Support for Collaborative Reflection in Healthcare: Comparing two Workplaces

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Slides from a presentation given as part of the 2013 ARTEL workshop on awareness and reflection in technology enhanced learning at the EC-TEL 2013 conference

Slides from a presentation given as part of the 2013 ARTEL workshop on awareness and reflection in technology enhanced learning at the EC-TEL 2013 conference

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Transcript

  • 1. Support for Collaborative Reflection in Healthcare: Comparing two Workplaces Michael Prilla, Martin Degeling Information and Technology Management, Ruhr University of Bochum
  • 2. Fostering Collaborative Redesign of Work Practice: Challenges for Tools Supporting Reflection at Work A Collaborative Reflection Blueprint Articulation and Essential Steps (Prilla, Degeling and Herrmann 2012) Documentation/ data capturing (data about work)
  • 3. The Talk Reflection App Collaborative Reflection of Conversations
  • 4. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 4 The Talk Reflection App Reflecting on conversations Conversations as a central part of daily work in many workplaces ▪Relatives, patients, residents, clients, citizens, … ▪Physicians, nurses, caregivers, police, traffic wardens, call agents, managers, …. Conversation as a burden ▪Difficult handling and emotional stress vs. acting professionally
  • 5. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 5 Using the Talk Reflection App Document experiences Comment on own/ shared experiences Document results from reflection
  • 6. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 6 Evaluating the Talk Reflection App Participants Data from studies Case 1/3 (Hospital) 5/6 physicians Questionnaires (Pre/Post), interviews, observations (meetings), log files Case 2 (Care home) 5 caregiver, 1 manager
  • 7. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 7 How does Collaborative Reflection Help? Reflecting on holding conversations with relatives (Case 3) Reflection results created mainly by using the app: Sharing experience, exchanging perspectives, agreeing on change Activity Articulation Documented Conversation “Patient with [diagnosis]. Excited relative talks about [problem] that she allegedly does not know about. Wants information about [the problem] and how we deal with it, which has already been given before.” Own Comment “[Maybe] medical lay people cannot understand some terms and are irritated rather than informed.” Comment by others “Here a second talk could help. Sometimes it needs to be explained again and again to reach understanding. (…) There is still the option to ask the senior physician”
  • 8. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 8 How does Collaborative Reflection Help? Creating results from reflection (Case 2) Reflection results outside the app: Sharing experience, sustaining change proposals  reflective communication outside the app Activity Articulation Documented Conversation „The resident passed away suddenly, had been here long, was liked by all staff. Was ill in the morning and her guardian admitted her to hospital, Unfortunately she passed away [there]. This was very distressing to the staff as they felt it would have been more dignified for the client to be in familiar surrounding.“ Own Comment - Comment by others - Result „After discussing with the homes manager about the staff being upset, it was decided that staff who were most affected get together and discuss thoughts and feelings.“
  • 9. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 9 Impact of Collaborative Reflection Apps Effects of Talk Reflection on communication / reflection (Case 2) Awareness for reflection “Since we are using the app, we are talking more to younger colleagues” Improving attribution “It helped to talk about these situations in more detail instead of only saying ‘it was difficult‘” Adoption and value added “It would be good if we had 10 minutes per day to use it. If you don’t have something to write down, you don’t have to”
  • 10. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 10 Impact of using the App
  • 11. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 11 Impact of the app and other factors
  • 12. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 12 The Evaluations of the Talk Reflection App Usage Data Activity ▪Most activity for documentation (and commenting in case 3) ▪(Too) Little usage of commenting, hardly any for results documentation, but reflection and results in f2f communication ▪All documents shared Actions / Stats Case 1* Case 2 Case 3 Days of data capturing 12 33 49 Users 5 5 (6) 6 (7) Documented conversations 7* 18 21 Comments (own / others) 9 (4/5) 14 (10/4) 45(32/13) Documented reflection results 3 3 3
  • 13. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 13 The Evaluations of the Talk Reflection App Usage Data Slow Adoption: Influence factors ▪Integration into work (“I asked them to use it in their breaks”) ▪Communication of value added (“You do not go to the app to make a comment, but when you have something to document”) ▪Lacking guidance (“I sometimes did not know what to comment”) Actions / Stats Case 1* Case 2 Case 3 Days of data capturing 12 33 49 Users 5 5 (6) 6 (7) Documented conversations 7* 18 21 Comments (own / others) 9 (4/5) 14 (10/4) 45(32/13) Documented reflection results 3 3 3
  • 14. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 14 The Evaluations of the Talk Reflection App ▪ Inequality of usage: Top 3 users account for 2/3 (and more) of app usage: Action Case 2 All (n=5) Top 3 Case2 Case 3 All (n=6) Top 3 Case3x Log In 62 46 146 99 View Document 99 86 141 99 Create Document 18 13 21 17 Add Comment (Own / shared content) 14(10/4*) 9(8/1) 45(32/13) 35(24/11) A matter of scale?
  • 15. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 16 Action U1 U2 U3 U4 U5 U6 ano n total Log in 17 21 8 5 16 32 2 101 View Document 21 33 12 14 20 45 1 146 Add Comment (shared / own content) 7(5/2) 5(5/0) 12(12/0) 3(1/2) 3(0/3) 13(7/6) 2(2/0) 45(32/13) Create Document 2 1 1 4 7 6 0 21 ▪ Commenter ▪ Roles: Superior, Helper ▪ “I made comments where I thought I could help colleagues” ▪ Inequality in usage: Top 3 users account for 2/3 (and more) of app usage ▪ Documenter ▪ Off-Loading, part of work ▪ “I documented when I thought this was relevant for colleagues” User Preferences in the Talk Reflection
  • 16. © MIRROR Project - Co-Funded by EU IST FP7 – www.mirror-project.eu 18 Fostering tool usage Balancing between Social and Technical Reflection Support ??
  • 17. Fostering Collaborative Redesign of Work Practice: Challenges for Tools Supporting Reflection at Work Escalating Prompts for Collaborative Reflection CSCL at Work: Flexible guidance by prompts ▪ Notify users to motivate tool usage (“Can you think of a recent conversation?”) ▪ Make users aware of collaboration features: Motivate comments (“Have you been in a similar situation?”) ▪ Prompt regularly: Leave traces from f2f situations (“Did you come up with an idea for change?”)
  • 18. Fostering Collaborative Redesign of Work Practice: Challenges for Tools Supporting Reflection at Work Collaborative Reflection: Socio-Technical Design
  • 19. Fostering Collaborative Redesign of Work Practice: Challenges for Tools Supporting Reflection at Work reflection community Scale: Community Support
  • 20. Thanks for your attention. Questions?