Thursday, 31 October 2013

Different ways of interacting with an information resource

I'm at a workshop on how to evaluate information retrieval systems, and we are discussing the scope of concern. What is an IR system, and is the concept still useful in the 21st Century, where people engage with information resources in many different ways? The model of information seeking in sessions for a clear purpose still holds for some interactions, but it's certainly not the dominant practice any more.

I was struck when I first used the NHS Choices site that it encourages exploration above seeking: it invites visitors to consume health information that they hadn't realised that they might be interested in. This is possible with health in a way that it might not be in some other areas because most people have some inherent interest in better understanding their own health and wellbeing. At least some of the time! Such sites encourage unplanned consumption, hopefully leading to new understanding, without having a particular curriculum to impart.

On the way here, I read a paper by Natalya Godbold in which she describes the experiences of dialysis patients. One of the points she makes is that people on dialysis exploit a wide range of information resources in managing their condition – importantly, including how they feel at the time. This takes embodied interaction into a new space (or rather, into a space in which it has been occurring for a long time without being noticed as such): the interaction with the technology affects and is informed by the experienced effects that flow (literally as well as metaphorically) through the body. And information need, acquisition, interpretation and use are seamlessly integrated as the individual monitors, makes sense of and manages their own condition. The body, as well as the world around us, is part of the ecology of information resources we work with, often without noticing.

While many such resources can't be "designed", it's surely important to recognise their presence and value when designing explicit information resources and IR systems.

Thursday, 10 October 2013

Safety: the top priority?

For the past two days, I've been at the AAMI Summit on Healthcare Technology in Nonclinical Settings. The talks have all been short and to-the-point, and generally excellent. They included talks from people with first-hand experience of living with or caring for someone with a long term condition, as well as developers, researchers... but no regulators, because of the US government shutdown. For many of the participants, the more memorable talks have been the first hand accounts of living with medical devices and of the things people do and encounter. I'll change names, but the following are some examples.

Megan's partner is on oxygen therapy. The cylinders are kept in a cupboard near an air conditioning unit. One day, a technician visited to fix something on the aircon unit. As he was working, she heard a sound like a hot air balloon. She stopped him just in time: he had just ignited a blow-torch. Right next to the oxygen cylinders. Naked flames and oxygen are an explosive combination. In this case, the issue was one of ignorance: the cylinders weren't sufficiently clearly labelled for the technician to realise what they were. However, there are also accounts of people on oxygen therapy smoking; in some cases, people continued to smoke even after suffering significant burns. That's not ignorance; it's a choice they make. Apparently, the power of the cigarette is greater than safety considerations.

Fred's son has type 1 diabetes. He was being bullied at school, to a degree that he found hard to bear. He took to poking a pencil into his insulin pump to give himself an excess dose, causing hypoglycemia so that his parents would be called to take him home (or, in more serious cases, to hospital). Escaping being bullied was more important than suffering the adverse effects of hypoglycemia.

In our own studies, we have found people making tradeoffs such as these. The person with diabetes who avoids taking their glucose meter or insulin on a first date because he doesn't want the new girlfriend to know about the diabetes until they have got to know each other (as people) a bit better first. The person on home haemodialysis who chooses to dialyse on her veranda even though the dialysate doesn't work well when it is cold, so she needs to use a patio heater as well. The veranda is a much more pleasant place to be than indoors, so again she's making a tradeoff.

Patient safety is a gold standard. We have institutes and agencies for patient safety. It's incumbent on the healthcare system (clinicians, manufacturers, regulators, etc.) to minimise the risks to patients of their treatment, while recognising that risks can't be eliminated. But we also need to remember that patients are also people. And as people we don't always prioritise our own safety. We drive fast cars; we enjoy dangerous sports; we dodge traffic when crossing the road; etc. We're always making tradeoffs between safety and other values. That doesn't change just because someone's "a patient".

Tuesday, 8 October 2013

Know your user: it's hard to imagine being older

I've just been reading Penelope Lively's enchanting article "So this is old age". It's an engaging read – at least for someone who sometimes thinks that they are experiencing old age! I love some of her description: for example, "the puzzling thing in old age is to find yourself as the culmination of all [your younger selves], knowing that they are you, but that you are also now this someone else". She is very articulate, and presents something like a persona for an older person. She also reminds us that it's easier for the older person to imagine what it's like to be younger than the reverse.

And yet, the older person who she portrays is importantly different from any individual (over the age of, let's say, 75) that I personally know. It is much easier to assume that we all age similarly – that people get more similar as they get older – than to get your head around all the individual differences. But as far as I can tell the converse is actually the case: variability increases as different kinds of degeneration compete against different enhanced competencies (kinds of wisdom, perceptions, appreciations).

We all have a tendency to stereotype "the other", whether they are older or younger, male or female, a nurse, teacher, cleaner or astronaut. It's much easier to design for people "like me" than to put yourself in someone else's shoes and design for them. Personas have an important role in helping to design for others, but they need to be used with sensitivity to real people. That's surely the best design: designing for people who are different from oneself in ways that empower and delight them.

Monday, 7 October 2013

Cultural heritage: sense making and meaning making

Last week, I was presenting at the workshop on Supporting Users' Exploration of Digital Libraries in Malta. One of the themes that came up was the relationship between meaning making and sense making. These seem to be two literatures that have developed in parallel without either referencing the other. Sense making is studied in the broad context of purposeful work (e.g. studying intelligence analysts working with information, photocopier engineers diagnosing problems, or lawyers working on a legal matter). Meaning making is discussed largely within museum studies, where the focus is on how to support visitors in constructing meaning during their visit. Within a cultural heritage context (which was an important focus for the workshop), there is a tendency to consider both, but it is difficult to clearly articulate their relationship.

Paula Goodale suggested that it might be concerned with how personally relevant the understanding is. This is intuitively appealing. For example, when I was putting together a small family tree recently, using records available on the internet, I came across the name Anna Jones about 4 generations back, and immediately realized that that name features in our family Bible. She's "Anna Davies" on the cover, but "Anna Jones" in the family tree inside. I had not known exactly how Anna and I are related, and the act of constructing the family tree made her more real (more meaningful) to me.

The same can clearly be true for family history resources within a cultural heritage context. But does it apply more broadly in museum curation work?
Following the workshop, we visited St Paul’s Catacombs in Rabat (Malta). 

The audio guide was pretty good for helping to understand the construction of the different kinds of tombs and the ceremonies surrounding death and the commemoration of ancestors. But was this meaning making? I’d say probably not, because it remained impersonal – it has no particular personal meaning for me or my family – and also because although I was attentive and walked around and looked at things as directed, I did not actively construct new meaning beyond what the curatorial team had invested in the design of the tour. Similarly, it wasn’t sense making because I had no personal agenda to address and didn’t actively construct new understanding for myself. So – according to my understanding – sense making and meaning making both require very active participation, beyond the engagement that may be designed or intended by educationalists or curators. They can design to enhance engagement and understanding, but maybe not to deeply influence sense making or meaning making. That is much more personal.