User-Centered Innovation for the Design and

Development of Complex Products & Systems

Alex Chang and Taryn Sanks
Stanford University, Center for Design Research
Abstract
In user-centered design the concept and definition of user is fundamental as the
users and their expressed needs are the focal point of the design process. In view of
the fact that users have such a great impact, choosing the most appropriate user
group is also very important. This study aims to track differences that may arise
when expert and novice members of a particular user group are targeted separately.
In order to achieve this, nurses and nursing students were divided into either the
expert or novice group based upon the number of intramuscular injections they had
completed in their careers. Users were then interviewed about requirements and
features they felt were important in the design of an intramuscular injection device
and the data gathered from these interviews was organized and used to develop
potential designs specific to each groups suggestions. Raw data collected from the
original interviews show slight discrepancies between the two groups in the value
assigned to certain requirements yet with original sample sizes of n=9 for each
group, more significant results will be acquired from concluding surveys of the final
designs with increased numbers of participants. These blinded surveys will record
trends in preferences for designs generated from each groups suggestions to
ultimately determine whether experts, who have much experience and are often
habituated to current methods, or novices, who have little experience and as a result
different concerns and values, generate ideas that produce a favored product.
Results gathered from these surveys could further emphasize the importance of
clearly defining a user group and help in the selection of the ideal user group in the
user-centric design process.

Results

Our initial data collection consisted of interviewing an equal number (9) of

nurses and nursing students to represent our novice and expert user groups.
The majority of our interviewees were either students or instructors at
Gurnick Academy of Medical Arts. Additionally, we interviewed nurses at
the Peninsula Eye Surgery Center.
All of the interviews were conducted in the same manner by the same two
interviewers, Alex and Taryn. We interviewed each user one at a time, with a
video recording device focused on the user. The interviews began with a
survey to assess the users experience in the nursing industry and specifically
his or her experience with intramuscular injections. As it turned out, this step
was crucial in the process of determining our novices and experts because
some nursing students that we assumed would be novices, actually fell into
our expert category based on significant past injection experience.

Figure 1. Frequency of novice user comments divided by theme.

Introduction
User-centered design is a term given to design processes primarily guided by the
influence of end-users. From the suggestions they give to designers based upon
their own experiences and preferences, the user is placed at the center of the design
and thus holds a great deal of importance. Just as the specifics of the process may
vary, the definition of who the user is varies according to the intended use of the
product. For example the term primary user generally refers to those actually
using the device but user, especially in medical device research, may also refer to
the person the device is being used on. Even within the provided description of a
primary user, other user groups emerge based upon factors such as age or
experience. The significance of the selection of the proper user group relates
directly to the centrality of the user in this type of design process and that reasoning
explains why this study focuses on the definition of specific user groups.
In this study we take the term user to describe people that use the intended device.
Intramuscular (IM) drug delivery devices were selected as the device since they are
intended for frequent interaction by users of diverse skill levels, are small yet
complex mechanical devices, have a variety of stakeholders and thus a range of
effects, and provide an accessible and clearly defined user group of nurses. Nurses,
depending upon their specialty, have varying levels of experience with
intramuscular injections. To distinguish novice users from expert users, we had
participants self report on their estimated number of injections given. After
conducting background research, we defined our novice user group as nurses with
less than 25 intramuscular injections, and our expert group as nurses with over 100.
Though this may appear not to hold much quantitative value, the average number
provided by the novice group was around 4 injections which is significantly smaller
than the estimated average of about 1400 injections for experts.

Methods & Materials

After the initial survey, the user was shown a short video prompt detailing
the basic steps included in a intramuscular injection. With these steps in
mind, the user was prompted to list any requirements for a new intramuscular
injection device. The user was given two sheets of paper to help with
generating concepts. One was labeled Functional Requirements,
encompassing any technical requirements of the device. The other was
labeled Design Requirements, to evoke any requirements or improvements
that make it easier for the nurse to use. These nuances were explained to the
interviewee.
The interviewee was allowed to write and talk freely with interruptions only
used to keep the users requirements on track. We also prompted the
interviewee when he or she began having difficulty generating more
requirements. After about 20 minutes of this format, the user was prompted
to consider all the requirements that he or she had listed and to rank the top 5
requirements, a ranking of 1 implying the user considered it the most
important requirement.
Finally, a post-study survey was conducted to assess the users comfort level
with technology in general, medical technology, and design, as well as their
adoption behavior for new technology and products.

Figure 2. Novice user comments divided by theme and ranked.

Preliminary Designs

After conducting all 18 interviews, we watched all of the interviews while

looking through the users written requirements. We compiled all of the data
so that quantitative analysis could be performed. The novice and expert
requirements were compiled separately. Additionally, we formatted the data
to be easily presentable to our design team. Finally, in conjunction with our
designers, we categorized each of the requirements into five themes (see
Figure1 and Figure 2).

Future Work
Our designers are currently working on designs based on the novice
requirements we have collected. We have two designers that will each design
two composite designs, highlighting the designers best representation of an
intramuscular injection device that would appeal to the novice group based
on the collected novice requirements. Some initial sketches are shown in
Figure 3.

With these different levels of experience the information received from each group
also varies. Our hypothesis states that at the conceptual level of design, all users of
the product, both expert and novice, will have a higher preference for designs
developed from input given by experts, due to the ability of experts to identify
needs of the target market. This hypothesis also agrees with past research similarly
discussing these preferences.

The same designers will then be given a similar set of data containing the
expert requirements. They will follow an identical design process to obtain
two more composite designs based on the expert data. In total, this will result
in 8 total designs: 4 per user group and 2 designers.

As a prospective cohort study, user sessions were initially completed with each user
group. The information they provided will be used to design specifically for each
group at varying levels of resolution including sketches and models. These will be
presented to study participants who will be prompted to rank their preferences. We
aim for this study to demonstrate the unique contributions made by novice and
expert users at various phases of the design process and for the designs created to
improve the design of drug delivery devices currently used in clinical practice.
Figure 3. Initial sketches of possible novice design.

We will then ask our 18 users to assess each of these 8 designs, first on
specific target areas such as safety and efficiency, then on their overall
impression of the designs. In order to track users preferences at different
stages of design, images ranging from sketches to 3-D SLAs may be
provided to the participants to rank. Given that 18 users is a relatively small
sample size, we hope to use a third party market research firm in order to
poll a larger (n = 250, 500, or 1000) panel of nurses and nursing students,
thus increasing the statistical significance.