The Wizard of Oz is an inspiration for interaction design within mobile phone UX communities. Medical device developers should also embrace wizard of oz methodologies. In this presentation I discuss how, by validating concepts early using interaction realistic prototypes, medical device developer have the opportunity to: generate innovation through interactions, optimise device usability and minimise use and development risk.
As Medtec moves beyond devices, beyond treatment and beyond the hospital we are moving into an era of people centered, real time, connected and outcome driven wellness solutions. I argue that Medtec should move beyond the research and development of technology alone and into the research of interaction, to become, wizards of objects. #wizardofobjects
Who know……
The name of the experiment comes from The Wonderful Wizard of Oz story (1900), an unlikely inspiration in interaction design, is a story in which an old man hides behind a curtain and create the illusion that he is a powerful wizard.
Until the point at which the wizard is revealved, all of Dorothy’s (the main character)s reactions were valid psychologically, anthropologically, and sociologically. To her the wizard was real ad so were all her experiences.
John F. (“Jeff”) Kelley coined the phrases “Wizard of OZ” and “OZ Paradigm” for this purpose circa 1980 to describe the method he developed during his dissertation work at Johns Hopkins University. (His dissertation advisor was the late professor Alphonse Chapanis, the “Godfather of Human Factors and Engineering Psychology”.)
Design methodology wherein an experimenter (the “wizard”), in a laboratory setting, simulates the behavior of a theoretical intelligent computer application (often by going into another room and intercepting all communications between participant and system). Sometimes this is done with the participant’s a-priori knowledge and sometimes it is a low-level deceit employed to manage the participant’s expectations and encourage natural behaviors.
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It’s not just wizards who can make illusions, medical device manufacturers can too……
….. By making models of interactions and experiences with a devices, to allow would be users to experience what a new device might be like to use
….. And this can be done, without actually bothering to design or make one!
It’s the creation of an illusion and a testing procedure which allow you to discover how users interact with a product that doesn’t exist yet
It’s not just wizards who can make illusions, medical device manufacturers can too……
….. By making models of interactions and experiences with a devices, to allow would be users to experience what a new device might be like to use
….. And this can be done, without actually bothering to design or make one!
It’s the creation of an illusion and a testing procedure which allow you to discover how users interact with a product that doesn’t exist yet
By validating concepts using interaction realistic prototypes to fool your customers, dorothy!
Does not need to……
work like the real thing
look like the real thing
Act like th real thing so that users and stakeholders can experience your visions(s) and so you can discover if your concept……….
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So, what the mobile and software industry has called “wizard of oz testing” I’ve rebranded for the medical device industry as “concept validation”
Perhaps it shouldn’t just be left to the end
And be done at other stages of development too? I believe we should validate concepts iteratively as they evolve so we can Prove that it is the right thing to do, kill it early, or learn enough to turn it into the right thing to do”
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It can be described.
Communicated – Feasible visions in the context of Constraints (technical/pipeline/roadmap, clinical, societal, market etc)
.Or experienced - through an interaction prototype to discover whether the reality (the interaction) enables the value to be extracted
And at each transition there is the opportunity for the value of a concept to be lost in translation or not be realised.
But there any many costs effective ways of validating concepts ……
Designers are not users
Marketing departments are not user
Engineers are not users
Even human factors specialists are also not users
In order to create facts about interaction, not opinions, based on what users want and need not what development teams think they might need – Validate concepts
In a recent project CDP worked with a surgical device manufacturer to put non functional handling models in front of surgeons early in the design process. Eliminating requirements which were based on the assumptions of the development team and adding new, more important, actual user interface requirements were identified . This was done in parallel with technical R&D work prior to formal design control so didn’t add to the timeline of the project. Create traceable evidence for user interface requirements and customer requirements focusing the development resources.
People can’t ask for what they don’t know is possible
Peoples imaginations (and hence their desires, are bound by their experience), they accept inadequacies and deficiencies in their environment as normal
Users are not designers, but by allowing them to interact and contribute to your ideas within the context of a well designed research programme they can contribute to your vision.
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Clearer device visions saving time and money through predictable and timely development programmes
Arm the team with all they need to get the device designed and built in the right way:
Clearly defined requirements
Collective vision
Oh, and one final reason to validate concepts early……..
The stick has driven usability in many organisations under the watchful eye and even direction of the compliance team
Opportunity to get out more than regulatory compliance alone from usability processes and methodologies including;
Delightful user experiences improve brand loyalty
User centred devices and services improve outcomes and empower patients and carers
Reduction training and support costs
and these opportunities can only be realised if usability teams (and design teams) are involved in concept definition and creation through dedicated R&D of interactions.
So how do you go about validating concepts…
Until the point at which the wizard is revealved, all of Dorothy’s (the main character)s reactions were valid psychologically, anthropologically, and sociologically. To her the wizard was real ad so were all her experiences. The wizard did a good job of creating an illusion and in order for you to do so too you need to understand…..
Fragmented decision-making in many
healthcare markets makes it extremely difficult for companies to understand
the requirements of all key stakeholders. To be selected for use, a device
might have to be approved by a national or regional authority, selected by a
healthcare provider, specified by a particular clinical team, and then chosen
by doctors, often in consultation with patients. Finally, it may be the patient’s , nurses if clinicans
own reactions to the device that define its success in use.
Each of these stakeholders will have an incomplete picture of product
attributes: payors might not understand the importance of usability in patient
compliance, while a physician may be unaware of the ongoing cost of
supporting a product in the field. As a result, the incentives to purchase in
many medical device markets may be fundamentally different from the benefits
ultimately enjoyed by end users.
Depending on what your application is, you will have to decide which stakeholder take priority in validating ideas and interactions and sometimes it will be more than one and not just users. While some stakeholders don’t interact with a device directly , by letting them interact with your prototypes you will learn which features may help sway the decisions of the gatekeepers to the sale of your devices.
Does this solve real problems
can people use it to solve those problems‘
Is value perceived
Is timing right
which ideas are strong and which are weak
are there any barriers we hadn’t identified,
But, the key creative leap in concept validation is the design of………
Remembering that the fidelity of the experience is NOT reflected by the fidelity of the prototype
Use anything to conjure up the experience, faking devices and scenarios is far cheaper than putting a device in the market
We wanted to know
And the most cost effective method to answer this question is through a standard multi casualty first response training exercise.
And a piece of card where vital signs and trends can be updated to a script and the effect on the time spend monitoring vital signs and triaging accuracy can be evaluated
You arrive at the scene of a road traffic accident. You are the first person on the scene with any medical skills.
On initial assessment you notice there are two cars involved. One vehicle has caught fire with the other vehicle ten metres away with significant damage to the drivers side.
All the passengers have moved from the scene. The injured people present you with signs and symptoms.
Work as normal using either only smart triage tags or smart triage tags and an IPM to each patient:
A key component in validating concepts is choosing an appropriate medium
They can be solution agnostic or describe some of the solution. Either way, ultimately the solution is envisaged by the user or stakeholder as they try and answer the question. They may be tainted by their inability to envisage how this could be achieved. Or the solution they imagine, may be technically over, or under optimistic and tainted by their experiences with other devices and products.
How much can you trust feedback to this stimuli?
Validate concepts as a realistic vision in the context of constraints as you see them (technical, workflow, societal, experience)
This can give you verbal feedback on reality of a communicated device vision and might help you decide whether it is worth investing in a technology further….
Validating workflow in the context of a set of use scenario
Allows feedback on reality of scenario and enables you to explore further scenarios
To increase the fidelity of a visual experience, you could use videas and animations to detail important elements of the use process. Always remember that the fidelity of the experience matters, not the fidelity of the prototype. Here’s an example of how we communicated an interface concept of the patient vital signs monitor.
These mediums of description and visual communication have their place, but don’t allow hand on interaction…… Which risks the
Lots of opinions, which may be unfounded or irrelevant when a real product is in their hands in ralmuse scenario.
Use a low techn interaction model so the participants who are experiencing a solution using more than sight and responding in real time to a device interface.
The fidelity of the experience matters, not the fidelity of the prototype
Validating whether the reality (the interaction) enables the value to be extracted safely (in a realistic scenario). Can the value of the technology and all it’s features be extracted through the form of the device and it’s interface?
We wanted to know
Next we took sample instructions to nurses
Along with non functional handling models. One of the funniest insights we had during this study was when the nurse can it, looked at our device and tried to sit on it. Without putting the device in context with real users we would never had thought that our device displayed the visual appearance of a comfy seat for tired nurse legs and realised that either a design requirement of strength or visual messaging communicating discomfort would be needed to ensure device robustness.
The final how is around understanding the problems with people.
People are constrained by their knowledge of the world “as it is” and some may not be more or less able than others to understand designs that change the status quo and see the future clearly.
Think about how the interaction might be different to existing experiences (with device or other products) design concept validation studies accordingly
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In a recent test of a connected device we were careful to take feedback in context of the users experience with smartphone technology and progressiveness with new ideas.
Hunt for honest opinions.
One technique I use to do this is to ask participants to put themselves in the shoes of other users and stakeholder to get a more honest view.
For example, how do you think less experience surgeons might feel about this technology. What kind of mistakes or assumptions might they make, what about your assistants.
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Asking people to speak for others gives them an outlet for being more honest of recalling what use of a device would be like when they were more naive with a technology.
With interaction prototypes there is always the risk that people can’t work out how to use the device and then feel like they are being testing.
Make sure people know they are testing the device and not them
And also look for non verbal communication relating to stress at trying to achieve a task.
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The key is asking why and probing in order to gain the insights to a level that a development decision can be made from it.
For example, when testing a medical device concept I’ve had feedback from nurses before where they said. I wouldn’t use it. Why not. It doesn’t look sterile. If it did look sterile and was packaged, approved and labelled as sterile then how would you feel? Yes, I’d use it!
I don’t think the nurses will like it. Why not? It’s too big to move around. How small would it need to be to make it appropriate for nurses to move around do you think? The size of a laptop would be good because it could easily fit in a storage cupboard when not in use. Can you show me the cupboard>? Yes. Great.
At the start of the development process marketing are concerned with “how people choose products”
Once a design is in development usability professional will get concerned with validating whether people can use a device safely and efficaciously
In between there is the opportunity to validate interaction, iteratively, prior to design freeze optimise usability and minimise risk associated with user interfaces
And it’s a low cost exercise, low/no tech prototypes access to small sample sizes representative users and stakeholders (5-8 from each grouo)
Reduce risks and optimise value and outcomes through usability and user experience
IT PAYS FOR ITSELF
Services and solutions to improve outcomes or drive costs down
Prevention and remote monitoring to improve outcomes more efficiently through real-time management of health conditions
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Enabling patients to manage their conditions at home and in the communityb without frequent, costly interventions
Have a heart, have a brain and have the courage to….
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