Presentation for the paper at SHI2019/ EHiN2019 in Oslo. Full paper: https://www.researchgate.net/publication/337324074_Immersion_and_Perspective_Taking_in_Healthcare_Technology_Supporting_Healthcare_Professionals_with_Daily_Tasks_and_Clinical_Procedures

1. Immersion and Perspective
Taking in Healthcare Technology
Supporting Healthcare Professionals with Daily Tasks and
Clinical Procedures
Renée Schulz
Osaka University
renee.schulz@ist.osaka-u.ac.jp
Santiago Martinez
University of Agder
Santiago.martinez@uia.no
Takahiro Hara
Osaka University
hara@ist.osaka-u.ac.jp

2. About the Project
• Collaboration between Norway and Japan
• Funded by JSPS through Forskningsrådet
• Link to ResearchGate: https://www.researchgate.net/project/Usability-and-Procedure-
Learnability-of-Evidence-based-Interactive-Clinical-Systems
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• Aims at improvement of the quality of
care and interchangability of health
professionals thorugh technology
support in practice and education

3. Introduction
• Electronic Clinical Procedure Libraries/ Guidelines
• Supporting Health Professionals
• How?
• Look at usability and learnability issues
• With a special attention on lessons learned from games
• In this part of the project: immersion and perspective taking
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4. Introduction
• User-centred methods
• „Gamification“
• Game-design approaches, procedures and elements
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5. 5

6. VARHealthcare
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7. 7
Both Processes together

8. Research Questions
• Stakeholders’ needs for digital technology support (research question (RQ) 1),
• How to adapt the presentation of clinical procedures and improve outcomes
(RQ2)
• Optimal visualisation (RQ2) depended on evidence-based guidelines as a source
for content but also on visualisation options such as video, picture and re-
creation of procedure-steps in visual and/or auditory ways to support the
understanding and accuracy of procedures
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9. • Survey was designed based on literature review and preliminary interviews
with healthcare professionals
• NSD reference number 111924
• Early stages of a human-centred design process, including the analysis of
users’ needs and inclusion of end-users
• Previous study on Immersion through Video and Perspective taking in a
Health Context
• Questionnaire with 19 questions
• Game-design Elements analyses (literature, interviews)
• Further Questionnaire Analysis
Methods
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10. Survey Results
• 19 participants from 6 different countries (Germany, Norway,
Denmark, Switzerland, United Kingdom, Iceland)
• Gender distribution of 15 female and 4 male participants.
• Participants’ education background ranged from master and PhD
students to professor, including retired health professionals
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11. • What technologies do you use in the hospital on a daily basis?
• Any additional comment regarding the technologies you use at the workplace?
• Where do you look things up to follow the steps on a clinical protocol/procedure/instrumentation or medical
device?
• How often do you encounter procedures that you may not know by heart (e.g. that you have to look up the
steps on how to proceed)?
• How do you keep yourself up to date with new or updated clinical procedures, medicine, etc?
• Please could you mention a complicated procedure that you had to look up recently to be able to conduct
it?
• Do you have a digital library/ a computer system to look up how to do certain procedures? E.g. what
materials are needed and what to do in which order?
• How did you learn (and remember) clinical and medical procedures?
• Have you heard about evidence-based procedure libraries?
• What support would you like to have to help you in your daily work related to clinical procedures?
• Can you imagine using a mobile device (e.g., smart phone, tablet) dynamic situations (accident, outdoors
injury, ...)?
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Core Questions of the Survey

12. 12
Survey Results

13. 13
Survey Results: „procedures that require support“ due
to previous research and mentioned during survey:
• Sårpleje /Wound Care
• Valg af stikketeknik (Dialysis)/ Selection of plugging technique (Dialysis)
• Oprettelse af isolationsregime, seponering af dræn/ Establishment of isolation regime, drainage
of sinks
• Jeg havde en patient isoleret for MRSA - jeg var usikker på de hygiejniske forholdsregler og måtte
læse op på det./ hygienic precautions for MRSA
• throat tumours
• Diabetes ketoacidose/ Diabetes ketoacidosis
• Wechsel bzw. Vorbereitung eines Lungendrainagesystems/ Change or preparation of a lung
drainage system
• Tube Enteral
• interaction of psychotropic substances, best treatment methods of a certain medical condition
• measurement of oligosaccharide utilization by the intestinal bacterial microbiota during intestinal
passage
• Aseptic Process Simulation for filling of parenterals

14. 14
Survey Results

15. Noteworthy statements
• “up-to-date videos could instruct how to perform a procedure”.
• Participants underlined the importance of revisiting the procedures
learned, mentioning repetition as one of the key methods to
remember them: “I learned by reading or seeing the procedure, and
by performing it repeatedly myself”.
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Noteworthy Statements

16. Quick Overview Osaka University Hospital System
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17. Quick Overview VAR Healthcare System
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18. 18
Example Visualisation: VAR Healthcare

19. Overview about Game-Design Elements
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20. Immersion Implications for ECPLs
• First- and third-person perspective (based on previous project
experiences)
• (1) Sensory (visual and auditive) immersion
• (2) Story, narration or plot-based immersion
• (3) Interaction-based immersion
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21. 21

22. 22

23. 23
• Sound design
• Animation and video
design
• Realism enhancement
vs abstraction
SensoryImmersion

24. 24
• Strongly connected to
sensory immersion
• Imaginative immersion
• Active/reactive support
Story,narrationandplot
Storyline, connections, user examples
„various types of interaction; they can
include interaction with objects, non-
player-characters (NPCs) or other
players “

25. 25
• Active participation
• Decisionmaking
• Flow state
Interaction-basedImmersion
assortment of quest log structures

26. Summary and Conclusion
• Next step: get elements together
• Prototyping
• User testing: education and practice
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27. Thank you!
Renée Schulz
renee.schulz@uia.no /
renee.schulz@ist.osaka-u.ac.jp
@Sciencefication
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