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Supporting hospital training staff

Key points

  • CHI+MED research has led to the development of resources to support the training of nurses and other medical staff.
  • We developed a video for a US hospital to demonstrate the wide range of design problems that can lead to user error, that has since been downloaded thousands of times.
  • A role-playing activity we developed has been adapted for use as part of training courses in a UK hospital.

Background
Nurses are often unaware of design issues with the devices they use. Some such problems could lead to them making mistakes without knowing, and through no fault of their own. They often share the common belief that machines are infallible and that if things go wrong, then it must have been a human was to blame. We have worked with several hospitals to support the training of their staff, to raise awareness of the problems of poor design, to promote learning culture and help highlight that the best long-term solutions to problems often involves the redesign of a the system.

A training video
At the request of one hospital, we created a video demonstrating a wide range of  issues we had uncovered while working with the US regulator. This work was part of a larger strand to identify use-related hazards related to the use of infusion pumps. Problems range across issues such as devices behaving inconsistently in different situations, silently ignoring invalid inputs, misleading feedback, displays that appear to show different numbers when viewed from different angles, and so on. We subsequently discovered similar issues existed in many other kinds of devices not just infusion pumps. It is important that staff using such devices are aware of the problems. CHI+MED researchers were asked to give a training workshop at the hospital where we had been investigating the issues, and as a consequence we were then asked to create a video of the issues discussed for future use. The video we developed uses our simulation tool, PVSioweb to demonstrate design problems in a wide range of marketed devices that nurses need to be aware of. It has been downloaded over 3000 times in less than 18 months.

 


"We have shown the training video [that demonstrates errors for numerous infusion pump types] and given some classes to some local hospitals, who were really blown away by what they were seeing. Some of the things we came up with they weren't aware of, so there has been a bit of an impact on local hospitals in terms of awareness of pumps and how to keep an eye out for some of these issues." - US government stakeholder


 

A role playing activity
Two other strands of our research provided a foundation for a training workshop developed for a UK hospital. One strand was to develop simple, but powerful, ways to communicate design challenges using scenarios and personas. These are fictional but realistic accounts of the people who use the technology, and of the situations they find themselves in. In other work, we were analysing past medical incidents. Based on this we created a role playing game that involves giving participants a scenario about a medical incident and asking them to role play different protagonists defending themselves in a discussion about who or what is to blame. After we demonstrated it to hospital training manager, Paul Lee, he decided to adapt it for nurses to help them understand the causes of incidents and, in particular, how poor design can cause incidents. It draws out a discussion of blame culture and how it hinders learning. Participants rarely see the device design as being the cause, even though design changes could have prevented the incident, and this is exposed by the activity. This activity has now been delivered to hundreds of nurses.

 


"Our nurses got hands-on experience and learning as to how to prevent problems before they started."


 

Related Resources
Design Issues in Medical User Interfaces, P. Masci. (2013)  [video]