Post-It Power: Low-tech approaches to user co-design (and why they’re more advanced than the ones we tend to use!)

When I first dabbled in “user led design”, working with experts in the fields of Human Computer Interaction and Design Science, one of the most striking things at first was how low-tech it all is. They used exciting words like “future workshop” and “prototyping”, and then in reality we sat around a table with coloured pens and lots of post-it notes. I’ve noticed that this has become a standard shot of workshops, user-events and so on: the wall of colourful, scribbly post-it notes. But it’s simplicity is deceiving.

In full disclosure, here's one of mine - the "graffiti wall" from our Patient Hack day.

In full disclosure, here’s one of mine – the “graffiti wall” from our Patient Hack day.

When other researchers come to talk me about these new-fangled ‘user co-design techniques’ I’m interested in, I suspect they’re a bit…underwhelmed when I essentially tell them to grab some pens and some sticky notes and ask people to jot down what comes to mind.  I think, on the surface, it looks rather unsophisticated, and they were perhaps expecting something a bit more advanced. The irony though is that these are more advanced methods, if you consider our usual method is “You’re a patient – what do you think then?” or it’s even less engaging cousin “You’re a patient – this is ok, isn’t it?” It’s just that those methods can actually seem more proper or more official, because we give them the trappings of formality. We will ask those questions, which are on The Agenda, in The Meeting, of the patients who might be our Advisory Panel or our User Steering Group, and then we document their responses (“Er…yes?”) in The Minutes and in The Report.

The result: “We discussed the appropriateness and sensitivity of the assessments with the Patient Led User Steering Panel at the 2nd Project Review Formulation Meeting. The patient attendees agreed that the assessments were both feasible and acceptable for delivery with this patient group.” That sounds comfortingly official and important. But in reality, it could well have been “This is ok, isn’t it?”, followed by “Er…yes?”

Arguably, these formal trappings aren’t just a bit woeful at engaging patients though – they could actually be off-putting. The Meeting and The Minutes and everything else sounds proper to we academics, because that’s the language of our world. But for patients, it may be meaningless, annoying and exclusive.

Another benefit of those scrappy little post-its is that starting small ensures we start with ‘the basics’ – the nuggets of experience and emotion that are going to be important to the intervention. I think some researchers are a bit disappointed when I wave the post-it note pad rather than introduce them to some kind of template system for getting your patients to design a brand new intervention in one go. But, firstly, you shouldn’t be expecting your patients to know how to design the whole thing at all, let alone in one go, It’s “co-design”, not “get patients to do all the work for a free lunch”, and it requires expertise from both sides to produce something worthwhile (there is a great post here by Mark Brown about recognising the value but also the limits of these kind of consultations.) Secondly, this assumes a very straight forward route from “This is my experience” to “This is the product/intervention to meet my needs.” and assumes you can, or should, move rapidly from one to the other. If you really want to hear about the experience first, you need to provide time and space for this to happen – not jump straight into trying to design a solution.

This also exposes the other ‘advanced’ element of these processes, namely the need to carefully plan and structure them, to support your participants to express themselves, and to make clear the aims and outputs that are expected. Again, I suspect the formal meetings described above seem more structured, but actually to us academics they’re quite standard and comfortable, whereas these workshop events take much more thought and more sensitive facilitation.

Finally, the low-tech approach demonstrates that you are willing to make changes to the design. This is where a technique called ‘low-fidelity prototyping’ comes in, meaning ‘sketching out a design on a bit of a paper’ for people to look at and critique. The beauty of this is that it’s quick, you can easily share it (no-one has to log on to anything or commit to reading a huge chunky document), and the rough-and-ready nature means people feel comfortable to critique it and suggest changes. Present people with an already finished product, laminated and in colour and the result of hours of work, and they’re going to look for things they like about it, rather than say it needs to be changed.

via brewlife.com, an example of a lo-fidelity prototype of a website.

via brewlife.com, an example of a lo-fidelity prototype of a website.

If you’re interested in learning more about these kind of techniques, the wonderful Innovation Labs blog would be the ideal place to start. To start you off, try this list this accurately named list of the “10 Most Awesomely Useful” posts as curated by Joe Roberson.

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