Co-designing Cultural Probes
By Catherine Montgomery, Joanne Mair and Santini Basra
This is the second post in our Critical Care Futures series. If you need to catch up, head back to the first post where we give a little context on this project — ‘Exploring Futures for Critical Care Research’ — while also introducing Cultural Probes as an engagement tool, and our rationale for using them in this project.
In this post we reflect on the process of designing cultural probes for this project. Cultural probes are complex research tools — there is a huge spectrum of possibility regarding the shape that they can take, and several factors need to be balanced in order to produce one which is appropriate and effective.
In our process, we brought together a diverse, interdisciplinary group to co-design the probes — the group was made up of four ‘co-designers’ who worked alongside the core project team. These co-designers represented the four intended audiences of the engagement activity:
- ICU Survivors and/or Relatives
- ICU Clinicians
- ICU Researchers
- Ethics Committee Members
Together we collaborated on the generation and then refinement of concepts for the probes, and then subsequently the four co-designers helped us test and iterate the first versions of these.
This post brings together three individuals who were involved in the co-production of the probes to reflect on the challenges and process from their own perspectives:
Catherine Montgomery is a Sociologist of Science and Medicine at the University of Edinburgh.
Santini Basra is the director of Andthen, a team of design researchers who specialise in conducting research about people’s perspectives on the future.
Joanne Mair is a Clinical Project Manager who focuses on the translation of novel diagnostics from bench to bedside. Joanne has also undertaken various roles as part of the NHS ethics committee service.
Santini: It’s been lovely collaborating with you both over the last couple of months to design these probes. I’m interested in learning about whether this has been a familiar experience for the two of you — both in terms of working collaboratively in this way, and contributing to the development such an open-ended exploratory research tool?
Catherine: For me, this has felt close to the ways in which I’ve done research in the past — engaging with key stakeholders, working in a multidisciplinary way, being led by what comes up (open-ended research is a mainstay of the sociological work I usually do). What has been less familiar, and really enjoyable, is the flipped power dynamic at work — rather than ‘steering’ this, being a participant in the process myself. Jo, I wonder how this has felt for you?
Jo: This is quite different to how I have carried out or been involved in research in the past. Although I engage with stakeholders and the end-users of the “product” they come from quite defined walks of life and set out with a specific aim which is normally to fulfil milestones in a grant. Within my ethics role, we work within a provided set of information over which we also have a very defined role. I really enjoyed the way everyone involved in this project was asked to look at it from their own perspective and expertise but also from other peoples’ and how they would engage, use and reflect on the outputs.
I feel that the openness of the collaboration allowed the team to explore the probes from all angles without feeling they had to be an expert in what they were saying, was that similar for yourself Catherine?
Catherine: Yes, it was. What worked really well was getting everyone around the table together — former patients, ethics committee members, researchers, clinicians and designers. This doesn’t often happen and I think the very act of getting people in the room together unlocked an energy and a mutual curiosity that helped shape the development of the probes in a very positive way. The kinds of spontaneous conversations you have in that scenario, and the way they stimulate others to jump in and add their ideas, are hard to manufacture through more traditional methods.
Santini: It’s interesting that you bring up flipping power dynamics — I often see the challenges around managing power dynamics when working on research or engagement projects. As researchers or facilitators we hold a lot of power, but for me, it’s always important to flip that, as ultimately those we are working with are experts in their own experience. Co-design is a great way to make this flip, it really positions participants as experts (and therefore collaborators). But co-design is a tricky process to manage, especially when dealing with something as open-ended as cultural probes — what did you both find challenging about it?
Jo: I found the inclusivity aspect challenging — in my head I kept going back to “would everyone manage to take part in this” rather than being able to see the probes as different elements that will hopefully encompass everyone. I found it difficult to separate out my “role” within the design process from the challenges I typically encounter when carrying out research and as part of the ethics committees. I really enjoyed hearing everyone’s viewpoints and felt we could have talked for much longer but everything has to have a time limit!
Catherine: Condensing these discussions into the timeframe of a workshop was challenging. Probes can sometimes invite expansive and unexpected responses, ideally it would be nice to have more time to explore these. Being both goal-oriented and at the same time inviting creative responses is a tension — I’m not sure if this was particularly pronounced because we’re working in health research. Distilling the ideas that everyone came up with as part of the co-design process was really tricky and I think there are multiple avenues we could have gone down with the probes, but didn’t due to the process of consensus-forming. Santini, I’d be interested in how this felt from your point of view as a designer?
Santini: That’s a key tension you highlight there, and it’s one that I think most designers wrestle with, especially as the practice of design has become more and more collaborative. Inviting some kind of openness and unconstrained creativity is really useful in getting the most out of a co-design session — this is why for instance designers will often encourage all ideas, and get away from the language of ‘good ideas’ and ‘bad ideas.’ But, design as you say needs to be outcomes focussed (eventually you need to make something) which means that you need to be careful about how you direct people’s contributions. You want people to be able to input in a way that is likely to have an impact on the outcome of the work, and typically you need people to be able to see a connection between their input and some kind of output — in this case, the design of the cultural probes. Finding that balance is difficult, as is distilling the range of ideas that you are left with after a co-design session. Typically, there will be several great ideas, but once you put them through a few filters — for instance, ‘what’s feasible?’ ‘what’s going to be easy to use?’ or ‘what best addresses the project objectives?’ — the answer becomes clearer and therefore easier to build consensus around.
You said something interesting there Catherine about the impact that the domain of health research might have on the way we were working. I’d be keen to explore that a little further — how do you think health research influences the tension between goal-oriented working and creative exploration?
Catherine: I think that a lot of health research is influenced by an epidemiological orientation to the world, which seeks to categorise, standardise, and provide answers to a tightly defined question within a given set of parameters. The logic of positivism underpins this approach, which tends to sideline more phenomenological, interpretative and constructivist ways of looking at the world. Qualitative research has sought to counter these tendencies and thereby expand the kinds of knowledge we produce related to health and illness, but even so, there can be constraints on what is considered useful knowledge, which can have a chilling effect on creativity. In this particular project, which is led by a multi-disciplinary team of people from design, medicine, nursing and sociology, I hope we’ve found a balance between creative exploration and providing useful insights to help shape the future of critical care research. But a part of me wonders if we could have been more radically creative if the topic was one where there was less at stake.
Jo, any further thoughts on this?
Jo: I have little experience with qualitative research but I appreciate the constraints on the impact we can have when trying to change the way we carry out research. I see this due to the processes and procedures that are in place due to other concerns for example legal and regulatory. Those who have to take responsibility for any comeback from participants or those who consent on behalf of them have processes in place to minimise any fallout, this means that we have to operate within a set of often rigid rules and behaviours. As such the useful knowledge that we gain can’t always be applied as freely as we would hope. Working within the “what can actually be done” and “what we would like to see” is difficult, I could see how this could create tension in a collaborative group. I felt that on one hand, I was really engaging with ideas whilst on the other hand I was thinking would these be difficult to carry out within the current processes effectively? When engaging with previous ICU patients I found out those who have been involved in trying to shape other research projects have found similar constraints. This doesn’t mean we shouldn’t keep advocating for change and demonstrating the buy-in from previous patients in a sensitive area for research.
Santini: I’d definitely agree that the topic (and also the target groups of participants) set some clear boundaries around how radical we can be with the research activity. When we’re researching less sensitive topics we’re generally very comfortable designing highly open-ended research activities, that really push a participant to explore the way they think or feel about something. But when working on sensitive topics such as this, there is a safeguarding component that needs to factor in. With cultural probes, we’re asking participants to complete activities on their own, without anyone from our team there to support them. With this topic, it’s likely that individuals we’re engaging have had very difficult experiences associated with the time that they or their family members have spent in the ICU, so it’s important to make sure the probes have some guardrails which avoid them straying into territory that’s triggering. Nonetheless, this will be a particularly interesting point to reflect on once everyone has completed the probes, and I’m keen to see what others think the impacts might have been if we structured them differently and whether they indeed feel like they’ve been co-designed. Let’s revisit this once they are all completed!
Sharing tools from our process
Some of the tools we developed to support this co-design process are available here to download for free, under a creative commons licence.
These include:
- Introduction to Cultural Probes — a brief introductory presentation which outlines what cultural probes are, and gives a range of examples. Download here.
- Cultural Probe Method cards — a printable set of cards which list different mediums one might use for developing a cultural probe. These can be used in an idea development session to help stimulate thinking and generate new concepts. Download here.
About ‘Exploring Futures for Critical Care Research’
‘Exploring Futures for Critical Care Research’ is funded by a Scottish Public Engagement Network (ScotPEN) Wellcome Engagement Award. The project is a collaboration between clinicians, social scientists and designers, working with ICU survivors and research governance staff to co-design cultural probes for public engagement. In addition to catalysing dialogue, the project aims to produce a set of future principles for person-centred approaches to data use and consent in ICU, as well as a public-facing installation about the future of ICU research.
