Integration with other classes
Learning
to narrow a problem to a learning need.
The tool that I've designed addresses many different problems: improving
the doctor-patient interaction, patient empowerment, improving information
management in a healthcare-management organization and on top of all that
education. It was easy wear the different hats of patient advocate and
learning designer but it was hard to think clearly of the problem taking
various positions.
I had to learn to narrow down a specific facet of the big picture and
design a solution that would address that particular problem; and detach
myself from the overall system design and postpone that problem till later.
Differentiating
myself as a Learning Designer vs. a User Interface designerWhile
user testing the interface on an old RISD classmate, we got into the details
of information design and page layout. I realized that I was more concerned
with the functionality of the page and the look and feel of the interface
more than the needs of the user.
Does
my interface address a real need of a patient?
Does it fit the mental model of a patient-doctor interaction?
Would a patient use this tool?
I realized that I had done what so many companies do, go ahead and provide
a myriad of functionality instead of listening to the few and specific
needs of the user. I spent the next day in Cowell Student Health Services
talking to triage nurses and patients instead. I realized that coming
up with relevant functionality was a full time job in itself and that
user interface design was another job.
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Positioning the Tool
I realized in talking with Dr. Choi that designing an online triage had
all kinds of political implications.Patients blanche at the idea of an
online tool diagnosing their health and would be resistant to any tool
that would replace their already scarce time with their doctor. However
positioning the tool as an intermediary step until the patient sees their
doctor received a warm response from my users. They all identified with
the frustration of having to wait for an appointment and responded well
to an intermediary step of care. In talking to the triage nurse, I realized
that they were effectively performing "diagnostic" procedures
over the phone by determining which symptoms were emergent and which weren't,
but they called the process "prioritizing". By positioning my
tool as a prioritizing agent that was set up to provide intermediary care
UNTIL the patient saw their physician it was much better received by the
patient. In my dialogues with Dr. Choi, he said that physicians would
be antagonistic to the tool because it provided a more detailed record
of the patient's symptoms. This provided litigious patients with fodder
for a lawsuit should a case go sour.
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Rapid
Prototyping
This interface evolved as fast as I could put together a prototype. While
talking to Dr. Choi about the overall design flow, it was hard to zoom
into the learning problem. Coming up with screenshot interfaces for the
tool gave a context for my users to talk about their learning problems
as to envision the functionality of the tool. While designing Prototype
1, keeping in mind that I was simply nailing out the functionality gave
me a lot more freedom to try out a different layout when users gave me
feedback. Taking the second prototype only as far as it would be useful
for the user testing enabled me to listen to the user's comments more
willingly and go back to the drawing board.
Cutting Corners Proudly
Programming As If People Mattered
Nathaniel Borenstein
Participatory Design as a Lone Designer
My JustDoIt project would be a very interesting case study about working
alone vs. a team. I found that because I was on the project alone, I sought
alot more feedback and critique than I would have had I been working on
a team. Much can be said about solicited, timed and formalized feedback.
The people on my "team" Dr Enoch Choi, Decker Walker, Chris
Hoadley, my classmates during critique Chris Manning, the triage nurse
and patients at Cowell provided valuable and critical input. Because I
was working alone, I was able to respond and react to their suggestions
with rapid prototyping without having to go back and negotiate each step
with my group. Had I been working on a team, internal negotiations would
have been so arduous that I would be less open to listening to external
feedback and critique. Because I was working solo, it was easier for me
to scrap ideas and go back to the drawing board and start all over, which
is a crucial point in any design process.
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Interdisciplinary Design
A big part of the joy of working on this project was seeing how things
I was learning in my other classes changed and refined my thesis. Even
a brief lecture on Voice Recognition in HCI became immediately relevant
and a 15min interchange with Chris Manning help me nail down a crucial
nuance of the user and learning experience in the tool. Listening to Clifford
Nass’s talk on the impact of voice on user decisions made me wonder
how the patient’s experience would change should the symptom questions
be read to them. I found my readings in Hci helpful and even my research
for my ED151x on distance learning immediately applicable.
A big part of my joy in coming back to school is to see ideas flow seamlessly
from one discipline into another (that is why my design journal is one
big solid bound UN-compartmentalized sketchbook) and I wondered if I would
have had the permission to flow so autonomously through each discipline
and been able to respond to each new idea with a design change had I been
working on a team.
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Design
Methodology
My methodology and process for project evolved with each new sketch and
flow chart I drew. I followed no key process except to articulate clearly
in the beginning the goals and objectives of this particular application.
To follow a clear and directed path would have meant that I skip the on
the fly visits to Cowell and the spontaneous interviews I had with the
director of triage. Having to account for each step would mean t hat I
would have to communicate 3 new redirection my product took as my ideas
evolved with each new exposure I had to ideas and information. In looking
back the only clear method I had was to visualize prototype and user test.
Most importantly to keep in mind a sense of fluidity and incompletion
so that I would be open to new ideas and reactions from my user.
The Private and the Public Learner
In my interview with an instructor at Excite@Home , I ran across a specific
distinction between two types of learners in a university setting. The
instructor was a brilliant high school Math teacher with a Masters from
Berkley and I was talking to her about the issue of engagement in an online
classroom. She presented me with a totally different perspective: "
I never wanted to be known in college. Berkley was huge and I liked it
that way. I just wanted to go to class, attend lecture and be left alone."
Her comments left me with a question " Does the learning experience
have to be an interactive, social and participatory experience for every
learner?" Assuming that there are varied learning styles, shouldn’t
each learner have the prerogative to synthesize knowledge in a way that
is most intuitive for them?
Her comments made me remember something I told Decker earlier on in the
summer when I was having great difficulty dealing with the situative teaching
style of LDT. I said ‘Sometimes Decker, learning is a private thing
and you don’t want to publicize your thoughts till you’re ready".
This JustDoIt project has provided me with just the right balance of private
and public learning so that I am excited enough to pitch my thesis to
several different critics as well as had the space to synthesis ideas
from different disciplines.
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Behaviorist Situated learning
It seems to me, to enforce a situative learning style on everyone is essentially
behaviorist. Since we are in a learning environment and not a production
environment, I assume idea synthesis and intellectual growth is of utmost
importance. Why enforce the tools of group negotiation and compromise
in academia when there is the real world to teach us that? The goals in
industry are so different: it’s not what is most fascinating and
innovative that counts, it’s what sells within the parameters of
technology and budget that is most important. If Stanford is suppose to
instill in its students a love for research, a fascination with new ideas,
an ability to synthesize ideas across disciplines, why enforce parameters
that researchers specifically want to shed by not choosing to work in
industry. Most of all, why choose a learning style and make it the predominant
style for all teaching in LDT? If we recognize and value the individuality
of different learning styles, shouldn’t we give students the choice
to produce, think and learn alone as well as in groups? I am not saying
do away with group work, but it would be nice like I had recently to be
given a choice to work autonomously, to solicit valued input and to invite
collaboration.
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Process
of Working Alone
This project has been the turning point in my time in LDT. Up till now,
I have been hesitant to take both executional and intellectual ownership
of my interests and ideas. Working alone this time has given me the freedom
to fuse my areas of interests across disciplines (E.g. Exploring Voice
Recognition in HCI in studying how to use it in the Triage Interface,
using the inspiration of Excite@Home's HPL learning tool) and to respond
fluidly to each new idea and reading. Because I am able to work independently
and initiate dialogue, I see the idea evolve and grow in a cohesive and
intact manner. Leveraging my different classes have given me a sense of
ownership and excitement. I feel myself using research methods I've learnt
in ED151x in the interviews I have with people. David Fetterman's emphasis
on ethnography has given me new awe and respect for my users. In the execution
of the site, I am able to see the big picture constantly, moving with
agility that I would not have been able to do had I not have the freedom
and access to make changes. I am proud of this product, but more importantly,
enchanted and thrilled with the process. The hours spent here are every
bit worth it and I look forward to doing more work in this manner.
Integration
with other classes
One of the most valuable things about trial running my project so early
in my LDT year was using different classes as a lens for understanding
re-framing and analyzing my project.
ED229B: Chris Hoadley
This class was the crucible for where ExpertPatient was born. Chris’s
JustDoIt project created just the right space and constraints for me to
trial run the idea. A valuable requirement for his class was producing
a design document articulating the justifications and premise for the
idea. It was during this class that I was forced to decide what problem
I was addressing and articulate it in a clear fashion. During this phase,
I explored with him possibilities of physician education, knowledge management
of the patient medical record and other ways to bridge the gap between
doctor and patient. Documenting my thoughts on paper and explaining the
idea over and over again crystallized the idea for me.
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Participatory Design
In this phase, I started the process with a lot of participatory design.
I interviewed patients about their interactions with their doctor and
examined already existent patient education sites online. I also researched
patient’s usage patterns via marketing statistics. In this stage,
I defined the targeted patient profile for the tool: patients of non-emergent
medical conditions and possibly pediatric mothers. My first priority was
the inquisitive patient, the proactive patient who wants to know and learn.
My second priority was the patient whom I am educating by seizing this
moment of learnability when he has a medical condition to apply his learning
to.
Interaction Interface
In Chris’s class, the prototype was one that allowed the patient
to lead the interaction by first recording his symptoms in natural language.
The idea was to re-enact the doctor-patient relationship in the office.
The application will then take the natural language and map it gradually
to the physician’s vocabulary and then walk the patient through a
series of protocols.
Education Interface
In this version of the prototype, I attempted to design an interface that
used patient symptoms and instructions as a navigational bar and then
allowed them to click on links to explore further. The page on the right
would refresh while the symptom navigation bar stayed the same. Hence,
the patient could explore patient education on the internet/ Intranet
using his symptom documentation as a navigational bar. I also included
options for video conferencing.
User Testing
Most user testing done in this phase was to understand how the patient
wanted to be educated. Some preferred the freedom of an "outside"
frame that allowed them to click on multiple links while still grounded
in their own symptom documentation. Others preferred a more tailored experience
where pop-up boxes explained each medical term.
ED151X: Qualitative Methods: David Fetterman
The skills I learnt through this class I carried with me throughout the
rest of my quarters at Stanford. It really impacted my sensitivity to
the user, my approach to design and my commitment to being a participant
observer.
From ED151X I had my first taste of survey design and to realize what
a skill and an art it was to elicit true and authentic data from a user.
It helped me ask open-ended questions in my later interviews with triage
nurses, it helped me make the user a true partner in the design process
as I tried to listen to their needs in the doctor-patient interaction.
Later in Spring Quarter, I would bring the skills, sensitivity and respect
for the user to my study of triage nurses at Palo Alto Medical Foundation.
There I had the privilege of listening in on conversations between nurses
and patients and watch the patient articulation first hand.
Fetterman’s class taught me to take time to listen to each and every
nurse’s definition of triage and patient education and to triangulate
the knowledge I was gathering. That class helped me realized that if I
was to do any kind of true observation, I needed to simply clock in the
hours and be onsite and watch and observe till I was one of them.
I carry those skills with me through all my other usability studies and
continued to be surprised and awed by the patient/user’s response.
CS147 Introduction to Computer Human Interaction: Terry Winograd
This class was useful in that it challenged the HCI aspects of the interface.
Key conversations were held with Chris Manning who came and lectured on
Natural Language Processing. He screened my prototype for technical feasibility.
Discussions with him led to my designing one key screen, which served
both a technical, and learning purpose. A feedback screen summarizing
the captured symptoms. While providing the user feedback about what he
actually articulated, it also
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CS 337 Understanding User Experience: Dianne Schiano
This class was crucial in grounding me in the different methods of usability.
It really drilled me on experiment design and forced me to define what
exactly I was testing for in my Master's Thesis. Using the format and
structure of this class, I reported my ethnographic study of the triage
nurses and also one think-aloud user study. I used to class to force me
to report my user findings in a formal and structured manner in way others
could understand.
It also showed me the complexity of what I was testing for. It provided
guidance for my first drafts of survey questions and usability design.
It helped me nail down the variables for what I was testing.
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ME115 Human Factors in Product Design: David Kelley
This product design class formalized the structure that I was taking in
designing this product. David Kelley's strong emphasis on user research/
need finding, brainstorming, iteration and prototyping provided a useful
backdrop to realize that product design and interface/learning design
did not differ that greatly in design methodology. I felt like this class
provided the structure that we were trying to nail down in ED229B, which
was a formal backdrop and methodology in which to take my design through
It was interesting to compare the difference between a physical product
and an application and realize that in both cases we are ultimately designing
an experience. It was interesting to realize the learning component in
product design and finding affordances that allowed people to learn the
functionality quickly.
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ED333 : Organizations in Education: Shelley Goldman
I took the museum exhibit design exercise in this class to re-cast my
Master's Project as an interaction exhibit. It was nice, fresh break to
be re-examining the problem from a different medium. I remembered in RISD,
my professors always warned me about being married to a specific medium.
So I thought I'd take this opportunity to rework my learning and persuasion
goals in a different medium for a different audience i.e. kids.
I used David's Kelley's design process of field observations as a guide,
I went and observed kids at the Tech and watch what intrigued them about
technology and learning.
However, the real problem lay in translating the learning goals of symptom
articulation into something that kids could understand. I thought of having
different balls symbolize different symptoms and have the kids regroup
them to form different diseases. Then I took a step back and addressed
my bigger goal that I was trying to use learning to do — alleviate
the stress in the interaction between doctor and patient. I realized that
the stress for children did not lie in the unknown diagnosis, it lay in
the medical examination.
Once I decided on the content of learning, designing the exhibit was a
lot of fun. Borrowing from the observations I saw at the Tech, I incorporated
3 elements in all my design, sensory interactivity, designing for different
age groups, designing for the spectator and the participant learner. The
result was 3 learning booths that incorporated technology but also the
tactile feel of play. What I took away from this project was a reunion
with my love for exhibit design, the value of refashioning a design goal
and the joy of designing for kids.
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ED229D: Dan Schwartz
Dan Schwartz input on my Master's project was invaluable and relevant.
He was the first to actually question my outcome of the learning and evidence
for learning each step of the way. He provided valuable input in my interface
design and how the patients would learn with each interaction. He guided
me in my assessment design in coming up with a method for measuring one
crucial element of my design — symptom articulation. He helped me
figure out a single path in which I can lead the user in assessing their
learning from the tool.
My first attempt to assess the tool involved a series of open-ended questions.
In the vein of David Fetterman, I wanted to know what they got out of
the tool. However, I knew from Diane Schiano's class, how unreliable self-report
was, so Dan and I came up with an assessment task that involved both sets
of users looking at the same video and answering the same questions. One
group used the tool and the other didn’t. We would compare the results.
I was really intrigued by the complexity of extracting information from
the user. It was easy for them to tell me what I wanted to hear. The task
kept the interaction objective and task oriented hence providing me relevant
data.
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