Blog Posts: Making UX more Accessible
Cambridge Alumni win funding to host expert symposium on technologically-driven rehabilitation in orthopedic and trauma surgery
The first Trans-European Trauma Rehabilitation Expert Symposium will bring together experts in the field to explore trauma rehabilitation concepts and their development based on the state of the art in patient-centred technology design.
The overarching goal is to improve patient outcomes through the design of assistive technology that assists both patients and surgeons. An emerging field is that of regenerative rehabilitation where trauma patients are treated by methods of regenerative medicine. In spite of the potential in this area, clinical success has not yet been realised; rehabilitative and assistive technologies are all too often rejected by patients because of the social stigma associated with temporary or permanent injury, illness or impairment. The symposium has been specifically organised to address these issues.
Dr Wolfram Bosbach specialises in trauma surgery at the University of Giessen and is a resident experimental trauma surgeon at the University Hospital and was the co-applicant for German DFG funding. Wolfram and I will be joined by Dr Anna Mieczakowski who will be leading the interactive session on day two of the symposium. Anna and I were both based in the University of Cambridge's Engineering Design Centre where we focused on the field of Inclusive Design, whilst Wolfram pursued research in the field of Biomechanics.
The inaugural symposium will draw insight from patients, surgeons, biomechanic experts, visual, product and interaction designers, and health care professionals. There will be a distinct focus upon the importance of involving patients and users throughout the design process; aspects at the core of the user centred and inclusive design process. The conference proceedings are available for free here.
A Step Change in Personalised Healthcare: Using Wearable Technology to help Stroke and Huntington's Patients Walk Again
Rhythmic haptic cueing (RHC) - using wearable devices to provide cues to walking – has returned promising results in trials involving stroke survivors; helping them re-learn their natural walking rhythm, coordination, increasing their independence, sense of well-being and self-worth.
Current work focusses on the application of similar techniques to those suffering from Huntington’s disease; an inherited disorder that results in the death of brain cells. As the disease advances, uncoordinated, jerky body movements become more apparent. Walking to a rhythm has been shown to help slow the progression of the neurodegenerative effects in gait which subsequently offers improvements in quality of life.
The research team led by Simon Holland at the Open University developed a set of haptic bracelets; devices worn on the ankles and wrists that deliver ‘pulses’ or rhythmic haptic cues that help the wearer to focus on when a specific limb should be articulated. Through a process of participatory design and user testing, the team were able to show how cues delivered via these haptic bracelets had positive effects upon stroke patients’ coordination, cadence, forward leaning and plantar flexion: or gait coordination.
The Origin of the OU Haptic Bracelets
The haptic bracelets herald from the field of music research. As a keen musician and technologist, Simon was interested in developing technology that could easily transfer key aspects of musicianship to novices; rhythm and coordination.
He developed a set of bracelets that could be worn on the wrists and ankles of experienced percussionists that detected movement and transmitted these signals to identical receivers worn by aspiring musicians. These ‘wannabe drummers’ were able to physically feel the rhythm and know when to move in time; the signal transmission and reception was to all intents and purposes instantaneous.
This, amongst other things, has direct application for teaching percussion as it removes the physical contact requirement between student and pupil that traditional teaching has relied upon. Something that today it is preferable to avoid, or at the very least reduce. It also has the potential to facilitate remote learning.
Josh Blackmore who studied at the Royal Academy of Music and who is professional percussionist and tutor having toured Europe and the United States, was particularly interested in the bracelets’ origin and potential. Although this avenue was ripe for development, Simon and the research team at the OU wished to pursue a more health-focussed application of the technology; applying it to stroke rehabilitation and reducing the impact of Parkinson’s and Huntingdon’s disease on patients.
User Centred Research and Design
Participatory and Inclusive Design is about placing the user at the centre of the design process to obtain insights that enhance user experience. This increases the accessibility of technology to a wider proportion of the population and improves the interactional experience for all users including those with impairment. As the vibrotactile technology has been developed to assist those suffering from stroke, Huntington’s disease and other neurological conditions, it was imperative to involve them throughout the development process to ensure the outcome was suitable for the intended user groups.
This project spans a wide range of highly technical, people-centric, disciplines including human computer interaction, neuropsychology, wearable computing, movement computing and gait rehabilitation, and all development is based on evidence acquired by user testing. This work will continue to have significant implications for clinical development and application within future rehabilitation and self-improvement programmes, and the outcomes will continue to further knowledge about the efficacy of haptic technologies for clinical and non-clinical use.
Georgiou, T., Holland, S. van der Linden, J. (2017). Rhythm and Gait rehabilitation: a case study using rhythmic haptic cueing for stabilising gait and improving asymmetries. In: 26th European Stroke Conference, 24–26 May 2017, Berlin, Germany.
Applying UX within organisational, collaborative contexts: Cambridge University
As I returned to help the University of Cambridge implement its long-term strategy for Equipment Sharing in January 2018, one thing I was keen to learn was how the sector and the equipment sharing movement had moved over the last 18 months. I began by reaching out to regional and national equipment sharing consortia and key individuals across the country.
Equipment booking systems remained a hot-topic for all the universities contacted, and seen as a way of increasing efficiency and effectiveness whilst reducing the burden on local administration. Those that hadn’t yet implemented systems were investigating the options available. This is an expanding market. Jisc produced a useful guide last year to a number of the products on the market for those wishing to learn about the options available. More solutions appear on an almost daily basis reflecting the growing interest in this area.
In terms of collaborative successes, the Royce initiative – a strategic partnership between the universities of Manchester Sheffield, Leeds, Liverpool, Cambridge, Oxford and Imperial College London – is now bearing fruit with Royce equipment housed within the Maxwell Centre at Cambridge becoming operational in April 2017.
Equipment Sharing 3.0 - Thinking of the User - Who are They and What do They Need?
On my return I was keen to action some insight analysis on a local basis to staff responsible for individual items of equipment on the Cambridge Database, and to Cambridge’s Small Research Facility managers. Engaging directly with the lab and facilities managers was a really useful way of gaining a snapshot into the sharing activity at Cambridge, and it also gained feedback from users of the system as to how things might be done better.
This user-centred focus is gaining momentum. The recent UKRI Infrastructure Roadmap Survey brought user consideration to the fore as well as seeking to understand how utilisation and capacity is measured and understood:
· Does your Research and Innovation Infrastructure (RII) have a single access point for users?
· What is the most appropriate way of estimating the number of users that your RII has?
· What is the most appropriate timeframe for this (annual, since records began, or something else)?
· Using this measure, approximately how many users does your RII have?
· How do you measure the capacity of your RII?
· What percentage of your RII’s capacity is used?
· What percentage of your RII’s capacity do you aim to use?
Use versus Utilisation
It does seem as though the sector drivers are listening and are keen to understand how accurate, effective, and useful metrics can be developed. However, a consensus or definition of terms remains outstanding. One sector colleague observed: “Utilisation is a subjective term that can be interpreted in multiple ways, making direct comparison flawed. For example, booking a driving simulator for one week’s use, requires a week allocated to set-up, a week of client use, and a subsequent week of data analysis; does utilisation cover the whole 3-week period or the actual time of client use?”
In the case of some microscopes, current set-ups will have to be dismantled and the required configuration assembled and calibrated. The ‘booked use’ of the microscope by the client may then take place, before the set-up is again dismantled, reassembled and recalibrated. If the associated booking system is electronic and monitors ‘actual’ use – when the user logs on to perform the desired task – it may only record actual use not total use. Again, this reinforces the need for all of us in the sector, when assessing usage and capacity, to reach consensus on what constitutes the user, utilisation, and capacity.
Deriving Maximum value from Big Data
For those involved in data acquisition and reporting – an often overlooked user base – publication tagging can be immensely useful in reporting impact for activities such as the Research Excellence Framework (REF) assessment. The Research Data Alliance’s Persistent Identification of Instruments Group seeks to explore a community-driven solution for the globally unique identification of active instruments in the sciences, and this linked with publication tagging will provide a powerful tool for future data analytics. This is something the User Facilities and Publications Working Group are looking at under the ORCID banner. Laurel Haak has written a compelling article on using identifiers to capture and expose facilities use . An ORCID report, entitled Findings and Opportunities, summarises the discussions around ORCID increasing data capture and reducing the reporting burden for researchers.
Who is the Audience and how can we best Support Them?
Thinking about users is central to the development of usable systems and exceptional user experiences. So, are Cambridge’s equipment users internal or external individuals, internal or external research groups, or commercial entities? Are they looking to find a short-term local solution to a mechanical failure, develop a long-term collaborative relationship, or do they merely have samples that require analysis. Are they involved in reporting activities at local, regional, or national levels? Are they funder-orientated, wish to submit research proposals, and do they want to increase the awareness of their equipment or facility?
Thinking about and speaking to each of these groups individually and eliciting their unique needs and requirements allows the development of systems that deliver exceptional value and efficiencies to local and national institutions as well as the sector as a whole.
This is an abridged article that was originally commissioned by JISC. The full transcript is available at the following url:
In-Car Systems Design
In a collaboration with a leading automotive manufacturer, I researched an enhanced in-vehicle safety system that provided tactile, visual, and auditory feedback in a way that was easy for drivers to understand and interact with.
Why was this system required?
The existing safety system monitored the vehicles two electronic throttle sensors. If one sensor failed, it placed the vehicle in Limp Home mode; restricting vehicle to speed 30mph and illuminating the vehicle's Engine Management System light.
Why was this a problem?
From a user centred perspective it isn’t good to place users in a situation in which they don’t understand the problem or error nor what to do about it (akin to Neilsen’s Heuristic guidelines that strive to "help users recognise, diagnose and recover from errors").
From a safety perspective, too, it is alarming at least to be travelling on a motorway doing the national speed limit and have the vehicle's performance suddenly constrained to such a degree.
There was also the concern that if the second throttle sensor failed, throttle control could be lost completely, immobilising the vehicle or, arguably worse, the vehicle exiting stage left at full rpm…
How can UX help?
The key thing in error situations is to give users back control by
a) Informing them what the error is
b) Informing them how to rectify the situation
You can see in the motorway scenario the last thing you want is a vehicle that is catastrophically loosing performance with the EMS light flashing away merrily. This doesn’t help the driver to understand the situation, nor helps them to find a suitable solution to their current predicament.
What did we do?
The first thing was to look at things from the perspective of the user.
We wanted to inform them of the error, and how to respond.
Cognitive overload in stressful situations should be avoided at all costs so, keeping the message simple, we revised the warning system to state “Engine Management System Fault – Please return vehicle for servicing”.
This efficiently informed the driver of the problem and the solution. And remember, we did want to encourage servicing because if the second sensor failed…
We also looked at the available performance and mapped different ways of degrading it over time, rather than reducing it immediately to Limp Home mode’s 30mph. This was in combination with a ‘countdown timer’ that gave the driver more information by indicating that although performance was affected, a predicable amount remained to allow them to make arrangements to have the vehicle serviced.
How were these solutions tested?
This was the really fun bit! We took a number of drivers to a private circuit and instigated the fault as they drove a predetermined course. But we didn’t tell them that we planned to instigate the fault.
In psychology this might be deemed duping the participants…
Using a talk-aloud protocol and asking participants to verbalise their internal thoughts, reasoning and actions, we were able to document when drivers became aware of the fault, their understanding of it, and how they responded and understood the information presented to them by the systems we’d developed.
All three systems were compared against each other; the original limp home mode, and the two degrading performance modes we’d created. We also analysed the driving history of all the participants. We were using professional circuit drivers, so it was important to log their driving experience so that we might account for the more ‘average’ driver.
Talk-aloud protocols are extremely effective at generating large amounts of rich, qualitative, data; one of the reasons I love using them so much! It can take time to analyse but it’s a very useful method of understanding what your users experience and feel about an interaction.
What was the outcome?
With no experimental bias (I swear), drivers preferred one version of the revised system over the other, and both over the original limp home mode. They felt more reassured by the extra information they received, understood the implications of current and continued use, and felt the malfunction didn’t impede their activity to the same extent but allowed them to plan ahead for the vehicle to be serviced.
All in all, mission accomplished!
Further reading and links:
Developing a Calibration Model for Degrading Vehicular Performance: A Human Factors Approach to Safety Critical Systems Implementation.