Contribution:
Research, Prototype, Design
Team:
1x Researcher, 1x Designer
Duration:
2023, 5 months
Client:
Michigan Medicine Simulation Center
Introduction
This project focuses on advancing the Fundamentals of Laparoscopic Surgery (FLS) training program at the Michigan Medicine Simulation Center, with a particular emphasis on enhancing the quality of education for aspiring surgeons.
Laparoscopic surgery, known for its minimally invasive techniques, demands a high level of precision and skill. The FLS program is essential in equipping future surgeons with the foundational skills needed for these complex procedures.
We were a team of 2 and worked closely with Residents and Surgeons from Michigan Medicine.
Discover [Generate Insights]
Frame
The primary issue addressed by this project is the need for effective training and evaluation methods for laparoscopic surgery.
Traditional evaluation techniques are considered inadequate, relying on subjective assessments and limited tools for assessing practical skills.
Laparoscopic surgery presents unique challenges, and the high level of precision required demands rigorous training. The existing methods are insufficient in providing the necessary skills and assessment tools for aspiring surgeons.
Research
I used both quantitative and qualitative research methods to set the field and give an idea on where the current technology is at and the pain points from stakeholders.
Field Observation
Professor Vitori gave us a tour of the Laparoscopy Simulation Lab and I observed how the current training system works.
Observations
Limited training feedback from mentors: Mentors are not always present in the lab during training to provide feedback. Residents currently rely on feedback from peers.
Height adjustments missing: Ergonomic needs, such as adjustments for residents of different heights, are neglected, potentially impacting training effectiveness.
Literature Review
I went through many Academic Journals, Research reports, blogs and Audit books to understand this domain and the problem more.
Findings from the review
Surveys
Surveys were used here because residents have a very busy schedule and it was not possible for us to connect with many residents via interviews. The survey was sent out to a total of 100 residents in UM Ann Arbor out of which 77 responded.
What did we find?
Challenges and shortcomings involved while training for the FLS exam
Timing practices during training
Contextual Interviews
I visited the labs while the residents were performing some tasks and interviewed them there. Through this I was able to understand routine behaviours that are not always articulated.
What did I find?
Engagement with Learning Materials: Residents frequently complement their FLS program materials with external online resources, mobile apps, and software, indicating a proactive approach to learning.
Motivation: Timely and standardized feedback is considered vital for skill development and for maintaining motivation throughout the training process.
Need for Effective Task-Timing Systems: All residents used a timer or a phone to record their task time and there was no place on the simulator bench to keep these devices comfortably.
Collaboration: While individual training is predominant, residents highly value collaboration with peers and instructors
"When I consistently achieve the performance metrics outlined for a task, I feel confident that I’ve met the training goal."
"I struggle with tasks like suturing, which often takes longer than I expect. I usually use a stopwatch to time myself during practice sessions."
"Error rates during tasks are key. Understanding the frequency and types of errors helps me focus on areas that need improvement."
Competitive Analysis
I analyzed five laparoscopic simulator products based on factors like practice environment, type of learning modules and simulation capabilities
Analyze [Refine Insights]
Interpret
To interpret key problems, I structured the data collected from my research by creating an affinity map.
Affinity Map
Creating the affinity map involved multiple levels of sorting:
First, the extracts from survey, interviews and literature reviews were represented in their original form.
The extracts were then changed to more general phrases that represented the key points the users were making.
All the phrases from these various research methods were then grouped into themes to understand the improvements required for the current training methods.
How might we statement
How might we enhance the Fundamentals of Laparoscopic Surgery (FLS) training program at the Michigan Medicine Simulation Center by creating a system that provides timely, comprehensive feedback and supports residents in passing the FLS Exam?
Synthesize
Based on the above interpretations, we devised the personas and mapped out the user's journey
Personas
User Journey Map
The user journey map became more clear and the phases could be broken down in a meaningful way to represent the personas as well. Below is a map of the Primary Persona, the Resident.
Create [Generate Ideas]
Generate Ideas
Sketching
The crazy 8 technique was used to generate ideas.
Narrative Storyboard
Once the pain points were grouped into categories, each category was broken down to understand the kind of solutions that could be used for the problem space. Each solution was storyboarded separately. Below is one for the workflow of users getting prompts on the screen when an error is made.
The user enters the training center and walks towards the machine to log in and start practicing.
The user practices independently while self monitoring the time and task number.
The system detects an error made by the user. The user panics since they made a mistake.
The system shows the user what the error is and the way that it could be fixed.
The user goes back to the task and corrects their mistake and finishes successfully.
Define Concepts
Questions Options Criteria (QOC)
8 tools and solutions were identified for the 8 problems
QoC was used to narrow down to the final solution:
The following tools were omitted from the QOC because they did not fall within the
requirements of the project to make a standalone product and/or they did not offer
enough different functions as indicated by the needfinding interviews:
1. Height adjusting mechanism
2. Stress management music integration
3. Gamified skill assessment system
4. Digital recording system for feedback
Story Mapping
Site Map (Residents)
Low Fidelity Wireframes
Based on all the requirements gathered, the low fidelity wireframes were created
Develop [Refine Ideas]
Test and Refine
Usability Test
The user testing was done with 5 residents and 5 mentors. The screens presented to the usere were not colored since we prioritized the workflow and did not want users to be guided by the color/design.
Score sheet for Residents
Task List
User 1
User 2
User 3
User 4
User 5
Total
Please set up a meeting to have your overall process performance reviewed by a mentor.
3
3
3
3
3
15
Find out the time you spent on suturing on 10/13
3
2
3
3
3
14
Time your practice session. Set the test time to 1 hour. Your task will be complete after you save the process summary.
3
3
3
3
3
15
Request feedback from the instructor.
3
3
3
3
3
15
Change your current class schedule
3
2
3
3
2
13
Score sheet for Mentors
Task List
User 1
User 2
User 3
User 4
User 5
Total
Add a new video to the list of system guiding prompts
3
3
2
3
3
14
View and accept a meeting request
3
2
3
3
3
14
View the resident list and flag a resident call Albert Flores
3
3
3
3
3
15
View a feedback request from Arlene McCoy and provide feedback
3
3
2
2
3
13
View learning analytics for the class
3
2
2
3
3
13
What went well?
Task Completion: All users (residents and surgeons) could complete the tasks. Scores ranged from 13 to 15, indicating a good understanding of tasks and the interface.
Surgeon Tasks: Despite initial confusion, users quickly located the 'add prompt' button and managed to give feedback by returning to the dashboard.
Resident Dashboard Task: Users could find the dashboard quickly after initial confusion, indicating overall ease of navigation.
What could be improved?
Request Feedback Button (Residents):
Issue: Users clicked on the hamburger menu and video before finding the ‘ask feedback’ button.
Improvement: Consider moving the button to a more intuitive location.
Profile Button (Residents):
Issue: Users looked for the profile button in the side menu rather than at the top.
Improvement: Consider moving the profile button to the side menu for consistency.
Learning Analytics (Surgeons):
Issue: Users did not realize the graph was clickable.
Improvement: Make the clickable areas more obvious.
Feedback Requests (Surgeons):
Issue: Users went to the resident list instead of the dashboard to find feedback requests.
Improvement: Add a feedback requests section in each resident’s profile.
