I have been enjoying the Brain Culture: Neuroscience & Society series via BBC Radio 4’s podcasts recently. In the series Matthew Taylor looks at how developments in neuroscience are changing the way we think about everything from law and punishment to education and marketing. As a fan of Raymond Tallis’s writing, who is somewhat of a neuroscience sceptic, I found Taylor’s account pretty balanced, but not without asking some provocative questions.
The last episode looked at the use of neuroscience with regards to behaviour change, perhaps most famous through the Nudge concept favoured by the previous and present UK governments. Its also something that has gained some attention in service design and public policy/social design fields as a potential tool for designing for behavioural change.
The theory is essentially that by bypassing our brains’ rational level, we can be nudged into changing our behaviour on the semi-unconscious level, because our brains frequently make decisions before we are rationally conscious of them. This is put into practice in political environments, such as election campaigns, policy and public service systems (as in the case of using it for preventing no-shows to doctor’s appointments) or in the slightly scary sounding field of neuromarketing. On the one hand the practice appears extremely devious and devalues our sense of self and of being rational beings because it denies us the possibility of changing out nature (Tallis’s argument). On the other hand, neuromarketers claim that these techniques are no different from anyone who has baked bread or made fresh coffee in order to sell their house during viewings.
Science was built on the foundation of rational thought. Until recently economics and business thinking was also based on this rationale, much of it still is. The irony of the new discoveries in neuroscience, it seems to me, is that rational science is essentially getting excited about something designers and many others have know all along. People aren’t rational and make decisions – from financial investments to buying a car to getting married – based on their gut feelings, which they mostly post-rationalise afterwards. It’s also why we are so naturally rubbish at understanding statistics and probabilities. Science has taken several decades to rationally prove that we are irrational.
Seth Godin has written an interesting observation about a common experience of hospitals in a piece titled Pre-Digital:
A brief visit to the emergency room last month reminded me of what an organization that’s pre-digital is like. Six people doing bureaucratic tasks and screening that are artifacts of a paper universe, all in the service of one doctor (and the need to get paid and not get sued). A 90-minute experience so we could see a doctor for ninety seconds.
Wasteful and even dangerous.
He goes on to imagine what the experience would be like if everything were digitised. Everyone would know what’s going on without having to ask ten times, basically. “The entire process might take ten minutes, with a far better outcome,” he suggests.
I like a lot of what Seth has to say, but on this its worth really asking if it would be the picture he imagines. Given the UK’s £11bn pretty useless attempt at this, I’m not so sure. Sure, a well-conceived and integrated digital patient system would seem like a dream, but large, government I.T. projects are never well-conceived and integrated. They are mired in over-wrought requirements documents that are miles away from actual human needs, frequently taken on by companies that under quote to get the job and then blow out the budget and schedule later. The UK NHS project also ended up in a nightmare of privacy issues.
What Seth is arguing for here is really the classic “we need more technology to solve this problem” approach. It’s something that has served him well with many of his projects, like The Domino Project and it’s particularly an American approach to the use of technology. But the technological solution he describes masks the real need. The need is for a well-conceived and integrated system of communication and a quicker journey through the hospital system (a need and an organisation which, in turn, have their own underlying needs). It seems likely that digital tools and networks would play a part in this, but it’s by no means a given.
Had I not have had my own copy of an X-Ray (okay it was on my iPad) at the hospital recently, we wouldn’t have been able to access the one the specialist gave us (in a proprietary format) on CD because the hospital’s radiology computer had crashed and they had to wait two hours for the I.T. guy to come and fix it.
Sometimes a whiteboard is the most efficient or usable way to display who is on duty or who is to be operated upon. It doesn’t flake out due to a system error, doesn’t go down when power fails and requires active effort to delete and change a name, not a typo or entry in the wrong field.
They are tools only. The question to ask when considering what the best drill is should really be, “how can we make holes?” or even “do we need holes here?”
Mads Soegaard and his wife Rikke Friis Dam have been hard at work over at their Interaction-Design.org site, a free and well put together resource of educational materials about interaction design. The whole site is set up as an encyclopedia with tightly focused articles that have expert commentary underneath and often plenty of video interview material. It’s also been formatted for print/PDF export as well as iPad/iPhone reading. A lot of effort has gone into the site (read the history of it) and it is well worth regularly visiting – the main encyclopedia page already has plenty of useful chapters.
Mads has pre-released some new material on End User Development, “a set of methods, techniques and tools that allow users of software systems, who are acting as non-professional software developers, at some point to create, modify, or extend a software artifact” (Lieberman et al 2006). The intro video is below, which gives some definitions:
While the focus of this tends to be on software, I think there are also some lessons to be learned in terms of service designers delivering tools and skills to organizations they are working for, who in turn can further develop according to their needs themselves. On the one hand, it feels like we’re almost putting ourselves out of business – the old teach a man to fish idea. But I think there are plenty of smaller situations in which organizations do well working internally and pull in outside expertise when they feel they need the external input or a deeper knowledge of a process. It’s much like the difference between basic car maintenance and hiring a mechanic. The added benefit is that organizations are much more receptive to your processes and interventions when they have already taken on the mindset themselves.