The Socratic Method on Steroids

Many people might have bristled as they listened to the product of weeks of hard work being dissected. But for the alumni, graduate students, and fourth-year undergraduates who make up the BIF / RISD Healthcare Innovation Project team, critiques - or "crits" - are nothing new.

Critiques are an integral part of the design process at RISD and beyond, providing essential feedback for designers as they move along the path towards solutions. Featuring advice from established practitioners (and generally bright people) like RISD faculty member Lorna Ross and team leaders Michael Lye and Charlie Cannon, crits will help the team refine their course and redirect it, if necessary. A session with Ross, Lye and Cannon was the first in a series of critiques that will occur with designers and health care leaders during the course of the project.

After receiving an explanation of the BIF / RISD team's first foray into visualizing the patient experience with primary care, the RISD faculty members began digging into the team's work. After seeing team member Gwen Frederick present a graphic illustrating wellness and life expectancy, Ross asked, "Is this supposed to be a cautionary tale?" Frederick replied, "It is a cautionary tale, but not one that's a foregone conclusion." Continuing the questioning, Lye asked how she would title the graphic, and Frederick responded that it depicts "the routine of wellness." Her teammate, Dann Spann, added that "we could have shown this linearly, but instead decided to put layers upon layers, allowing us to depict changes as people age."

Ross offered suggestions for the graphic, based on her experiences working at the intersection of health issues and design. "I think it would be easier to read as an illustration of a specific person. For it to have an impact, it has to be either personal and specific or statistically accurate." Lye agreed, noting that "we need to base this on the specific examples we've found." Team members resolved to incorporate these suggestions into their ongoing work on the project.

The discussion continued in this manner for hours, with team members presenting visualizations, Ross, Lye and Cannon asking questions, team members responding, and the faculty members offering suggestions for improvement. The Socratic method on steroids, one might say.

Ross brought a well-informed perspective to the group that supplemented insights from Cannon and Lye. After earning an advanced degree in Interaction Design from the Royal College of Art in London, she worked at Interval Research Corporation (Paul Allen's Silicon Valley think tank) and the Defense Advanced Research Projects Agency, where she specialized in mobile / wearable technologies and smart materials. Her interest in the healthcare experience began in the fall of 2000, when she jointed MIT Media Lab Europe as one of seven principal investigators, establishing the Wellbeing Group to explore the future of healthcare for the Lab's European sponsor community. More recently, Ross founded and served as director of the experimental collaborative program "Design In Residence" at the Hasbro Children's and Women's and Infants Hospitals.

For Ross, the team's work is both urgent and long overdue, and the emphasis on the patient-doctor relationship is essential to understanding why good practices haven't been successfully implemented. Using the example of wellness, she noted that although experts agree on the proper outcomes and solutions, few have been able to identify specific actions that, if implemented, would positively affect the healthcare system: "Why is it not already happening? Rather than being romantic we, need real things you can point to" that are preventing people from behaving in ways that obviously benefit their health. In wellness (and chronic and acute care), "there are more curious reasons than the obvious ones" to explain why the system isn't performing properly, Ross suggested. The team's job is to use ethnographic research, sketches, and other tools they have access to as designers to understand the problems that policymakers and physicians can't see.

Ross encouraged the team to continue pushing forward in visualizing and sketching individual patient experiences, and that despite the effort necessary to draw each one, it would not be for naught: "something emerges from doing a lot of models." The resolve and energy with which team members went back to work after their first "crit" suggests that they couldn't agree more.

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