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Expert blind spot
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The term design thinking has cropped up in education journals and conference brochures more and more over the past few years, but its meaning remains a mystery to most instructors. The term comes from the business sector, where it refers to a process of learning about a customer’s needs to inform product design. Education has adopted it in two ways:
As a method for designing programs, courses, and lessons
As a course activity where students do design thinking to solve a problem
I will describe the process by showing how I might use it to design my medical ethics class, how it differs from other methods, and its benefits and limitations.
Design thinking has five steps: empathize, define, ideate, prototype, and test (Ní Shé et al., 2022). The empathize step involves researching the intended user to understand where they are and where they want to go. The research can include the usual tools, such as literature studies and surveys. But advocates pay particular attention to focus groups of potential users to better understand the problems they face.
In applying this step to my class, I would gather a group of future students to ask them about their motivations for taking the class, their concerns, their future plans, and the like. Those meetings would lead to me to create “empathy maps” to structure the information from the conversations. These empathy maps take the form of squares with four quadrants:
Says What is actually said in the conversations
“I plan to be a doctor and want to know about the ethical issues I will face.”
“I have never had an ethics class before. My classes have been in science.”
“I am taking this class because it is a requirement for my premed program.”
Thinks Inferences the researcher makes about the user based on what they say
The student wants practical information that they will use in their medical career.
The student is science-oriented and wants clear answers to questions.
The student is taking the class just to check a box.
Feels The user’s emotions
The student is drawn to the human aspect of being a doctor.
The student is worried that they will not understand the performance requirements of the class.
The student thinks this will be a soft humanities class without much value.
Does What the user does in relation to the product being designed
The student is preparing for all aspects of being a doctor, not just gaining medical knowledge.
The student studies for long hours to memorize information that will be on the exam.
The student works part time at a hospital.
It should be clear by now that design thinking focuses on crafting a holistic picture of the user. This means considering the user in terms of not only such categories as “undergraduate student” or “first-year nursing student” but also their desires, wants, hopes, and fears.
To help with this process, the designer creates personas of hypothetical students, making them as detailed as possible. For instance, one might start with the following:
Jennifer is a 30-year-old medical technician who works in a healthcare lab.
She is interested in interacting with patients and so has decided to return to school in the post-bac premed program to get into medical school.
She has had nearly all science courses and likes clear answers to problems.
She is deeply interested in the lifestyle issues that lead to a patient’s medical problems.
While there is no set number of personas, they should represent a sampling of the range of types of students that the class is likely to attract.
From this information, the researcher defines the user problem that the product is meant to solve. Here, the transition from business process to educational planning is a bit tricky as it is not always clear how to define student motivations to take a course as problems. Many students take a class just because it is required for their major, not to solve a real-life problem. For this reason, it might be better to think of this stage as defining the long-term wants and needs that the course will serve:
The student needs methods for solving ethical dilemmas that they will face as a doctor.
The student wants to understand how patients think of issues like end-of-life treatment, fetal genetic testing, and privacy.
The next stage of design thinking is to come up with several options for solving the customer’s—or student’s—problems. Just as a car manufacturer might come up with multiple vehicle designs, an instructor might develop multiple course topics and activities. The instructor might also consider different course formats. Will a traditional face-to-face lecture be best—or perhaps a flipped classroom? How many of the students are working adults who might need some flexibility in class schedule or deadlines? The personas should help the instructor see how the various options would affect different students, thus guiding the choices. Here I might decide that I want most of the content delivery done online to free up class time for discussion of case studies because those discussions will prepare students for the ones they will have with care teams as medical practitioners.
The fourth stage is to develop a prototype. Applied to education, this would mean developing some or all of the curriculum. I might create the case studies that students will discuss as well as pick or create the lesson content. I would also sketch out the course topics and the course format.
The final stage is testing. Here is where the distinction between business and education is most stark. Businesses test prototypes before releasing them to customers, and any business that does not would be considered negligent. But education rarely, if ever, does prerelease testing, instead using students as the test subjects for the first course offering.
If I were to apply design thinking, I would give different groups of potential students samples of the curriculum to see how they react. I would give one group some of the case studies and watch how the discussion goes. Did students understand the case study? Did they find enough to discuss? Were they interested in the case studies, and did they identify the relevant considerations for deciding them? I would also have students read, watch, or listen to course content examples and test for comprehension. I would also give groups a list of topics and see if there are any important ones that I left out. All this would be with an eye toward revising the curriculum (the prototype) and testing it again until it achieved the desired results.
Benefits and weaknesses
A critic of design thinking might say its lauded learner-centered focus is nothing new because all courses are designed for learners; they’re not designed to teach to the classroom door. But here I think it contrasts with a topic-centered approach. I designed my first medical ethics course by identifying the major topics in the field on the belief that I needed to cover those topics. Design thinking focuses on what will benefit learners to know—a fundamentally different question. This would help ensure that the curriculum stays tethered to practical application.
A second benefit is that the detailed information about students would help instructors overcome “the expert’s blind spot,” the tendency for experts to speak over the heads of novices because they don’t see how comprehending what they are saying requires background information that the novice lacks. It would also help the instructor understand the obstacles that students face on their learning journey and design into the course features that would anticipate and head off the causes of student failure.
My only question is whether this model works better with adult working students than with traditional students straight out of high school. Traditional students often go to college because it is expected of them; their parents, siblings, friends, and relatives all went to college, and so they do so without much thought. Adult students are more likely than traditional students to have a clear idea of their wants and needs, which makes it hard to use traditional student profiles to guide curriculum design. Nevertheless, the model provides an intriguing method to design a course from the student’s perspective.
Ní Shé, C., Farrell, O., Brunton, J., & Costello, E. (2022). Integrating design thinking into instructional design: The #OpenTeach case study. Australasian Journal of Educational Technology, 38(1), 33–52. https://doi.org/10.14742/ajet.6667