Visualization and Simulation Technology in Healthcare - From a technology-centered to a human-centered perspective

Abstract

With the aid of modern computer technology the application of visualization and simulation technology has become increasingly important in today’s society. Through computer modelling it is possible to experience, understand and explore environments, systems or objects in two or three dimensions and to see, hear and sometimes tangibly feel them. It may be environments or objects that do not yet exist, that are to be changed or for some reason are not possible to interact with or evaluate in the real-life setting.

Many areas of application have been found for visualization and simulation technology over the years. Examples are systems for training in various settings or for simplifying and sharing complex information. But the technology can also be used as a method in design and planning processes as a mediating tool for concretizing ideas or transforming stakeholders into active participants.

Healthcare is one context in which visualization and simulation technology has been adopted for certain tasks but has the potential to contribute to many more. Healthcare is characterized by continuous changes related to work organization, facility planning, treatment routines, and use of technical equipment, in order to improve care and make it more resource efficient. This requires new ways of thinking about how resources are to be allocated when planning new healthcare organizations or changing existing ones.

As part of this process I suggest that visualization and simulation technology can be used to train generic and specific skills, plan new organizations and involve staff and patients in the design and development. The first aim of the research presented in this thesis is thus to increase the knowledge about how visualization and simulation technology can be used as a method for sharing information and knowledge and to support training, planning and participation in the healthcare context. In so doing, the

results can contribute to an improved work environment for the staff and safety for both patients and staff. Three empirical cases were examined, two of which relate to training applications and one to planning. Participation is touched upon in all of them but has had a more central role in the latter two.

When it comes to the development of visualization or simulation systems, much of the research has had a technology-centered perspective, often focused on more advanced graphical representations and new ways of interacting. Less focus has been put on the actual use situation around these systems. In this thesis I argue that a human-centered perspective can help to ensure that the users’ needs, tasks and contexts are guiding the

design and development processes. The second aim has thus been to put forward a discussion about a technology-centered versus a human-centered approach in the design and development process of visualization and simulation technology. This discussion has grown out of the different methodologies adopted in the three case studies.

The research has been guided by methods and principles from human factors and human computer interaction with data gathered through observations, interviews, questionnaires and video recordings. This means that the results are based on both subjective data from the participants in which they have expressed their thoughts about the visualization and simulation that has been applied, and on objective data in which the participants’ reactions have been assessed by analyzing video or observing the participants directly in the context.

The results show that visualization and simulation technology can contribute to information and knowledge sharing as well as support training, planning and participation in the healthcare context. Case 1 is a typical example of how the development of these systems is carried out today – with a technology-centered perspective. The case involves an expansion of an existing system so that it can be used for the training of a wider range of patient cases and for planning specific surgical procedures. Case 2 however shows that when adding a human-centered perspective to the development process by involving users in design and focusing on their needs, tasks

and context, new applications and new ways of designing the technology may be found. Case 3 is an example of how a range of visualization and simulation technologies can be combined to involve staff in a development process to elicit their knowledge of the work organization that can contribute to the planning process.

The results also show that a human-centered approach is employed to some extent in a small part of the simulation training community, while a more comprehensive implementation of this way of thinking falls short. One of the obstacles to a more frequent and easy employment of visualization and simulation technologies in general is that the method still “belongs to” the technical community and in order to use it, someone with technical expertise has to be part of the process. If human-centered perspectives becomes a natural part of the development and application of visualization and simulation technology, a better balance can be achieved between the technology-centered focus of creating high-tech and advanced solutions and the human-centered focus, where the needs, tasks and context of the users guide the development.

Abstract (Swedish)

Popular Abstract in Swedish

I ett väderälskande land som Sverige finns det väl ingen som inte är bekant med den väderkarta som ger oss information om hur prognosen för den närmaste tiden ser ut? Många av oss tittar dagligen på väderrapporten och låter den hjälpa oss att bestämma om vi ska cykla eller ta bussen, sätta på grillen

eller laga mat i ugnen. Genom enkla visualiseringar i form av sol, regn och moln kan vi alla ta till oss information som i grunden är oerhört komplex och baserad på avancerade matematiska datasimuleringar. Väderkartan är ett exempel på hur visualiserings‐ och simuleringsteknik kan användas för att förmedla komplex eller abstrakt information på ett sätt som var och en kan ta till sig.

Med fokus på arbetsmiljöer inom sjukvården utforskar denna avhandling hur just visualiserings‐ och simuleringsteknik kan vara ett verktyg för utbildning, planering och förändring. Sjukvården är en intressant miljö då den ständigt genomgår förändringar på olika nivå och står inför stora utmaningar i och med en växande äldre befolkning och en ökad andel människor som lever med allvarliga sjukdomar. Visualiserings‐ och simuleringsteknik kan vara ett hjälpmedel i förändrings‐ och effektiviseringsprocesser i denna miljö genom att bidra med nya sätt att fortbilda personal och sprida

information, samt som ett hjälpmedel att planera framtida förändringar på ett hållbart och resurseffektivt sätt.

De tre empiriska fallen som avhandlingen är baserad på handlar om 1) träning och planering av höftledsoperationer, 2) övning av beslutsfattande kring utvalda situationer inom intensivvård, samt om 3) planering av nya lokaler för en barnklinik. En viktig del i arbetet har varit delaktighet, dvs. hur

denna teknik också kan stödja att personalen blir delaktig i processerna, oavsett om det handlar om nya verktyg för fortbildning eller utformning av den fysiska miljön. Huvuddelen av arbetet har utförts inom ramen för ett forskningsprojekt där metoder för att arbeta med delaktighet varit centralt.

Avhandlingen vill också lyfta diskussionen om hur fokus i utvecklingen av visualiserings‐ och simuleringsteknik kan skiftas från det nu rådande teknikcentrerade perspektivet till ett människocentrerat perspektiv där användarnas behov och kontext är centrum för vilken teknik som utvecklas och tillämpas. Denna diskussion bygger på erfarenheter från de empiriska studierna samt en litteraturöversikt om hur dessa perspektiv behandlas i utvecklingen av visualiserings‐ och simuleringsbaserade verktyg för utbildning inom sjukvården.

Så med samma principer som används för att göra den avancerade väderdatan tillgänglig för var och en av oss kan visualiserings‐ och simuleringsteknik användas som ett verktyg för utbildning, planering och förändring där personal och andra intressenter kan bli en delaktig part i utvecklingen.

• author: Persson, Johanna
• supervisor: Gerd Johansson; Elisabeth Dalholm Hornyánszky; Mattias Wallergård
• opponent: Professor Cobb, Sue, Human Factors Research Group, Faculty of Engineering, University of Nottingham, United Kingdom
• organization: Ergonomics and Aerosol Technology; Ergonomics and Aerosol Technology-lup-obsolete (research group)
• publishing date: 2015
• type: Thesis
• publication status: published
• subject: Production Engineering, Human Work Science and Ergonomics
• keywords: planning, education, training, technology-centered, human-centered, user involvement, participation, work environment, healthcare, simulation, Visualization
• pages: 165 pages
• defense location: Stora Hörsalen, Ingvar Kamprads Design Centrum, Sölvegatan 26, Lund University Faculty of Engineering, LTH.
• defense date: 2016-01-22 10:15:00
• ISBN: 978-91-7623-594-2
• language: English
• LU publication?: yes
• id: db8b5cc5-0907-4bd8-9571-114ad4897150 (old id 8412475)
• date added to LUP: 2016-04-04 09:38:50
• date last changed: 2018-11-21 20:54:34