcare services, 77.0% for the cyborg services model, and 77.7% for the human services model. This means, all the models of this This research models result shared the same importance of social influence and effort expectancy on the intention to use those services. The impact of social influence gives a general idea about the nature of the healthcare sector in Jordan, where a part of the society gives more attention to the recommendation from others (e.g. family members and friends, users) while choosing their surgeons. And the effort expectancy impact contributes to patients' expectations of simplicity, in terms of use and interaction with the proposed surgeons. On the other hand, the result of analyzing cyborg and human services models didn’t agree about the impact of perceived risk on the intention to use those services. On the contrary, the results of the robot services model confirmed the impact of perceived risk on the intention to use the robot surgeon. In this context, if the comparison is between cyborg and robot surgeons, this research results confirmed that a part of the society is accepting those services with an advantage to the cyborg surgeon over the robot one. Therefore, maximizing the benefits of the cyborg services if compared to human services could make cyborgs the preferred customers choice. These benefits could be in terms of speed, accuracy, and ability to interact with customers. Regarding robots’ services, the main idea of using robots is to improve patient safety and to perform surgical care remotely, and to perform the entire surgery autonomously in the future. However, a part of society still believes in the risk that could be associated with using robot services. This risk could be a result of unexpected electro-mechanical faults, the potential of bleeding and infection probability during the surgeries, which may threaten the patient’s safety. This explained why the perceived risk showed a significant impact on the intention to use the proposed robot surgeon. Even though the choice of robot surgeon has been the least preferred option, it was accepted by a part of society. In order to improve the acceptance as per this research results, the perceived risk should be minimized by maximizing the benefits of using such technology. Moreover, participants considered effort expectancy, performance expectancy, and social influence as the main choice criteria for robot services. Those benefits could be maximized by improving robot performance, simplifying its use, improving its interaction ability, and highlighting the said improvements to the customers in a way that will be able to deliver the message to the customers probably. Also, the results pointed to the importance of robot functionality over its social skills (i.e. empathy). This is understood because patients are interested in the ability of the robot surgeon to perform the surgery successfully and safely. Ultimately, the acceptance of the proposed robot technology and cyborg technology by a part of the society could give an idea about the expected struggle in the future among developing robots and enhancing human capabilities. Even though some of the researchers supporting the idea of directing effort and resources to develop the implants technology to enhance humans, instead of consuming time and energy to develop robots that could go beyond human abilities and intelligence. The fears of human extinction because of robots, reinforce their belief about the ability of human enhancements to face those fears. Partial Least Squares Multi-Group Analysis has been applied to measure whether there are differences in the way variables affect the intention to use the proposed services. The first multi-group analysis has been applied between cyborg and robot models using the permutation approach. The results confirmed that the models' variables are affecting the intention to use cyborg and robot services in the same way. Likewise, the multi-group analysis didn’t show significant differences among cyborg and human services models regarding the relationship between independent variables and intention to use. However, the differences between robot and human service models existed in the relation between effort expectancy and intention to use only. This research opens a new line of researches related to the acceptance of cyborg technology as an entity and robot as an autonomous device that could be used in critical service settings (i.e. medical surgeries). With regards to cyborg technology, few studies have been conducted to investigate cyborg acceptance, which helped the companies in promoting their related products (i.e. wearables and implants), and to understand the factors stimulating the acceptance of those products. At the same time, the acceptance of the proposed cyborg services will help the service providers to know the factors that can lead to the acceptance of hiring cyborg in a specific service setting. According to that, the developers and manufacturers of cyborg products can build their design based on customers’ expectations of these enhancements and to match their needs. For instance, the result of cyborg services confirmed the impact of effort expectancy, performance expectancy, social influence, and arousal on the acceptance of the proposed cyborg services. Spreading awareness about the simplicity in dealing and interacting with cyborgs and the superiority of their performance will be required to convince the society about accepting the cyborg services. In addition to that, the idea of the possibility of being served by an enhanced human could make customers excited to try it. This consequently requires reinforcing those emotions by promoting cyborg superior abilities. The same should be done with robot services too with considering the impact of risk perception. A practical solution to minimize expected risk could enhance people's perception toward such robots, which needs further investigation and development in the robot's design. In addition to creating marketing campaigns about the benefits of using the proposed services, which may help to instill more confidence in this technology, thereby customers' risk perception could be minimized. One of this research limitations is related to investigate the ethical impact while studying the acceptance of such technologies. The robot and cyborg surgeons are representing an advanced technology that may have the ability to imitate and/or exceed human abilities. If these futuristic surgeons become a reality, they will compete with human surgeons and could eventually replace them. Thereby, increasing the professional and social gap between humans from one side, robots and enhanced humans on the other side. Another ethical concern is, if these advanced surgeons are available for high-income customers, it could create a new social class that can buy the proposed superior services. This could consequently increase the equity gap too. Furthermore, the study has been conducted in a single country. The differences in culture could affect customers intention toward those technologies. According to that, this research should be extended to different countries for evaluating the impact of cultural differences on the intention to use the proposed services. In addition, customers' knowledge about cyborg technology and robot applications is limited. Therefore, this research results represented a general belief of the consumers about the advanced technologies. Even though the proposed services are still under the development stage, enhancing respondents’ awareness about these technologies could affect their perception toward the proposed services. Consequently, future research could investigate whether providing participants more information about those technologies before the data collection process - through, for instance, video demonstrations and prototypes – can impact their perception towards these services and their intention to adopt them. In the same context, this research proposed a specific use of cyborg and robot technologies. The result could vary if the proposed use conducted in different service settings. Therefore, future research could apply this research model to different service settings. On the other hand, further integration of service quality dimensions could be required in future research, since the service itself can control the intention of consumers toward using it. Also, the humans’ expectations toward the quality of these services could impact their attitude, intention, and use behavior.