Form 0920-20PR Robot Experience Questionnaire

Form Approved OMB No. 0920-XXXX

Exp. Date xx/xx/20xx

Instrument E

Robot Experience Questionnaire

1. Prior experience with industrial robots

1. Do/did any of your previous or current workplaces have ANY types of robots operating in the work areas?

YES | NO

If you answered ‘No’ to the previous question, skip the following 4 questions and go to Question 2.

2. Which of the following types of robots does/did your workplaces have? Check all that apply.

• Traditional industrial robots, such as work in robotic cells and cages away from human workers

• Collaborative robots, that may physically interact with humans in a shared workspace

• Mobile robots or autonomous ground vehicles

• Aerial robots or drones

• Wearable robots or exoskeletons

• Other: ________________

3. How long have you used or worked with the technology that you selected above?

______________ years

4. How often have/had you worked in direct interaction or within a shared work area with the selected robot(s)?

• Never

• Hardly ever

• Occasionally

• Quite often

• Frequently

• Nearly all the time

2. Following questions will ask your opinion regarding current and future robots in workplaces.

1. Using a percentage, please mark how many jobs do you think will be replaced by robots in 10 years (by year 2030)?

0% – 10% – 20% – 30% – 40% – 50% – 60% – 70% – 80% – 90% – 100%

2. Using a percentage, please mark how many jobs do you think will be replaced by robots in 30 years (by year 2050)?

0% – 10% – 20% – 30% – 40% – 50% – 60% – 70% – 80% – 90% – 100%

3. Following questions will ask your attitudes towards robots in general. Please indicate to what extent you agree or disagree with each of the following statements on a five-point scale:

1. I would feel uneasy if robots had emotions.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

2. Something bad might happen if robots developed into living beings.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

3. I would feel relaxed talking with robots.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

4. I would feel uneasy if I was given a job where I had to work alongside a robot.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

5. If robots had emotions, I would be able to make friends with them.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

6. I would feel comfortable being with a robot that had emotions.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

7. The word “robot” means nothing to me.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

8. I would feel nervous operating a robot in front of other people.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

9. I would hate the idea that robots or artificial intelligences were making judgments about things.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

10. I would feel very nervous standing in front of a robot.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

11. I feel that if I depend on robots too much, something bad might happen.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

12. I would feel paranoid talking with a robot.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

13. I am concerned that robots would be a bad influence on children.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

14. I feel that in the future, society will be dominated by robots.

(I strongly disagree) 1---2---3---4---5 (I strongly agree)

Public reporting burden of this collection of information is estimated to average 6 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).

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