Mike, I'm glad you didn't write off my critique as totally negative, but as often in design contexts (as always?) "it depends." There are contexts an evidence-based epistemology is necessary and expected. Much of my practice work involves services for clinical work and information support for clinical decision making, where the information user depends on high quality medical evidence. But even the clinical "user" makes judgments not ON the evidence but with support of the available and best studies.
Perhaps its only my reading of the evidence-based design literature - which has grown extensively - but its strongest applications entirely evidence-based, as a physician - as a practitioner - is not either. They are often patient-centered supported by evidence.
Diagnosis - in its advanced practice at least - is a sensemaking process, not a outcome of measures. A vast proportion of clinical assessment and treatment is based on field knowledge, retrospective understanding, heuristics that have conformed into guidelines. And there remains a lot of controversy in evidence-based medicine - the EBM movement has become tempered by the patient-centered movement. I think a third movement is emerging, systemic, integrative, and "designable."
Design methodologies are rooted in interpretive (e.g. qualitative) stances toward data collection and social betterment. Even sociotechnical research methodologies and cognitive engineering would not claim to be evidence-based schools. They are more than that, but they used mixed methods, mixed evidentiary forms.
Yes, there is an evidence-based design movement but I find it very method-driven and positivist, at least in its publications. The Roger Ulrich tradition of studying patient impacts of architecture and environments is very compelling. But I would not design care services in the same way. There's such complexity in social health, education, and clinical work practices that you would not want to "drive" decisions on dependent variables. Perhaps I'm boxing evidence-based design here, but if it is to be distinguished from other forms of design and social sciences research, we need to know its uses and boundaries.
I was trained as a scientist originally, but moved into design in practice and then PhD. As Nelson and Stolterman have made the case, design is a different "way" of human knowledge production, and is a valid knowledge system for formulating decisions and outcomes. There's certainly room in the design field for all types of methodological perspectives to form and yield results. And working in healthcare we are also bound to follow methodologies understood as valid in their (client's) worldview and even regulatory frameworks.
I'd also be interested in seeing cases or research from UC DAAP. I was a psychology undergrad at UC and have spoken at DAAP, know of Marybeth Privitera's excellent development of medical device design there. I am finishing my last chapter edits and can squeeze in a few references if they fit and I have time to read and contextualize another case study.
Best, Peter
Peter Jones, Ph.D.
Associate Professor, Faculty of Design
Sr. Fellow, Strategic Innovation Lab (sLab)
OCAD University
http://designdialogues.com
http://slab.ocad.ca
-----Original Message-----
From: Paul Mike Zender [mailto:[log in to unmask]]
Sent: Thursday, October 18, 2012 10:08 PM
Subject: Re: Health Information Design
Monica:
Peter's comment "encumbered by evidence-based research" sounds as though he sees this as is a negative, though I may understand him wrongly. Design is pathetically weak on evaluation of outcomes: hence the call for evidence-based design in Jorge Frascara's recent Visible Language article. (46.1/2) We wholly view the rigors of proving success as a positive for design. This is part of why we so substantially collaborate in design research with medical colleagues: their rigorous demand for evidence of outcomes. We love it.
I'll contact you off line with descriptions of some current medical research projects (I prefer medical because it is narrower than health) involving communication and related publications to see if they are of any interest to you.
Mike Zender
Mike Zender
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Professor, Director, Graduate Program in Design
University of Cincinnati
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5 1 3 556.1072
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