Close the Loop

Our aim is to design an affordable and accessible solution to improve closed-loop communication to enhance positive team dynamics, improve confidence and develop widely recognisable medical vernacular in high stress ALS scenarios.

Project Overview

Our design brief for this was to improve the ALS training experience. After our background and user research we found there was already an effective existing design that focused on the practical process and medical knowledge aspects of ALS training. This allowed us to focus on a design that would be supplementary to the existing methods.

Time frame:

12 Weeks

Tools:

Adobe Illustrator, Adobe InDesign, Adobe XD, Miro

Team:

Kaitlyn Briden, Alexandra Churchin, Anna Macgregor and Kaitlyn Briden

Responsibilities:

User Research and Analysis
Ideation and Iteration
UX/UI Design
Interaction Design

'Close the Loop' is a training program designed to help standardised and familiarise trainees with medical nomenclature, improve team dynamics and overall improve the trainees experience through the ALS algorithm. Closed-looped communication in ALS experience is vital to reducing medical errors stemming from misinformation and miscommunication, enhancing team rapport and improving decision-making skills, pertinent in enhancing a patient's overall outcome.

Our Design Process

The Brief

01. Design Direction

Understanding our direction & role as designed for the Simulation Lab at Westmead.

Research

02. Problem Space

Primary statistics, online ethnography, theory of learning and design precedent of existing approaches to ALS training.

Investigate

03. Engage and Explore

Interviews with stakeholders, surveys and further secondary research.

Co-Design

04. Collaborate

Re-engaging our stakeholders in a co-design session to refine design direction.

Ideate

05. Generate the Ideas

KJ Brainstorming, brainwriting, PMIs and decision-matrix of ideated solutions.

Iterate

06. Revise and Improve

Design critique with stakeholders, iterating through understanding psychological needs and ethics.

Testing

07. User Experience

Usability testing, Wizard of Oz Prototyping.

Critique

08. Looking Forward

Critical analysis and future outlook for ‘Name’

Approach to the Problem Space

When designing for wicked problems, collaborative and participatory design approaches foster divergent and innovative thinking to help change existing practices and practices (Chamberlain and Partridge, 2017). Using the 'experts of their experience' has helped to gain deeper insights into the 'needs and dreams' of future users so that designed solutions fit within their actual lives (Sanders & Stappers, 2007). As our team is designing with and for the needs and wants of medical students and educators, a group initially unfamiliar to us, a co-design approach has helped to develop a contextually relevant and user-focused solution.
Technology mediated solutions offer various and extraordinary unrealised possibilities for education (Glassman, 2016). Already e-learning, augmented reality and digital gaming has begun to enhance learning for medical students by helping to replicate high stress medical scenarios and promote active learner centred-learning (Peterson, 2012). In designing to improve ALS training, technology will help to improve decision-making skills, enhance skill coordination and improve endurance of medical knowledge and skills.
Medical education aims to develop students to become knowledgeable, skilled and up-to-date cadre of professionals who put patient care above self-interest and to continue to learn across their lifelong career (Swanwick, 2014). In designing for this group, so different to our own experience, it was vital that we practiced reflexivity throughout the design process. Team reflexivity saw us practice reflective design by debating ideas, processes or changes to concepts to help enhance design ideation (Schippers, 2015)). We also devised a 'governance supervisor' who was responsible in overlooking the design process and providing reflective feedback on design decisions.
Moreover, our design process strived to be ethically considerate. From understanding basic psychological needs of users, stakeholder confidentiality and limitations of technology, our designed solution is ethically responsible.

The Problem Space

Despite cardiac arrest having a low incidence rate of 99.4 per 100,000 people, compared to heart attacks which have an incidence rate of 339 per 100,000 people, out of hospital cardiac arrests only have a 10% survival rate (Beck et al., 2018)

Medical education and accreditation are essential in addressing this high stake yet low frequency event by providing quality care for cardiac arrest patients. In doing so, medical educators provide accreditation training for students and re-accreditation training for current medical practitioners to ensure developing enduring and resilient medical skills and know-how.

Regular exposure to cardiac arrest scenarios and ongoing ALS training helps for nurses to address and adapt to various local variations of ALS to develop various technical skills such as advanced airway management, electrical defibrillation and endotracheal intubation to bring back spontaneous circulation (Moore et al., 2020). Medical students are required to learn and retain these ALS skills in stressful and chaotic environments in which they will be working with 6 to 10 clinicians with tasks (Figure 1.1) to manage a patient's health outcome.

As a low frequency event in Australia, ALS skills and knowledge are at risk of decay between six to twelve months after initial training. This has called for the opportunity for us as designers to research and design for accessible and effective ALS training methods to promote skill endurance.

The Design Approach

From our further exploration of user needs, we found an opportunity to explore the importance of focusing on how ALS training methods may be enhanced by supplementing easily learnable technical skills with essential non-technical skills such as teamwork and communication. Our design direction is shaped to address how current ALS training lacks a focus on closed-looped communication between ALS team members in undertaking essential tasks, a skill essential to the success of the positive ALS and enhanced patient outcomes.

The User Journey

A hollistic view of the needs, motivations and pain points of the user.

The Final Design

'Close the Loop' is an interactive multiplayer experience that allows medical trainees and nurses to practice and learn closed-looped communication skills. 'Close the Loop', which is access via any app-based platform such as phones, tablet or computers, is an affordable and accessible learning module that allows trainees to learn the differing roles in an ALS team, practice and become familiar with medical vernacular and work within culturally and skilfully diverse teams. In 'building your own' ALS team, individuals have the opportunity to work with an array of ALS trainees and work through various real-world ALS algorithms. To help users throughout the process, the training approach integrates sources of help and prompts if trainees are stuck.

With differing difficulty levels, an ESL option and individualised feedback and personal goals, 'Close the Loop' hopes to encourage trainees to develop inter-professional skills that can be taken into high-stake medical scenarios to promote confidence and enhance positive patient outcomes.