EMPOWERING EMPATHYIN MEDICAL EDUCATION
Empathy is a crucial ingredient for medical education competencies in (1) Patient Care; (2) Communication; and (3) Systems-Based Practice.
Design Thinking X Medical Education is a series of interactive educational modules for clinicians’ empathy development using Design Thinking (DT).
The project aims to enable the learners to (1) recognize their biases; (2) apply practicable skills to understand patients’ perspectives; and (3) use the feedback from patients to deliver context-sensitive care.
PI : Hannah Park , MDes School of Architecture & Design, University of Kansas (KU)
Co-PI : Blake Lesselroth, MD, MBIUniversity of Oklahoma-Tulsa School of Community Medicine (OUTU)
KU Graduate Student Col laborators: Maria Jose Cardona Giraldo, Denise Chiao, Kait lyn M Jerome, Ar turo Erasmo Pini l la Perez, Shant Thomas
KU students in 2020 Spring ADS 712 par t ic ipated a research project run by Park and Lesselroth to develop a ser ies of DT exercises that aims to enhance cl inicians’ empathy toward their pat ients. Selected exercises wi l l be tested at the Student Academy: Social Determinants of Health and Patient-Centered Care, an al l -day workshop for medical students and nursing students at the School of Community Medicine, University of Oklahoma-Tulsa, in May, 2020.
Reference
Albala L., Bober T., Mallozzi M., Koeneke-Hernandez L., & Ku, B. (2018). Design-Thinking, Making, and Innovating: Fresh Tools for the Physician’s Toolbox. Universal Journal of Educational Research, 6(1), 179-183. doi: 10.13189/ ujer.2018.060118.
Batt-Rawden, S. A., Chisolm, M. S., Anton, B., & Flickinger, T. E. (2013). Teaching Empathy to Medical Students. Academic Medicine, 88(8), 1171–1177. doi: 10.1097/acm.0b013e318299f3e3.
Heath, S. (2018, October 17). Understanding Physician Empathy, How It Impacts Patient Care. Retrieved from https://patientengagementhit.com/news/understanding-physician-empathy-how-it-impacts-patient-care.
Hirsch, E. M. (2007). The Role of Empathy in Medicine: A Medical Students Perspective. AMA Journal of Ethics, 9(6), 423–427. doi: 10.1001/virtualmentor.2007.9.6.medu1-0706.
Menendez, M. E., Chen, N. C., Mudgal, C. S., Jupiter, J. B., & Ring, D. (2015). Physician Empathy as a Driver of Hand Surgery Patient Satisfaction. The Journal of Hand Surgery, 40(9). doi:10.1016/j.jhsa.2015.06.105.
Roberts, J. P., Fisher, T. R., Trowbridge, M. J., & Bent, C. (2016). A design thinking framework for healthcare management and innovation. Healthcare, 4(1), 11–14. https://doi.org/10.1016/j.hjdsi.2015.12.002.
Shin, A., Blenkhorn, L. (2018, June 26). National Survey Data Presented at the Compassion in Action Conference Show Mixed Reactions on State of Compassion in U.S. Healthcare. Retrieved April 19, 2020, from https:// www.prnewswire.com/news-releases/national-survey-data-presented-at-the-compassion-in-action-conference- show-mixed-reactions-on-state-of-compassion-in-us-healthcare-300480125.html.
* This project was suppor ted by CTE’s 2020 January Jumpstar t .
DESIGN THINKINGX
MEDICAL EDUCATION
CHALLENGE
Empathy is a crucial ingredient to medical education program object ives,
including pat ient care, communicat ion, and systems-based pract ice (Hirsch,
2007). We acknowledge that medical education attracts learners who are
compassionate and empathet ic. Yet , much of this learning occurs dur ing the
precl inical years; research has shown that empathy diminishes as medical
students advance in their education due to stress, fat igue, a need for
detachment , and the “unwritten curr iculum” of cl in ical t raining (Batt -Rawden,
Chisolm, Anton, & Fl ickinger, 2013).
Empathy intervent ions must be implemented throughout the ent i re medical
educational continuum so that learners can recognize (1) their own biases;
(2) the pat ient ’s perspective and feel ings; and (3) the unique context-of-care.
DT EXERCISE EXAMPLES FROM ADS 712
REFLECTION
Clinician’s biases Patient ’s perspective Context-of-care
Responding with an evidence-based and pat ient-centered plan that addresses
the social determinants of health, future medical education curr icula must
teach learners how to co-create solut ions with their pat ients that address the
needs and concerns of society at large.
SOLUTION
We propose to develop interactive educational modules for empathy development
using Design Thinking (DT). I t is a methodology for creat ive problem-f inding
and solving that emphasizes empathy and human-centered approach (Rober ts
et al . , 2016, p. 12). We hypothesize DT wi l l empower residents’ empathy and
systems thinking abi l i ty to suppor t the ethnical ly and socioeconomical ly diverse
pat ient populat ions (Albala et al . 2018).
EMPATHIZ
E
DEFINE IDEATE PROTOTYPE
TEST
Experiential-learning exercise, which encourages utilizing patient feedback to inform and co-create solutions that enhance patients’ well-being.
Building Empathy through a Design Thinking Workshop
How we can do it...
EMPATHY DIMINISHES AS MEDICAL STUDENTS ADVANCE THEIR EDUCATION (Batt-Rawden, Chisolm, Anton, & Flickinger, 2013, p. 1172)
empathy
time in medical school
+
+–
–EMPATHY IS NOT WIDELY AND/OR SYSTEMATICALLY INTEGRATED IN MEDICAL SCHOOL CURRICULA (Batt-Rawden, Chisolm, Anton, & Flickinger, 2013, p. 1174)
patient dissatisfaction
malpractice claims
can lead to
due to
80% of
these
Lack of understanding & communication
skills
PHYSICIANS THAT LACK COMMUNICATION SKILLS ARE MORE LIKELY TO BE INVOLVED IN MALPRACTICE CLAIMS(Hojat, et al., 2002, p. 523)
Empathyinterventions
Medical education
A human-centered approach, which focuses on the needs and experiences of real people. It is a multidisciplinary creative process that strives for feasibility, viability, and desirability. (Gobble, 2014, p. 59)
Design thinking + empathy interventions in medical school will allow students to: 1. Recognize their own biases, and 2. Involve the community to understand how they want to be helped and treated, and therefore, co-create solutions that address the needs and concerns of society at large.
combined with
combined with
2
1
3
2
Design Thinking
More empathetic physicians
GOALS
1. Mastering patient-centered care through patient feedback to solution co-creation
2. Learning design-thinking skills and establishing validity through multiple rounds of affinity diagramming.
3. Developing problem-solving skills to find diverse courses of action
4. Promote empathetic and engaging communication skills through storyboarding
LOGISTICS
Duration: 1 hour
Participants: Third Year Medical Students / Residents
Ideal # of participants: 20 Max # of participants: 50 Min # of participants: 10
Format: In person or Virtual
Materials: In Person (pens, markers, big sheets of paper, sticky notes with patient feedback, push pin board or whiteboard, push pins / tape, big room to sort cards either on floor or tables, magazines, scissors) Virtual (Mural Board app, Zoom)
patient Feedback
Affinity Diagrams
Ideation
Storyboards
1 participants are given
to sort and cluster with2
utilize insights and themes for3
choose best ideas and share using4
‘I want to believe’ Workshop Instruments
Project DescriptionIn order to incorporate, maintain, and enhance the learning of empathetic physicians, the “I Want to Believe” workshop is an experiential-learning exercise that will allow participants to utilize feedback from patients to co-create potential solutions, which enhance patients’ visits.
The activity will involve participants receiving feedback from fictional patients based on literature and real surveys, which will be provided in the form of sticky notes.
When this information has been gathered, participants will then split into groups, share their feedback and look for themes. Once participants have their themes, groups will storyboard and share the most plausible ideas to incorporate in a hospital setting. In this manner, medical students will 1) learn to actively listen and involve patients, 2) use problem-solving skills and design thinking to collaborate and co-create empathetic solutions.
Objectives1. Mastering patient-centered care through patient feedback to solution co-creation2. Learning design thinking skills through Affinity Diagramming1 and Storyboarding2
3. Developing problem-solving skills to find diverse courses of action4. Establishing validity through different multiple rounds of sorting and clustering
Assesment RubricParticipants will be graded according to:1. How they incorporate feedback from patients2. How they utilize Affinity Diagramming3. How they incorporate Storyboarding into their presentation4. How they use problem-solving skills in a group setting5. How they bring together multiple viewpoints to final solution
Empathy through Design ThinkingI WANT TO BELIEVE...
1Affinity Diagramming is a process cluster and organize insights from research based on affinity (share a similar intent, problem, or issue), which form relevant themes.2Storyboarding is a linear sequence of drawings, arranged together to visualize a story.
Empathy through Design ThinkingI WANT TO BELIEVE...
Matthew Weprin - UX@SAP
Affinitity Diagramming is a process to meaninfully cluster and organize insights from research, based on affinity (share a similar intent, problem, or issue), which form relevant themes. Use an affinity diagram to:1. Understand what is most important from ambiguous data2. Tame complexity3. Identify connections in data4. Create hierarchies5. Identify themes6. Identify what factors to focus on that will support the most successful design possible from a customer’s perspective.
Affinity Diagram
Storyboard Template
Title:
Theme:
“I have had doctor for a long time. But it is nice if they listen... not being talked down to...”
“I am afraid to change to another one [GP]. I don’t think he benefits me because he is not actively involved...”
“The nurse is good and comes straight round and explains. Dieticians talked to me to get the right food; I had a few run-ins with the nurses – they disagreed with what the dieticians had said. No communicating with one another...”
Man, 64 years old; he wasn’t eating.
“I would like him [GP] to ask me how this is going and how that is going. I need to be told, but also listened to...”
“I feel very angry. The nurses think they know it all, despite it being my illness. I’m not going back”
“The doctors advised me to have an operation, but I declined because this was not consistent with the advice I was given in another hospital.”
Woman, sometimes, in the hospital, she threw away her medications.
Man, 68 years old Woman, 46 years old, stopped attending the general practice
“I was drugged and was not clear about what washappening and the doctor didn’t tell me anything and I was discharged although I was feeling pain”
“IThey [practice nurses] don’t give you a chance to finish what you are saying. They walk off and say ‘I can’t hear you’”
“The pharmacist and GP don’t say the same things, I wonder if they ever talk to each other”
Woman, 66 years Woman, 68 years
Asian woman, 50 years old
“ I only go to see a doctor when a new problem with my health comes up”
“IThey [practice nurses] don’t give you a chance to finish what you are saying. They walk off and say ‘I can’t hear you’”
“The pharmacist and GP don’t say the same things, I wonder if they ever talk to each other”
Woman, 66 years Woman, 68 yearsMan, Low-income,
36 years old
Man, Low-income, 56 years old
Man, 75 years old
Project Description / Objectives Handout Affinity Diagram Handout
Storyboard Template Handout Patient Feedback Sticky Notes
KateGraduate Medical StudentResidency
ABOUTAge: 31 years oldStatus: MarriedLocation: Tulsa, OklahomaAttributes: Highly motivated and organizedDebt: $180,000
MOTIVATIONSKate has found a new love for teaching the next generation of medical stu-dents and residents while being a resident herself. She is now in the board at her hospital, where her input is valued for the teaching curriculum.
FRUSTRATIONS�ate is still struggling to find time that leads to a more balanced and healthy life. Sometimes she goes on 2�hr shifts and that takes a toll on her body and relationships.
CORE NEEDSExperiential learning�aintain stamina and empathy �hile in residencyWork-Life balance
“It’s hard to find time for myself, my husband, and family while taking good care of my patients”
Final theme 1 Final theme 2 Final theme 3
I want to believe...
1
2
34
5
6
12
3
4
56
1
23
4
5 6
1
2
3
4
56
1
2
3
456
theme 1theme 2
theme 3
Final theme 1 Final theme 2 Final theme 3
theme 1
theme 2
theme 3
Themes1.2.3.4.5.6.7.8.9.10.11.12.13.
scenarios
Persona Definition
Workshop Prototype A/B Test
Concept Scenarios
Batt-Rawden, S. A. , Chisolm, M. S. , Anton, B. & Flickinger, T. E. (2013). Teaching Empathy to Medi-cal Students. Academic Medicine, 88(8), 1171–1177.
Becker, G., & Newsom, E. (2003). Socioeconomic status and dissatisfaction with health care among chronically ill african americans. American Journal of Public Health, 93(5), 742-8.
Cykert, D., Williams, J., Walker, R., Davis, K., & Egede, L. (2017). The association of cumulative discrimination on quality of care, patient-centered care, and dissatisfaction with care in adults with type 2 diabetes. Journal of Diabetes and Its Com-plications, 31(1), 175-179.
Gobble, M. (2014). Design Thinking. Re-search-Technology Management, 57(3), 59-62.
Maria Jose CardonaADS 712 Advanced Design Methods in Design
PI: Hannah Park, Blake Lesselroth
Numerous iterative phases allowed this project to come to life.
1. Research: Understanding the medical curriculum, the importance of empathy, and how design thinking can help.
2. Persona Definition: Learning and caring for who you’re designing for so you can make something of value.
3. Concept Scenarios: Brainstorm multiple ideas to deliver the best viable solution based on research.
4. Workshop Prototyping: By going through the logistics, you can smooth the rough edges.
5. A/B Testing: Arranging the information in a memorable, engaging, and easy to follow manner.
Hojat, M., Gonnella, J. S., Mangione, S., Nasca, T. J., Veloski, J. J., Erdmann, J. B., Callahan, C. A., & Magee, M. (2002). Empathy in medical students as related to academic performance, clinical com-petence and gender. Medical Education, 36(6), 522–527.
Hodson, B. (2020, March 26). How to storyboard experiences. Retrieved from https://uxdesign.cc/how-to-storyboard-experiences-fc051e2bc04d
Muldoon, L. (2013). Patient poverty and workload in primary care. Study of prescription drug benefit recipients in community health centres (vol 59, pg 384, 2013). Canadian Family Physician, 59(6), 612.
Sally, F. D., Silvester, A., Barnett, D., Farndon, L., & Ismail, M. (2019). Hearing the voices of older adult patients: Processes and findings to inform health services research. Research Involvement and En-gagement, 5
Wise, B. & Dreussi-Smith, T. (2018). The primary care provider and the patient living in poverty. Journal of the American Association of Nurse Prac-titioners, 30(4), 201–207.
Weprin, M. (2016, November 13). Design Think-ing Methods: Affinity Diagrams. Retrieved from https://uxdict.io/design-thinking-methods-affini-ty-diagrams-357bd8671ad4
I WANT TO BELIEVE...
WHY we should CARE...
Who deserves credit...
WHat we can do...
How we can do it...‘I Want to Believe’ Workshop
How it developed...
Instruments allow any medical school, program, or instructor to incorporate the workshop in their curriculum and further enhance the learning of empathetic physicians.
Experiential-learning exercise, which encourages utilizing patient feedback to inform and co-create solutions that enhance patients’ well-being.
Building Empathy through a Design Thinking Workshop
How we can do it...
EMPATHY DIMINISHES AS MEDICAL STUDENTS ADVANCE THEIR EDUCATION (Batt-Rawden, Chisolm, Anton, & Flickinger, 2013, p. 1172)
empathy
time in medical school
+
+–
–EMPATHY IS NOT WIDELY AND/OR SYSTEMATICALLY INTEGRATED IN MEDICAL SCHOOL CURRICULA (Batt-Rawden, Chisolm, Anton, & Flickinger, 2013, p. 1174)
patient dissatisfaction
malpractice claims
can lead to
due to
80% of
these
Lack of understanding & communication
skills
PHYSICIANS THAT LACK COMMUNICATION SKILLS ARE MORE LIKELY TO BE INVOLVED IN MALPRACTICE CLAIMS(Hojat, et al., 2002, p. 523)
Empathyinterventions
Medical education
A human-centered approach, which focuses on the needs and experiences of real people. It is a multidisciplinary creative process that strives for feasibility, viability, and desirability. (Gobble, 2014, p. 59)
Design thinking + empathy interventions in medical school will allow students to: 1. Recognize their own biases, and 2. Involve the community to understand how they want to be helped and treated, and therefore, co-create solutions that address the needs and concerns of society at large.
combined with
combined with
2
1
3
2
Design Thinking
More empathetic physicians
GOALS
1. Mastering patient-centered care through patient feedback to solution co-creation
2. Learning design-thinking skills and establishing validity through multiple rounds of affinity diagramming.
3. Developing problem-solving skills to find diverse courses of action
4. Promote empathetic and engaging communication skills through storyboarding
LOGISTICS
Duration: 1 hour
Participants: Third Year Medical Students / Residents
Ideal # of participants: 20 Max # of participants: 50 Min # of participants: 10
Format: In person or Virtual
Materials: In Person (pens, markers, big sheets of paper, sticky notes with patient feedback, push pin board or whiteboard, push pins / tape, big room to sort cards either on floor or tables, magazines, scissors) Virtual (Mural Board app, Zoom)
patient Feedback
Affinity Diagrams
Ideation
Storyboards
1 participants are given
to sort and cluster with2
utilize insights and themes for3
choose best ideas and share using4
‘I want to believe’ Workshop Instruments
Project DescriptionIn order to incorporate, maintain, and enhance the learning of empathetic physicians, the “I Want to Believe” workshop is an experiential-learning exercise that will allow participants to utilize feedback from patients to co-create potential solutions, which enhance patients’ visits.
The activity will involve participants receiving feedback from fictional patients based on literature and real surveys, which will be provided in the form of sticky notes.
When this information has been gathered, participants will then split into groups, share their feedback and look for themes. Once participants have their themes, groups will storyboard and share the most plausible ideas to incorporate in a hospital setting. In this manner, medical students will 1) learn to actively listen and involve patients, 2) use problem-solving skills and design thinking to collaborate and co-create empathetic solutions.
Objectives1. Mastering patient-centered care through patient feedback to solution co-creation2. Learning design thinking skills through Affinity Diagramming1 and Storyboarding2
3. Developing problem-solving skills to find diverse courses of action4. Establishing validity through different multiple rounds of sorting and clustering
Assesment RubricParticipants will be graded according to:1. How they incorporate feedback from patients2. How they utilize Affinity Diagramming3. How they incorporate Storyboarding into their presentation4. How they use problem-solving skills in a group setting5. How they bring together multiple viewpoints to final solution
Empathy through Design ThinkingI WANT TO BELIEVE...
1Affinity Diagramming is a process cluster and organize insights from research based on affinity (share a similar intent, problem, or issue), which form relevant themes.2Storyboarding is a linear sequence of drawings, arranged together to visualize a story.
Empathy through Design ThinkingI WANT TO BELIEVE...
Matthew Weprin - UX@SAP
Affinitity Diagramming is a process to meaninfully cluster and organize insights from research, based on affinity (share a similar intent, problem, or issue), which form relevant themes. Use an affinity diagram to:1. Understand what is most important from ambiguous data2. Tame complexity3. Identify connections in data4. Create hierarchies5. Identify themes6. Identify what factors to focus on that will support the most successful design possible from a customer’s perspective.
Affinity Diagram
Storyboard Template
Title:
Theme:
“I have had doctor for a long time. But it is nice if they listen... not being talked down to...”
“I am afraid to change to another one [GP]. I don’t think he benefits me because he is not actively involved...”
“The nurse is good and comes straight round and explains. Dieticians talked to me to get the right food; I had a few run-ins with the nurses – they disagreed with what the dieticians had said. No communicating with one another...”
Man, 64 years old; he wasn’t eating.
“I would like him [GP] to ask me how this is going and how that is going. I need to be told, but also listened to...”
“I feel very angry. The nurses think they know it all, despite it being my illness. I’m not going back”
“The doctors advised me to have an operation, but I declined because this was not consistent with the advice I was given in another hospital.”
Woman, sometimes, in the hospital, she threw away her medications.
Man, 68 years old Woman, 46 years old, stopped attending the general practice
“I was drugged and was not clear about what washappening and the doctor didn’t tell me anything and I was discharged although I was feeling pain”
“IThey [practice nurses] don’t give you a chance to finish what you are saying. They walk off and say ‘I can’t hear you’”
“The pharmacist and GP don’t say the same things, I wonder if they ever talk to each other”
Woman, 66 years Woman, 68 years
Asian woman, 50 years old
“ I only go to see a doctor when a new problem with my health comes up”
“IThey [practice nurses] don’t give you a chance to finish what you are saying. They walk off and say ‘I can’t hear you’”
“The pharmacist and GP don’t say the same things, I wonder if they ever talk to each other”
Woman, 66 years Woman, 68 yearsMan, Low-income,
36 years old
Man, Low-income, 56 years old
Man, 75 years old
Project Description / Objectives Handout Affinity Diagram Handout
Storyboard Template Handout Patient Feedback Sticky Notes
KateGraduate Medical StudentResidency
ABOUTAge: 31 years oldStatus: MarriedLocation: Tulsa, OklahomaAttributes: Highly motivated and organizedDebt: $180,000
MOTIVATIONSKate has found a new love for teaching the next generation of medical stu-dents and residents while being a resident herself. She is now in the board at her hospital, where her input is valued for the teaching curriculum.
FRUSTRATIONS�ate is still struggling to find time that leads to a more balanced and healthy life. Sometimes she goes on 2�hr shifts and that takes a toll on her body and relationships.
CORE NEEDSExperiential learning�aintain stamina and empathy �hile in residencyWork-Life balance
“It’s hard to find time for myself, my husband, and family while taking good care of my patients”
Final theme 1 Final theme 2 Final theme 3
I want to believe...
1
2
34
5
6
12
3
4
56
1
23
4
5 6
1
2
3
4
56
1
2
3
456
theme 1theme 2
theme 3
Final theme 1 Final theme 2 Final theme 3
theme 1
theme 2
theme 3
Themes1.2.3.4.5.6.7.8.9.10.11.12.13.
scenarios
Persona Definition
Workshop Prototype A/B Test
Concept Scenarios
Batt-Rawden, S. A. , Chisolm, M. S. , Anton, B. & Flickinger, T. E. (2013). Teaching Empathy to Medi-cal Students. Academic Medicine, 88(8), 1171–1177.
Becker, G., & Newsom, E. (2003). Socioeconomic status and dissatisfaction with health care among chronically ill african americans. American Journal of Public Health, 93(5), 742-8.
Cykert, D., Williams, J., Walker, R., Davis, K., & Egede, L. (2017). The association of cumulative discrimination on quality of care, patient-centered care, and dissatisfaction with care in adults with type 2 diabetes. Journal of Diabetes and Its Com-plications, 31(1), 175-179.
Gobble, M. (2014). Design Thinking. Re-search-Technology Management, 57(3), 59-62.
Maria Jose CardonaADS 712 Advanced Design Methods in Design
PI: Hannah Park, Blake Lesselroth
Numerous iterative phases allowed this project to come to life.
1. Research: Understanding the medical curriculum, the importance of empathy, and how design thinking can help.
2. Persona Definition: Learning and caring for who you’re designing for so you can make something of value.
3. Concept Scenarios: Brainstorm multiple ideas to deliver the best viable solution based on research.
4. Workshop Prototyping: By going through the logistics, you can smooth the rough edges.
5. A/B Testing: Arranging the information in a memorable, engaging, and easy to follow manner.
Hojat, M., Gonnella, J. S., Mangione, S., Nasca, T. J., Veloski, J. J., Erdmann, J. B., Callahan, C. A., & Magee, M. (2002). Empathy in medical students as related to academic performance, clinical com-petence and gender. Medical Education, 36(6), 522–527.
Hodson, B. (2020, March 26). How to storyboard experiences. Retrieved from https://uxdesign.cc/how-to-storyboard-experiences-fc051e2bc04d
Muldoon, L. (2013). Patient poverty and workload in primary care. Study of prescription drug benefit recipients in community health centres (vol 59, pg 384, 2013). Canadian Family Physician, 59(6), 612.
Sally, F. D., Silvester, A., Barnett, D., Farndon, L., & Ismail, M. (2019). Hearing the voices of older adult patients: Processes and findings to inform health services research. Research Involvement and En-gagement, 5
Wise, B. & Dreussi-Smith, T. (2018). The primary care provider and the patient living in poverty. Journal of the American Association of Nurse Prac-titioners, 30(4), 201–207.
Weprin, M. (2016, November 13). Design Think-ing Methods: Affinity Diagrams. Retrieved from https://uxdict.io/design-thinking-methods-affini-ty-diagrams-357bd8671ad4
I WANT TO BELIEVE...
WHY we should CARE...
Who deserves credit...
WHat we can do...
How we can do it...‘I Want to Believe’ Workshop
How it developed...
Instruments allow any medical school, program, or instructor to incorporate the workshop in their curriculum and further enhance the learning of empathetic physicians.
Experiential-learning exercise, which encourages utilizing patient feedback to inform and co-create solutions that enhance patients’ well-being.
Building Empathy through a Design Thinking Workshop
How we can do it...
EMPATHY DIMINISHES AS MEDICAL STUDENTS ADVANCE THEIR EDUCATION (Batt-Rawden, Chisolm, Anton, & Flickinger, 2013, p. 1172)
empathy
time in medical school
+
+–
–EMPATHY IS NOT WIDELY AND/OR SYSTEMATICALLY INTEGRATED IN MEDICAL SCHOOL CURRICULA (Batt-Rawden, Chisolm, Anton, & Flickinger, 2013, p. 1174)
patient dissatisfaction
malpractice claims
can lead to
due to
80% of
these
Lack of understanding & communication
skills
PHYSICIANS THAT LACK COMMUNICATION SKILLS ARE MORE LIKELY TO BE INVOLVED IN MALPRACTICE CLAIMS(Hojat, et al., 2002, p. 523)
Empathyinterventions
Medical education
A human-centered approach, which focuses on the needs and experiences of real people. It is a multidisciplinary creative process that strives for feasibility, viability, and desirability. (Gobble, 2014, p. 59)
Design thinking + empathy interventions in medical school will allow students to: 1. Recognize their own biases, and 2. Involve the community to understand how they want to be helped and treated, and therefore, co-create solutions that address the needs and concerns of society at large.
combined with
combined with
2
1
3
2
Design Thinking
More empathetic physicians
GOALS
1. Mastering patient-centered care through patient feedback to solution co-creation
2. Learning design-thinking skills and establishing validity through multiple rounds of affinity diagramming.
3. Developing problem-solving skills to find diverse courses of action
4. Promote empathetic and engaging communication skills through storyboarding
LOGISTICS
Duration: 1 hour
Participants: Third Year Medical Students / Residents
Ideal # of participants: 20 Max # of participants: 50 Min # of participants: 10
Format: In person or Virtual
Materials: In Person (pens, markers, big sheets of paper, sticky notes with patient feedback, push pin board or whiteboard, push pins / tape, big room to sort cards either on floor or tables, magazines, scissors) Virtual (Mural Board app, Zoom)
patient Feedback
Affinity Diagrams
Ideation
Storyboards
1 participants are given
to sort and cluster with2
utilize insights and themes for3
choose best ideas and share using4
‘I want to believe’ Workshop Instruments
Project DescriptionIn order to incorporate, maintain, and enhance the learning of empathetic physicians, the “I Want to Believe” workshop is an experiential-learning exercise that will allow participants to utilize feedback from patients to co-create potential solutions, which enhance patients’ visits.
The activity will involve participants receiving feedback from fictional patients based on literature and real surveys, which will be provided in the form of sticky notes.
When this information has been gathered, participants will then split into groups, share their feedback and look for themes. Once participants have their themes, groups will storyboard and share the most plausible ideas to incorporate in a hospital setting. In this manner, medical students will 1) learn to actively listen and involve patients, 2) use problem-solving skills and design thinking to collaborate and co-create empathetic solutions.
Objectives1. Mastering patient-centered care through patient feedback to solution co-creation2. Learning design thinking skills through Affinity Diagramming1 and Storyboarding2
3. Developing problem-solving skills to find diverse courses of action4. Establishing validity through different multiple rounds of sorting and clustering
Assesment RubricParticipants will be graded according to:1. How they incorporate feedback from patients2. How they utilize Affinity Diagramming3. How they incorporate Storyboarding into their presentation4. How they use problem-solving skills in a group setting5. How they bring together multiple viewpoints to final solution
Empathy through Design ThinkingI WANT TO BELIEVE...
1Affinity Diagramming is a process cluster and organize insights from research based on affinity (share a similar intent, problem, or issue), which form relevant themes.2Storyboarding is a linear sequence of drawings, arranged together to visualize a story.
Empathy through Design ThinkingI WANT TO BELIEVE...
Matthew Weprin - UX@SAP
Affinitity Diagramming is a process to meaninfully cluster and organize insights from research, based on affinity (share a similar intent, problem, or issue), which form relevant themes. Use an affinity diagram to:1. Understand what is most important from ambiguous data2. Tame complexity3. Identify connections in data4. Create hierarchies5. Identify themes6. Identify what factors to focus on that will support the most successful design possible from a customer’s perspective.
Affinity Diagram
Storyboard Template
Title:
Theme:
“I have had doctor for a long time. But it is nice if they listen... not being talked down to...”
“I am afraid to change to another one [GP]. I don’t think he benefits me because he is not actively involved...”
“The nurse is good and comes straight round and explains. Dieticians talked to me to get the right food; I had a few run-ins with the nurses – they disagreed with what the dieticians had said. No communicating with one another...”
Man, 64 years old; he wasn’t eating.
“I would like him [GP] to ask me how this is going and how that is going. I need to be told, but also listened to...”
“I feel very angry. The nurses think they know it all, despite it being my illness. I’m not going back”
“The doctors advised me to have an operation, but I declined because this was not consistent with the advice I was given in another hospital.”
Woman, sometimes, in the hospital, she threw away her medications.
Man, 68 years old Woman, 46 years old, stopped attending the general practice
“I was drugged and was not clear about what washappening and the doctor didn’t tell me anything and I was discharged although I was feeling pain”
“IThey [practice nurses] don’t give you a chance to finish what you are saying. They walk off and say ‘I can’t hear you’”
“The pharmacist and GP don’t say the same things, I wonder if they ever talk to each other”
Woman, 66 years Woman, 68 years
Asian woman, 50 years old
“ I only go to see a doctor when a new problem with my health comes up”
“IThey [practice nurses] don’t give you a chance to finish what you are saying. They walk off and say ‘I can’t hear you’”
“The pharmacist and GP don’t say the same things, I wonder if they ever talk to each other”
Woman, 66 years Woman, 68 yearsMan, Low-income,
36 years old
Man, Low-income, 56 years old
Man, 75 years old
Project Description / Objectives Handout Affinity Diagram Handout
Storyboard Template Handout Patient Feedback Sticky Notes
KateGraduate Medical StudentResidency
ABOUTAge: 31 years oldStatus: MarriedLocation: Tulsa, OklahomaAttributes: Highly motivated and organizedDebt: $180,000
MOTIVATIONSKate has found a new love for teaching the next generation of medical stu-dents and residents while being a resident herself. She is now in the board at her hospital, where her input is valued for the teaching curriculum.
FRUSTRATIONS�ate is still struggling to find time that leads to a more balanced and healthy life. Sometimes she goes on 2�hr shifts and that takes a toll on her body and relationships.
CORE NEEDSExperiential learning�aintain stamina and empathy �hile in residencyWork-Life balance
“It’s hard to find time for myself, my husband, and family while taking good care of my patients”
Final theme 1 Final theme 2 Final theme 3
I want to believe...
1
2
34
5
6
12
3
4
56
1
23
4
5 6
1
2
3
4
56
1
2
3
456
theme 1theme 2
theme 3
Final theme 1 Final theme 2 Final theme 3
theme 1
theme 2
theme 3
Themes1.2.3.4.5.6.7.8.9.10.11.12.13.
scenarios
Persona Definition
Workshop Prototype A/B Test
Concept Scenarios
Batt-Rawden, S. A. , Chisolm, M. S. , Anton, B. & Flickinger, T. E. (2013). Teaching Empathy to Medi-cal Students. Academic Medicine, 88(8), 1171–1177.
Becker, G., & Newsom, E. (2003). Socioeconomic status and dissatisfaction with health care among chronically ill african americans. American Journal of Public Health, 93(5), 742-8.
Cykert, D., Williams, J., Walker, R., Davis, K., & Egede, L. (2017). The association of cumulative discrimination on quality of care, patient-centered care, and dissatisfaction with care in adults with type 2 diabetes. Journal of Diabetes and Its Com-plications, 31(1), 175-179.
Gobble, M. (2014). Design Thinking. Re-search-Technology Management, 57(3), 59-62.
Maria Jose CardonaADS 712 Advanced Design Methods in Design
PI: Hannah Park, Blake Lesselroth
Numerous iterative phases allowed this project to come to life.
1. Research: Understanding the medical curriculum, the importance of empathy, and how design thinking can help.
2. Persona Definition: Learning and caring for who you’re designing for so you can make something of value.
3. Concept Scenarios: Brainstorm multiple ideas to deliver the best viable solution based on research.
4. Workshop Prototyping: By going through the logistics, you can smooth the rough edges.
5. A/B Testing: Arranging the information in a memorable, engaging, and easy to follow manner.
Hojat, M., Gonnella, J. S., Mangione, S., Nasca, T. J., Veloski, J. J., Erdmann, J. B., Callahan, C. A., & Magee, M. (2002). Empathy in medical students as related to academic performance, clinical com-petence and gender. Medical Education, 36(6), 522–527.
Hodson, B. (2020, March 26). How to storyboard experiences. Retrieved from https://uxdesign.cc/how-to-storyboard-experiences-fc051e2bc04d
Muldoon, L. (2013). Patient poverty and workload in primary care. Study of prescription drug benefit recipients in community health centres (vol 59, pg 384, 2013). Canadian Family Physician, 59(6), 612.
Sally, F. D., Silvester, A., Barnett, D., Farndon, L., & Ismail, M. (2019). Hearing the voices of older adult patients: Processes and findings to inform health services research. Research Involvement and En-gagement, 5
Wise, B. & Dreussi-Smith, T. (2018). The primary care provider and the patient living in poverty. Journal of the American Association of Nurse Prac-titioners, 30(4), 201–207.
Weprin, M. (2016, November 13). Design Think-ing Methods: Affinity Diagrams. Retrieved from https://uxdict.io/design-thinking-methods-affini-ty-diagrams-357bd8671ad4
I WANT TO BELIEVE...
WHY we should CARE...
Who deserves credit...
WHat we can do...
How we can do it...‘I Want to Believe’ Workshop
How it developed...
Instruments allow any medical school, program, or instructor to incorporate the workshop in their curriculum and further enhance the learning of empathetic physicians.
ReferencesAmin, M. (2019, September 28). Running the Perfect Design Thinking Workshop: 15 Best Practices. Retrieved from UXPlanet.org: https://uxplanet.org/running-the-perfect-design-thinking-workshop-15-best-practices-28e97d8fb49c
Batt-Rawden, S. A., Chisolm, M. S., Anton, B., & Flickinger, T. E. (2013). Teaching Empathy to Medical Students:. Academic Medicine, 88(8), 1171-1177.
Boodman, S. G. (2015, March 15). How to Teach Doctors Empathy. Retrieved from The Atlantic: https://www.theatlantic.com/health/archive/2015/03/how-to-teach-doctors-empathy/387784/
Both, T. (2016, April 27). The Wallet Project. Retrieved from Stanford Design Resources: https://dschool-old.stanford.edu/groups/designresources/wiki/4dbb2/the_wallet_project.html
Thank you.
HUMAN CENTERED
PROTOTYPE
EMPATHY
IDEATE
TEST
DEFINE
MethodHow we developed the workshop
Interviews and discussions with students and faculty at the University of Oklahoma - Tulsa School of Community Medicine.
A/B Testing
Design TableTo help participants organize their thoughts
PersonasFor participants who are uncomfortable sharing their own information
Facilitator GuideTo enable a successful workshop, with checklists to stay organized
Presentation Slides and ScriptTo inform and introduce the workshop
Participant GuideDesigned for mobile to inform the participants as they go
SurveysTo asses the usefulness of the workshop
Provided Resources
About Tanya: Tanya is a busy mom of three small kids. She always puts her kids first, at home and in class. This means she doesn’t have a lot of time to take care of herself. Though obese, she is trying to take control of her health and her diabetes. Her children are her ultimate motivation! Tanya likes to use the workout room at school to get some exercise in once or twice a week, but there often doesn’t seem to be time. The tote bag she always carries is stuffed full of things for her children, her blood glucose monitoring device, papers to grade, tissues and cough drops - she’s always catching something from those kids!
Tanya R.
30 years old
Female, Caucasian
Married, 3 kids under 5
Lower-middle class
Teacher
From a small, rural town in Minnesota
Obese, Type II Diabetes
About Beck: Beck rides his bike every day to his florist shop about six New York blocks from his house. Sometimes the bike-ride makes his back and hips ache; Beck suspects he may be getting arthritis. His horticulture endeavors keep him covered in dirt and plant matter. Having contracted HIV as a young man, Beck has taken his health very seriously. His family could luckily afford treatments as soon as they were offered throughout the past decades of HIV/AIDS research. Beck is currently on antiretrovirals and is generally healthy, though a diet of spicy foods is starting to cause acid reflux as he ages.
Beck
58 years old
Male, Latino
Married, no kids
Florist - owns and operates his own business
Shares an apartment with his husband in Staten Island, NY
HIV positive
About Taylor: Taylor is nearly finished with her graduate degree in Education. As a teacher, she never expects to get rich, but she’s very excited about her future. She is pregnant! Though the father is not in the picture, she knows she will be a great mom. Taylor continues to exercise routinely -yoga is a great stress reliever. Taylor does not have a car, but her roommate does help her out a bunch. She is starting to worry about stretch marks, and of course, keeping her baby as healthy as possible while she’s pregnant.
Taylor
Female, 27 years old
Vietnamese American
Single, but lives with a roommate.
Graduate Teaching Assistant living in a mid-sized college town
Pregnant (8 weeks)
Priorities How does this fit in the bag?
ex. Allergies ex. Easy-access, outside pocket.
Example ScenarioWhat’s the hardest part of staying healthy when you’re on the go? Hmm...I think remembering my
allergy medicine
1. Pocket for allergy medicine
2. Pocket tissues
3. Pouch for Visine for dry, allergy eyes
4. Small and easy to carry
5. Clip for hand sanitizer
Tissues
Visine
Allegra Purell
I made this to help you control your allergies no matter the weather. Thanks! This looks good.
I think it would be even better if there was a lined pouch to put used tissues.
Interview and understand
Use empathy to design
Draw or prototype
Share and get feedback
The Workshop Goals & Objectives
Learning Outcomes: To empathize with a partner such that you can successfully integrate into their life.
Goal: Represent a patient’s needs in a physical artifact, a MEDICAL ON-THE-GO BAG.
Time needed: 60min
x10
Ideal participants: 10, Min: 2, Max: 50For medical students and other clinicians
1hr
Suggested Craft SuppliesFor in-person workshops:• Felt of different colors• Paper of different colors• Scissors• Hot glue• Safety pins• Iron on heat-n-bond and instructions• Iron• Sharpies/pens• Yarn and yarn needles
For web-based workshops:• Video conferencing software (e.g. Zoom,
Skype, etc...)• Digital collaboration space (e.g. Mural, 3M
Post-it)
Activity Overview
Activity Description Materials
IntroductionLearn purpose and instructions10 minutes
Presentation slides, script, personas
Listen and UnderstandParticipants interview each other15 minutes
Participant Guide,Design Table
Show Your EmpathyParticipants prototype or draw a solution15 minutes
Craft suppliesor digital drawing software
Share Your CreationParticipants share-out and get feedback from their partners 5 minutes
Collaboration software, if on-line workshop
Wrap UpBreakdown discussion and final surveys15 minutes Surveys
SolutionThe Medical On-the-Go BagDesign Thinking Exercise
Design Thinking is a problem solving philosophy that puts humans in the center of the solution. Though it can take form in many ways, there are always five major stages: empathy, define, ideate, prototype, test (Amin, 2019).
This twist on the classic “wallet” design thinking activity asks participants to fit into their partner’s lives (Both, 2016). Through interviews and hands-on prototyping, medical students and residents will be able to synthesize a patient’s challenges into a physical manifestation of their ability to empathize with their patient. The on-the-bag should help make a patient’s health priorities easy to manage.
While the Medical On-the-Go Bag exercise is not in any way a complete solution to the problem, it is a fun way to start making progress.
HUMAN CENTERED
PROTOTYPE
EMPATHY
IDEATE
TEST
DEFINE
ProblemInadequate empathy education and skills in medical professionals
The decline of empathy in students during medical school is a well-documented phenomena. In most people, it is a behavior the lasts throughout a doctor’s career.
Physicians who lack empathy attract malpractice suits and have lower patient healthcare satisfaction (Boodman, 2015).
Doctors on average interrupt their patients after only 18seconds of discussion (Boodman, 2015).
Students can fake professional behavior for exams, without having gained actual empathic skills (Batt-Rawden et al, 2013).
18s
MEDICALON-THE-GO BAGa design thinking exercise in empathy for medical students and personnel, bringing abstract empathy into a physical artifact.
Kaitlyn JeromeADS 712 Advanced Methods in DesignPI: Hannah Park, Blake Lesselroth
ReferencesAmin, M. (2019, September 28). Running the Perfect Design Thinking Workshop: 15 Best Practices. Retrieved from UXPlanet.org: https://uxplanet.org/running-the-perfect-design-thinking-workshop-15-best-practices-28e97d8fb49c
Batt-Rawden, S. A., Chisolm, M. S., Anton, B., & Flickinger, T. E. (2013). Teaching Empathy to Medical Students:. Academic Medicine, 88(8), 1171-1177.
Boodman, S. G. (2015, March 15). How to Teach Doctors Empathy. Retrieved from The Atlantic: https://www.theatlantic.com/health/archive/2015/03/how-to-teach-doctors-empathy/387784/
Both, T. (2016, April 27). The Wallet Project. Retrieved from Stanford Design Resources: https://dschool-old.stanford.edu/groups/designresources/wiki/4dbb2/the_wallet_project.html
Thank you.
HUMAN CENTERED
PROTOTYPE
EMPATHY
IDEATE
TEST
DEFINE
MethodHow we developed the workshop
Interviews and discussions with students and faculty at the University of Oklahoma - Tulsa School of Community Medicine.
A/B Testing
Design TableTo help participants organize their thoughts
PersonasFor participants who are uncomfortable sharing their own information
Facilitator GuideTo enable a successful workshop, with checklists to stay organized
Presentation Slides and ScriptTo inform and introduce the workshop
Participant GuideDesigned for mobile to inform the participants as they go
SurveysTo asses the usefulness of the workshop
Provided Resources
About Tanya: Tanya is a busy mom of three small kids. She always puts her kids first, at home and in class. This means she doesn’t have a lot of time to take care of herself. Though obese, she is trying to take control of her health and her diabetes. Her children are her ultimate motivation! Tanya likes to use the workout room at school to get some exercise in once or twice a week, but there often doesn’t seem to be time. The tote bag she always carries is stuffed full of things for her children, her blood glucose monitoring device, papers to grade, tissues and cough drops - she’s always catching something from those kids!
Tanya R.
30 years old
Female, Caucasian
Married, 3 kids under 5
Lower-middle class
Teacher
From a small, rural town in Minnesota
Obese, Type II Diabetes
About Beck: Beck rides his bike every day to his florist shop about six New York blocks from his house. Sometimes the bike-ride makes his back and hips ache; Beck suspects he may be getting arthritis. His horticulture endeavors keep him covered in dirt and plant matter. Having contracted HIV as a young man, Beck has taken his health very seriously. His family could luckily afford treatments as soon as they were offered throughout the past decades of HIV/AIDS research. Beck is currently on antiretrovirals and is generally healthy, though a diet of spicy foods is starting to cause acid reflux as he ages.
Beck
58 years old
Male, Latino
Married, no kids
Florist - owns and operates his own business
Shares an apartment with his husband in Staten Island, NY
HIV positive
About Taylor: Taylor is nearly finished with her graduate degree in Education. As a teacher, she never expects to get rich, but she’s very excited about her future. She is pregnant! Though the father is not in the picture, she knows she will be a great mom. Taylor continues to exercise routinely -yoga is a great stress reliever. Taylor does not have a car, but her roommate does help her out a bunch. She is starting to worry about stretch marks, and of course, keeping her baby as healthy as possible while she’s pregnant.
Taylor
Female, 27 years old
Vietnamese American
Single, but lives with a roommate.
Graduate Teaching Assistant living in a mid-sized college town
Pregnant (8 weeks)
Priorities How does this fit in the bag?
ex. Allergies ex. Easy-access, outside pocket.
Example ScenarioWhat’s the hardest part of staying healthy when you’re on the go? Hmm...I think remembering my
allergy medicine
1. Pocket for allergy medicine
2. Pocket tissues
3. Pouch for Visine for dry, allergy eyes
4. Small and easy to carry
5. Clip for hand sanitizer
Tissues
Visine
Allegra Purell
I made this to help you control your allergies no matter the weather. Thanks! This looks good.
I think it would be even better if there was a lined pouch to put used tissues.
Interview and understand
Use empathy to design
Draw or prototype
Share and get feedback
The Workshop Goals & Objectives
Learning Outcomes: To empathize with a partner such that you can successfully integrate into their life.
Goal: Represent a patient’s needs in a physical artifact, a MEDICAL ON-THE-GO BAG.
Time needed: 60min
x10
Ideal participants: 10, Min: 2, Max: 50For medical students and other clinicians
1hr
Suggested Craft SuppliesFor in-person workshops:• Felt of different colors• Paper of different colors• Scissors• Hot glue• Safety pins• Iron on heat-n-bond and instructions• Iron• Sharpies/pens• Yarn and yarn needles
For web-based workshops:• Video conferencing software (e.g. Zoom,
Skype, etc...)• Digital collaboration space (e.g. Mural, 3M
Post-it)
Activity Overview
Activity Description Materials
IntroductionLearn purpose and instructions10 minutes
Presentation slides, script, personas
Listen and UnderstandParticipants interview each other15 minutes
Participant Guide,Design Table
Show Your EmpathyParticipants prototype or draw a solution15 minutes
Craft suppliesor digital drawing software
Share Your CreationParticipants share-out and get feedback from their partners 5 minutes
Collaboration software, if on-line workshop
Wrap UpBreakdown discussion and final surveys15 minutes Surveys
SolutionThe Medical On-the-Go BagDesign Thinking Exercise
Design Thinking is a problem solving philosophy that puts humans in the center of the solution. Though it can take form in many ways, there are always five major stages: empathy, define, ideate, prototype, test (Amin, 2019).
This twist on the classic “wallet” design thinking activity asks participants to fit into their partner’s lives (Both, 2016). Through interviews and hands-on prototyping, medical students and residents will be able to synthesize a patient’s challenges into a physical manifestation of their ability to empathize with their patient. The on-the-bag should help make a patient’s health priorities easy to manage.
While the Medical On-the-Go Bag exercise is not in any way a complete solution to the problem, it is a fun way to start making progress.
HUMAN CENTERED
PROTOTYPE
EMPATHY
IDEATE
TEST
DEFINE
ProblemInadequate empathy education and skills in medical professionals
The decline of empathy in students during medical school is a well-documented phenomena. In most people, it is a behavior the lasts throughout a doctor’s career.
Physicians who lack empathy attract malpractice suits and have lower patient healthcare satisfaction (Boodman, 2015).
Doctors on average interrupt their patients after only 18seconds of discussion (Boodman, 2015).
Students can fake professional behavior for exams, without having gained actual empathic skills (Batt-Rawden et al, 2013).
18s
MEDICALON-THE-GO BAGa design thinking exercise in empathy for medical students and personnel, bringing abstract empathy into a physical artifact.
Kaitlyn JeromeADS 712 Advanced Methods in DesignPI: Hannah Park, Blake Lesselroth
MEDICAL ON-THE-GO BAG: Abstract empathy to a physical ar t i fact .
FINDING SOLUTIONS: El ic i t ing deep ref lect ion on pat ients ’ needs.
CARE+EMPATHY: Br inging empahty by role playing & mind mapping.
The par t ic ipat ing graduate students used design thinking to teach design thinking to
medical students. The students did not have any pr ior experience in design thinking.
They learned about design thinking act ively by developing design thinking exercises.
This ‘ learning by teaching’ module enabled the students to engage proact ively with
the subject matters. Fur thermore, having a physician in the team helped the students
tremendously to understand the targeted user demographics and medical education.
TEAMWORK DETERMINATION + EMPATHY.
Arturo Pinilla PerezADS 712 Advanced Methods in DesignPI: Hannah Park, Blake Lesselroth
FINDING SOLUTIONSA DESIGN THINKING EXERCISE TO DEVELOP EMPATHY TOWARDS PATIENTS IN MEDICAL EDUCATION
Finding Solutions is a design thinking exercise that aims to foster empathy towards patients in medical education students by eliciting deep reflection on patients’ problems, needs, and emotional states that may affect the way healthcare services could be delivered and by encouraging the ideation of solutions and strategies to help them.
FINDING SOLUTIONS - THE EXERCISE
T I M E F R A M E
Activity Description Resources and Materials
Introduction
18 min
The moderators will explain the purpose of the exercise, the methodology, tools to be used, and will introduce an example of how to create a Problem Tree for Person X.
Presentation slides & Script.
Part 1: Person X
10 min
Participants will be divided into teams. Teams brainstorm ideas of problems and emotional effects for Person X and create the Problem Tree.
Presentation slides & Script.Virtual whiteboard (collaboration tool).Personas (Person X).
Part 2: Finding Solutions
13 min
Team members will engage in meaningful discussions to ideate strategies to address Person X needs and create the Solution Tree.
Presentation slides & Script.Virtual whiteboard.
Part 3: Sharing Thoughts
12 min
Teams will share their Person X and Solution Tree with the rest of their peers.Moderators will evaluate teams’ outcomes.
Presentation slides & Script.Virtual whiteboard.Group Evaluation Instrument.
Closure and Evaluation
7 min
Closing thoughts by the moderators.Evaluation of the seminar by the participants.
Seminar Evaluation Survey forparticipants.
HOW CAN DESIGN THINKING HELP?Design Thinking may provide a useful methodology to address problems in medical education.
Design thinking tools include ethnographic research techniques, sense-making tools, visualization tools, ideation tools, and prototyping.
Design thinking places empathy at the center of the design process.
Design thinking is a systematic process that prioritizes deep empathy for end-user desires, needs, and challenges.
• Reflect on problems and emotional affects individuals may have in their daily life.
• Exercise empathy by considering patients background and needs.
• Infer the possible outcomes of adopting empathetic communication towards patients.
• Formulate strategies to empathize with patients in their medical practice.
Goals
Required materials• Videoconference tool.• Online collaboration tool.• Computer or mobile device.
Format and Logistics• Audience:
• Duration: 1 hour.
• 3rd year medical students.• Minimum: 24 participants.• Maximum: 48 participants.• Ideal number: 30 participants.
• For in person: colored post-it notes, markers, poster boards, pencils.
• Virtual resources: video conferencing tool, laptop, smartphone or tablet.
Resources.
THE NEED FOR EMPATHY
Empathy tends to drop in third year of medical education and the process extends to their medical residences.
Despite the efforts to develop empathy in medical education students, they continue to report low empathy towards patients.
The decrease in empathy is related to the increased contact with patients in clinical training.
Short seminars aimed to foster emapthy tend to have effects that are not sustained in time.
Instructor’s ManualSeminar Evaluation Survey for Participants
Group Evaluation Instrument
INSTRUMENT SThe exercise will required the use of resources for its implementation.
Presentation slides Personas for the exercise
EXERCISE DEVELOPMENT PRO CESS
ConceptOriginal concept of the exercise
REFERENCES
Bayne, H. B. (2011). Training Medical Students in Empathic Communication. The Journal for Specialists in Group Work, 36(4), 316–329. https://doi.org/10.1080/01933922.2011.613899
Kumar, V., & LaConte, V. (2012). 101 Design Methods: A Structured Approach for Driving Innovation in Your Organization. John Wiley & Sons, Incorporated. http://ebookcentral.proquest.com/lib/ku/detail.action?docID=861699
Liedtka, J. (2013). Design Thinking: What it is and Why it works. Design at Darden.
Liedtka, J. (2017). Evaluating the Impact of Design Thinking in Action. Academy of Management Proceed-ings, 2017(1), 10264. https://doi.org/10.5465/AMBPP.2017.177
Neumann, M., Edelhäuser, F., Tauschel, D., Fischer, M. R., Wirtz, M., Woopen, C., Haramati, A., & Scheffer, C. (2011). Empathy Decline and Its Reasons: A Systematic Review of Studies With Medical Students and Residents. Academic Medicine, 86(8), 996–1009. https://doi.org/10.1097/ACM.0b013e318221e615
Roberts, J. P., Fisher, T. R., Trowbridge, M. J., & Bent, C. (2016). A design thinking framework for health-care management and innovation. Healthcare, 4(1), 11–14. https://doi.org/10.1016/j.hjdsi.2015.12.002
A|B Tests 75% prefered pre-defined determinants for personas to random assignment of determinants.
Even results for survey delivery, technology tool tutorial, and problem tree design.
100% prefered to use laptops for seminar delivery.
Results for questions related to the exercise delivery and format.
Simulation
Person X
The Process
Problem Tree
Solutions Tree
The participant considered the exercise valuable at making her think about and reflect on other people’s problems and needs as well as consider possible strategies to empathize with patients.
Part 1: Person X
Part 2: Finding Solutions Part 3: Sharing Thoughts
(Batt-Rawden et al., 2013)(Neumann et al., 2011)(Neumann et al., 2011)
(Roberts et al., 2016) (Liedtka, 2013)(Liedtka, 2017)
Arturo Pinilla PerezADS 712 Advanced Methods in DesignPI: Hannah Park, Blake Lesselroth
FINDING SOLUTIONSA DESIGN THINKING EXERCISE TO DEVELOP EMPATHY TOWARDS PATIENTS IN MEDICAL EDUCATION
Finding Solutions is a design thinking exercise that aims to foster empathy towards patients in medical education students by eliciting deep reflection on patients’ problems, needs, and emotional states that may affect the way healthcare services could be delivered and by encouraging the ideation of solutions and strategies to help them.
FINDING SOLUTIONS - THE EXERCISE
T I M E F R A M E
Activity Description Resources and Materials
Introduction
18 min
The moderators will explain the purpose of the exercise, the methodology, tools to be used, and will introduce an example of how to create a Problem Tree for Person X.
Presentation slides & Script.
Part 1: Person X
10 min
Participants will be divided into teams. Teams brainstorm ideas of problems and emotional effects for Person X and create the Problem Tree.
Presentation slides & Script.Virtual whiteboard (collaboration tool).Personas (Person X).
Part 2: Finding Solutions
13 min
Team members will engage in meaningful discussions to ideate strategies to address Person X needs and create the Solution Tree.
Presentation slides & Script.Virtual whiteboard.
Part 3: Sharing Thoughts
12 min
Teams will share their Person X and Solution Tree with the rest of their peers.Moderators will evaluate teams’ outcomes.
Presentation slides & Script.Virtual whiteboard.Group Evaluation Instrument.
Closure and Evaluation
7 min
Closing thoughts by the moderators.Evaluation of the seminar by the participants.
Seminar Evaluation Survey forparticipants.
HOW CAN DESIGN THINKING HELP?Design Thinking may provide a useful methodology to address problems in medical education.
Design thinking tools include ethnographic research techniques, sense-making tools, visualization tools, ideation tools, and prototyping.
Design thinking places empathy at the center of the design process.
Design thinking is a systematic process that prioritizes deep empathy for end-user desires, needs, and challenges.
• Reflect on problems and emotional affects individuals may have in their daily life.
• Exercise empathy by considering patients background and needs.
• Infer the possible outcomes of adopting empathetic communication towards patients.
• Formulate strategies to empathize with patients in their medical practice.
Goals
Required materials• Videoconference tool.• Online collaboration tool.• Computer or mobile device.
Format and Logistics• Audience:
• Duration: 1 hour.
• 3rd year medical students.• Minimum: 24 participants.• Maximum: 48 participants.• Ideal number: 30 participants.
• For in person: colored post-it notes, markers, poster boards, pencils.
• Virtual resources: video conferencing tool, laptop, smartphone or tablet.
Resources.
THE NEED FOR EMPATHY
Empathy tends to drop in third year of medical education and the process extends to their medical residences.
Despite the efforts to develop empathy in medical education students, they continue to report low empathy towards patients.
The decrease in empathy is related to the increased contact with patients in clinical training.
Short seminars aimed to foster emapthy tend to have effects that are not sustained in time.
Instructor’s ManualSeminar Evaluation Survey for Participants
Group Evaluation Instrument
INSTRUMENT SThe exercise will required the use of resources for its implementation.
Presentation slides Personas for the exercise
EXERCISE DEVELOPMENT PRO CESS
ConceptOriginal concept of the exercise
REFERENCES
Bayne, H. B. (2011). Training Medical Students in Empathic Communication. The Journal for Specialists in Group Work, 36(4), 316–329. https://doi.org/10.1080/01933922.2011.613899
Kumar, V., & LaConte, V. (2012). 101 Design Methods: A Structured Approach for Driving Innovation in Your Organization. John Wiley & Sons, Incorporated. http://ebookcentral.proquest.com/lib/ku/detail.action?docID=861699
Liedtka, J. (2013). Design Thinking: What it is and Why it works. Design at Darden.
Liedtka, J. (2017). Evaluating the Impact of Design Thinking in Action. Academy of Management Proceed-ings, 2017(1), 10264. https://doi.org/10.5465/AMBPP.2017.177
Neumann, M., Edelhäuser, F., Tauschel, D., Fischer, M. R., Wirtz, M., Woopen, C., Haramati, A., & Scheffer, C. (2011). Empathy Decline and Its Reasons: A Systematic Review of Studies With Medical Students and Residents. Academic Medicine, 86(8), 996–1009. https://doi.org/10.1097/ACM.0b013e318221e615
Roberts, J. P., Fisher, T. R., Trowbridge, M. J., & Bent, C. (2016). A design thinking framework for health-care management and innovation. Healthcare, 4(1), 11–14. https://doi.org/10.1016/j.hjdsi.2015.12.002
A|B Tests 75% prefered pre-defined determinants for personas to random assignment of determinants.
Even results for survey delivery, technology tool tutorial, and problem tree design.
100% prefered to use laptops for seminar delivery.
Results for questions related to the exercise delivery and format.
Simulation
Person X
The Process
Problem Tree
Solutions Tree
The participant considered the exercise valuable at making her think about and reflect on other people’s problems and needs as well as consider possible strategies to empathize with patients.
Part 1: Person X
Part 2: Finding Solutions Part 3: Sharing Thoughts
(Batt-Rawden et al., 2013)(Neumann et al., 2011)(Neumann et al., 2011)
(Roberts et al., 2016) (Liedtka, 2013)(Liedtka, 2017)
PARTICIPANT MATERIALSEXECUTIVE SUMMARY & MODERATOR MATERIALS
Design Thinking Empathy Workshops for Medical Residents
CHIEF COMPLAINTS
RECOMMENDED COURSE OF ACTION
FOSTER EMPATHY through DESIGN THINKING
WHAT is DESIGN THINKING?
Activity
Moderator will present a scenario to all participants that features either a patient or healthcare provider. The objective for each individual in their groups is to review the scenario from that the perspective of healthcare provider or patient.
Groups will break off and discuss how best to address the issues presented in the hypothetical scenario. Participants will be encouraged to use discussion starting points to help tease out potential empathetic design thinking solutions to the scenario.
Moderator will reconvene the groups and reveal generalized anonymous results from each of the discussion groups, drilling down into pertinent areas for group discussion (e.g. “a majority you labeled as ‘providers’ said you didn’t think a more empathetic, understanding approach was necessarily appropriate for this situation – why? Why not? What would you have done differently? What empathetic approach have you used, or your seen used, that you think would work better?”).
TIme Allotment
15 minutes
30 minutes
15 minutes
Materials Required
Executive Summary
Participant Materials 1
Participant Materials 2
Shant S. ThomasADS 712 Advanced Methods in Design
PI: Hannah Park, Blake Lesselroth
Develop a DEEP UNDERSTANDINGof the TARGET AUDIENCE
OBSERVE & develop EMPATHY for the intended users
QUESTION EVERYTHING: the PROBLEM, the ASSUMPTIONS, & the IMPLICATIONS
Tackle problems that are ILL-DEFINED or UNKNOWN by reframing them in HUMAN-CENTRIC WAYS
WHY DESIGN THINKING?
(Dam & Teo, 2020)
SCENARIO WORKSHOP LOGISTICS
THE CARE+ EMPATHY SCENARIO SERIES
Group sessions in a workshop setup
Each session guided by a moderator
No more than 50 participants to ensure maximum participation.
10 groups of 5 participants.
During a session, participants will be divided evenly into one of two groups: “healthcare provider” or “patient.”
SCENARIO WORKSHOP TIMELINE
CONCEPT SKETCHES
Heath, S. (2018, October 17). Understanding Physician Empathy, How It Impacts Patient Care. Retrieved from https://patientengagementhit.com/news/understanding-physician-empathy-how-it-impacts-patient-care
Menendez, M. E., Chen, N. C., Mudgal, C. S., Jupiter, J. B., & Ring, D. (2015). Physician Empathy as a Driver of Hand Surgery Patient Satisfaction. The Journal of Hand Surgery, 40(9). doi:10.1016/j.jhsa.2015.06.105
Shin, A., & Blenkhorn, L. (2018, June 26). National Survey Data Presented at the Compassion in Action Con-ference Show Mixed Reactions on State of Compassion in U.S. Healthcare. Retrieved April 19, 2020, from https://www.prnewswire.com/news-releases/national-survey-data-presented-at-the-compassion-in-action-conference-show-mixed-reactions-on-state-of-compassion-in-us-healthcare-300480125.html
Dam, R., & Teo, Y. (2020, April 14). What is Design Thinking and Why Is It So Popular? Retrieved April 20, 2020, from https://www.interaction-design.org/literature/article/what-is-design-thinking-and-why-is-it-so-popular
REFERENCES
ASSESSMENT
REFERENCESBatt-Rawden, Samantha A., MBChB; Chisolm, Margaret S., MD; Anton, Blair; Flickinger, Tabor E., MD, MPH (2013, August) Teaching Empa-thy to Medical Students Retrieved from: https://journals.lww.com/academicmedicine/fulltext/2013/08000/Teaching_Empathy_to_Medi-cal_Students__An_Updated,.37.aspx
Laura A. Weingartner, Susan Sawning, M. Ann Shaw, Jon B. Klein (2019) Compassion Cultivation Training Promotes Medical Student Well-ness and Enhances Clinical Care required from: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-019-1546-6
Rikke Friis Dam and Yu Siang Teo (2020, February) 5 Stages in the Design Thinking Process Retrieved from: https://www.interaction-de-sign.org/literature/article/5-stages-in-the-design-thinking-process
Tessa Forshaw (2019, July) This Is What Design Thinking Will Teach You Retrieved from: https://medium.com/stanford-d-school/this-is-what-design-thinking-will-teach-you-85d7c9212d66
https://stock.adobe.com/search?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=1&filters%5Bcon-tent_type%3Azip_vector%5D=1&filters%5Bcontent_type%3Avideo%5D=1&filters%5Bcontent_type%3Atemplate%5D=1&filters%5Bcon-tent_type%3A3d%5D=1&filters%5Binclude_stock_enterprise%5D=0&filters%5Bis_editorial%5D=0&safe_search=1&order=relevance&-model_id=188492565&asset_id=188492565
ONE OF THE FIRST TO THEFINAL SKETCH
TESTING
A/B TESTING
INSTRUCTOR’S MANUAL
POWER POINT PRESENTATION
WORKBOOK
TIMEFRAMEDURATION ACTIVITY
5 MINUTES
8 MINUTES
5 MINUTES
15 MINUTES
7 MINUTES
3 MINUTES
7 MINUTES
3 MINUTES
7 MINUTES
Introduction of the professorAbout the activity
Class objectivesAssesment RubricAny questions?
Reflection time in the workbook
Get to know your team activity
Patient Care activity
Professor shares his or her thoughts
Patient Care activity
Professor shares his or her thoughts
Final Thoughts
GOALS1. Why did you want to become a doctor or a nurse? What droveyou to want to be in health care? Reflect on who or how itimpacted you in your career decision.
2. It is important to work with other health care membersbecause working with others brings more ideas to the table. Italso builds communication and a judgement free zone.
3. Evaluate the cases given in the workbook. Work with teammembers on how to treat the patient. How can you get creativein treating a patient? Do something different vs. what you wouldin the exam room.
4. After doing these exercises reflect on how you can bringthis into patient care. Would you want to start doing thingsdifferently? How are you going aim for your goals?
REQUIRED MATERIALSDifferent color pens for note taking: your thoughts, team members thoughts, and professors thoughts
COMPOSTIONDURATION:1 HOUR
PARTICIPANTS:THIRD YEAR MEDICAL STUDENTRESIDENTSNURSES
MINIMUM: 20 STUDENTSMAXIMUM: 50 STUDENTSIDEAL: 30 STUDENTS
FORMAT:IN-PERSON OR VIRTUAL
DESIGN THINKINGDESIGN METHODOLOGY THAT PROVIDES A SOLUTION-BASED APPROACH TO SOLVING PROBLEMS.
01 02 03 04 05EMPATHISE DEFINE IDEATE PROTOTYPE TESTTo gain understanding of the problem you are trying to solve. Empathy is crucial to a human-centered design process and allows design thinkers to set aside their own assumptions about the world to gain insigh into users and their needs.
Putting together the information you have created and gathered during the Empathise stage. Analyze your observations andsynthesise them inorder to define the core problems that you and your team have identified.
Can start to “thinkoutside the box” to identify new solutionsto the problemstatement you’vecreated, and you can start to look foralternative ways ofviewing problems. It is important to get as many ideas or problem solutions as possibleat the beginning ofthe phase.
Will be producing a number of inexpensive, scaled down versionsof the product orspecific features found within the product, so they can investigatethe problem solutionsgenerated in theprevious stages. Aimto identify the bestpossible solution for each of the problems identified during thefirst three stages.
Designers or evaluatorsrigorously test thecomplete productusing the best solutionsidentified duringprototyping phase.Results generated during the testing phase are often used to redfine one or more problems and inform understanding of the users, the conditions of use, how people think, behave, and feel, and to empathise.
(RIKKE, 2020)
EMPATHY
WELLNESS
PATIENTCARE
EMPATHY DECLINESDURING MEDICAL SCHOOL(BATT-RAWDEN,2013)
DESIGN THINKING HELPS STUDENTS PRACTICEABILITIES CENTRAL TOHUMAN-CENTEREDDESIGN.(TESSA FORSHAW,2019)
CHRONIC STRESS ISPERVASIVE IN MEDICALOCCUPATIONS ANDASSOCIATED WITHDECREASEDCOMPASSION AND EMAPTHY.LAURA A. WEINGARTNER, 2019)
MINFULNESS TRAININGHAS SHOWN PROMISETO ADDRESS STRESSAND SUPPORT EMPATHY.LAURA A. WEINGARTNER, 2019)
EMPATHY EROSIONNOTABLY PEAKS DURING CLERKSHIP IN MEDICAL SCHOOL WITH HIGHTENED STRESS OF TRANSITIONING TO PATIENT CARE.LAURA A. WEINGARTNER, 2019)
COMPASSION TRAINING, WHICH CAN CULTIVATEAND IMPROVECOMPASSION FOR BOTH OTHERS AND ONESELF THROUGH STRUCTURED TRAINING.LAURA A. WEINGARTNER, 2019)
TEAMWORKAND
DETERMINATION
E M PA T H Y
DENISE CHIAOADS 712 ADVANCED METHODS IN DESIGN
PI: HANNAH PARK & BLAKE LESSELROTH
A DESIGN THINKING EXERCISE BUILDING EMPATHY THROUGH DEDICATION AND TEAMWORK.
I WANT TO BELIEVE: Ut i l iz ing pat ient feedback to co-create solut ions.
FIVE PHASES OFDESIGN THINKING
report that healthcare policies make it more difficult to deliver compassionate and patient-centered healthcare.(Heath, 2018)
report seeing a decline in communication and emotional support from other healthcare professionals when dealing with patients. (Shin & Blenkhorn, 2018)
can be directly attributed to physician empathy.(Menendez, Chen, Mudgal, Jupiter & Ring, 2015)
69% of U.S. PHYSICIANS
63% of U.S. PHYSICIANS& NURSES
65% of PATIENT SATISFACTION
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