Human-centred design in the healthcare setting can include patients’ and families’ perspectives when researching, designing, and developing interventions. There are multiple qualitative research methods that may be employed to collect user data. Naturalistic video recordings are a powerful means of observing and coding multiple participants and evaluating their interactions over time. However, in the healthcare space, researchers need to be especially intentional with use of video-based data, so the confidentiality of all participants is maintained. Digital storytelling can be used as an effective way to securely share the interaction and emotions directly from the videos so that the content can be disseminated with researchers, clinicians, participants, and policymakers. The goal of the digital stories is to authentically convey observed experiences to a broader audience, including as educational tools for healthcare team member training. This paper presents a collaborative approach to producing animated stories that can be used to promote discussion and action for clinical quality improvement, from our work with birthing parents, their companions, and their healthcare team members in a hospital- based postpartum unit. We describe various considerations related to digital storytelling for provocation, involving multi-disciplinary stakeholders in identifying priority scenarios, and the development process of digital stories. Considering the growing emphasis on patient-centred and equitable healthcare, our reflection may be useful to designers and researchers working with sensitive data, or healthcare educators and administrators seeking ways to build more empathy around human experiences and prompt discussions to improve systems of care.

1. A COLLABORATIVE APPROACH TO DIGITAL
STORYTELLING IN HEALTHCARE SETTINGS
The 24th International Conference on Engineering and Product Design Education | E&PDE 2022
Sana Behnam Asl,1 Carolina Gill,1 Kelly Umstead,1 Raunak Mahtani1 , and Kristin P. Tully2
Please cite us:
Link to the article
DOI number: 10.35199/EPDE.2022.107

2. https://www.postnatalsafety.com/
Redesigning Systems of Postnatal Care
(Funded by the Agency for Healthcare Research and Quality R18HS027260)

3. Human-centered Research
We are applying human-centered research and design principles in this
project; to transform processes and outcomes for families and those
serving them, such as healthcare professionals.

4. Multi-method data
TT
• Surveys
• Interviews
• Shadowing
• Participatory workshops
• Naturalistic videos

5. Naturalistic Videos
Naturalistic video involves “the video recording or filming of the stream of
activity of subjects or observation of real-life experiences in their natural
setting, in order to experience, interpret, and represent behavior”
Iedema. et al., 2006; Pink , 2020; Tully et al., 2012)

6. These videos document the raw, unfiltered
emotions, reactions, and actions.
Naturalistic Videos
Naturalistic videos of patients and healthcare
professionals in the postnatal unit

7. Multiple methods of data collection including:
• 461 hours of naturalistic videos
• Among 15 postpartum patients and their companions
(in an academic medical center in the southeastern
United States)
• Videos averaged 31 hours (range 10 to 76) from two
camera views in the participants’ postpartum unit rooms
Our Study
Two camera views in the participants’
postpartum unit room

8. Limitations of Naturalistic Videos
Asan, O., & Montague, E., 2014; Iedema et al., 2006
• These videos contain sensitive and confidential information.
• The length of the videos would be too long for teaching purposes
• It can be difficult to isolate the information and convey certain aspects of the
recorded experience or behaviors
• Traditional formats for sharing qualitative data findings such as written reports or
presentations may remove the empathic pieces and fail to convey the critical
emotional components

9. These limitations are opportunities for design

10. Our questions
• How can storytelling and digital stories elicit conversation and enable healthcare
professionals to engage in a discussion around system strengths and opportunity areas?
• How can we emphasize specific dimensions of the interaction, experience, or setting to
bring attention to one issue at a time?
• How can we leverage the richness of the naturalistic videos to share stories of/from the
postnatal unit while protecting participants’ confidentiality?
• What are the best practices and technical considerations for creating narratives that are
engaging while the context, behaviors, and dialogue are kept intact?

11. Digital Storytelling for Provocation
Gubrium, 2009 ; Hughes, 1998
By transforming the data into shareable visualizations, such as digital stories,
participants can see that their stories are heard, verified, and represented.

12. Gubrium, A., 2009
Digital stories are “short visual narratives (approximately 3- to 5-min) or
animations that create engaging and compelling accounts of experience”
Digital Storytelling

13. Our Process
The design team, along with research partners:
• Reviewed ,analyzed and identified the emerging themes from videos
• Followed multiple iterative steps
• Coded the videos in 5-minute increments

14. Vignettes
Summarized accounts of events,
participants, situations, and structures,
which made it possible to refer to important
points in the study of behaviors,
perceptions, and attitudes in the context.

15. Developing Digital stories
To create actionable digital stories we followed specific steps, including:
1. Technical considerations
2. Defining the scope
3. Shaping the style

16. Technical Considerations
Two main considerations for
the choice of the software:
1. The ease of use
a. Short onboarding
b. Built in features
2. Collaboration
a. Shared library
Built-in features
Shared library
Vyond , 2022

17. Defining the Scope
We developed a worksheet that allowed the
research partners to select and summarize
sections of the video and note examples that
they felt were worth discussing .
We followed a participatory approach
to prioritize the content and define the scope.

18. Shaping the Style
1. Design of environment
Exploring different color pallets and asset design

19. Shaping the Style
1. Design of environment
Third person view
First person view

20. Shaping the Style
1. Design of environment
Final minimalistic environment

21. Shaping the Style
1. Design of environment
2. Maintaining concordance with
characters’ appearance,
mannerisms, and voices
Companion character development process

22. De-identified video footage (A) Precise style of the environment (B) Final minimalistic environment (C)
Shaping the Style

23. Smithsonian Museum Presentation
2022 ACCelerate Festival, DC

24. Reflection
Collaboration Human-centered Perspective
Iterative prototyping

25. Shaping the Style
A collection videos

26. Thank you
Sana Behnam Asl
sbehnam@ncsu.edu

27. Reflection
Naturalistic videos Digital stories
Complex process!