Author Archives: Åsa Cajander

About Åsa Cajander

Researcher in the area of Human Computer Interaction with research interest in eHealth, User Centred Design and HCI Education.

Tip of the Day: Putting your Research on Wikipedia

Last week I listened to a very interesting and inspiring talk by Olle Terenius on Wikipedia and outrearch. You can look at something similar online, found here.  The abstract of the talk was:

Wikipedia is at the core of knowledge transfer in contemporary society and one of the most efficient ways to communicate research to others. In order to keep Wikipedia relevant, as accurate and up to date as possible, it is important that researchers contribute in their field of expertise. In a world ripe with alternative facts, it is our job to stand up for transparency and the scientific method. Wikipedia also provides a place for your research and for you as a researcher where literally everyone looks.

I have edited Wikipedia some in the past, and this lecture gave me renewed inspiration to put a few hours adding references to research papers. Now you find 5-6 if my papers and some of my favourite research papers on Wikipedia. Perhaps you should try to make sure that your knowledge is found on Wikipedia too!?

Teaching a New Course: Complex IT Systems in Large Organizations

Next semester Diane Golay and I are teaching a new course called “Complex IT systems in Large Organisations” as a part of the IT, DV and STS programmes at Uppsala University. The majority of the students are from the IT programmes, and around 35 students have signed up to join this new course.

The course description is as follows:

Complexity problems that arise in large organizations where different user groups have different requirements. Development and implementation of IT solutions with multiple interoperable systems and management of the effects of prolonged continuous updates and maintenance of such systems.

The learning outcomes of the course are related to describing challenges and problems that arise in connection with the development and introduction of IT systems in large organizations, and methods to deal with these. Students should also be able to discuss advantages, disadvantages and applicability of a method in a specified problem situation. Moreover, they should be able to propose appropriate IT solution for a given problem situation and motivate and discuss the solution.

Last week we started off the work with the course and had a workshop with a few of our colleagues to get ideas for the set up. We have also booked meetings every other week the coming weeks to plan the course, so that we are prepared when it starts in week 12.

The course is indeed very close to many of the HTO research groups projects, and we will make use of our own research material as course material. We will probably also do interviews with people from industry as a part of the course. It will indeed be great fun to develop this course and the course content!

Students who are reading about this course are welcome to apply to it!

If you work with “Complex IT in Large Organisations” and would be OK with being interviewed about your job (on Skype or IRL) please send me or Diane Golay a mail!

Open Ended Group Projects – The IT in Society Course Setting Preparing Students for Working with the Complexities of IT

Software engineering is about creating IT systems that work well in their context of use. It is however, a well-known fact that the art of designing software is a wicked problem and that the work in the software engineering projects often is complex and multifaceted. Studies have shown that 50-70% of all systems development projects fail! Understanding the problem as such is very much a part of the problem solving, as for example Schön argues in his book about the Reflective Practitioner.

Even though this is the reality that students face when they start working, there is very little in the educational setting that supports them in handling this future situation with complex problems. We have therefore in our course developed the idea of exposing the students to a real problem, one that has no obvious solution and preferably encompassed aspects from many different areas. In short, an open-ended problem. The name of the course is “IT in Society”

The course setting that we developed includes students working in groups and where the problem they address is clearly impossible for one individual to deal with alone. Our involvement as educators is limited to being facilitators and coaches, and being there for discussions about the students’ progress, with an emphasis on scaffolding the quality of how they worked rather than focusing on how good the solution to the problem will be.

Another feature is that we accept that students assume different roles in the projects as long as there was a real collaboration in a group, and that we work to build a good community of practice in the project through the reflections and discussions that we have with the students. We have named this new arena for learning Open-Ended Group Projects (OEGP). For further reading on how the theories of learning are applied in OEGP see the journal paper “On valuing peers: theories of learning and intercultural competence”.

 

On Learning of Supervision Skills

I constantly improve my supervisions skills through experience and reflection, and this blog post will be about how I work with improving in this area. Being a good supervisor is not easy, but I do try to be a supportive and coaching supervisor helping students. In a way it is like playing chess to be a supervisor. You always need to think and learn from the new situations that occur.

Participating in Leadership Courses. One way of improving is also through participating in different leadership courses, as supervision and leadership are closely connected.

Discuss Supervision with a Coach. At Uppsala University, you also have the possibility to meet and discuss with a coach, Rabbe Hedengren, which is such a nice learning opportunity.

Book Circle on Leadership. I also very much enjoy reading about leadership, and I meet and discuss leadership books with a group of leaders around once a year. Recently I read: ”Innan floden tar oss” by Helena Thorfinn and we are going to discuss it in relation to leadership and our view of being leaders.

Listen to Pod Casts. I also listen to pod casts on leadership, academia and positive psychology that motivate me to reflect and improve. Some of the pod casts I really like are:

Mentoring other Other Supervisors. One way of learning and improving supervision skills is to talk to other supervisors about it. Since 2011 I am a member of the network of experienced PhD supervisors at Uppsala University. This means that I have the opportunity to discuss supervision of PhD students with colleagues taking the “supervision of PhD students course” two or three times every semester. The visits have three steps:

1) We meet and discuss the supervision situation before a supervision meeting during approximatively one hour.

2) They auscultate a supervision meeting during 1-2 hours.

3) We discuss what happened during the meeting. Often these visits result in new ideas and reflections on improvements of my supervision skills, and they are as much a learning opportunity for me as for the person visiting me.

Writing about Learning of Supervision Skills. Other ways of learning is of course writing! In 2016, I wrote a journal paper on inclusive supervision skills together with Ulrike Schnaas where we elaborate on collegial learning.

Organizing Workshops on Supervision. We also organized a workshop on inclusive supervision skills at the Network and Development Educational Conference (NU in Swedish) conference. The workshop was a success and included a role play and many good discussions on supervision. Such an interesting learning experience!!

Participating in Conferences on Supervision. I also participated in the conference European University Association (EUA-CDE) on the theme “The Future of Doctoral Education” in Delft, 2015 where I presented work on supervision and discussed it with experienced supervisors from around the globe.

Reflection. Most of all I try to give myself time to reflect on what I am doing at work. I am a dedicated believer in Shöön’s The reflective practitioner, and that reflection is key to learning.

My View of Supervision

My philosophy regarding supervision is to coach depending on background, motivation, and current situation of the person, and to come up with a joint model about how to go forward. This way of thinking is inspired by Vygotsky´s zone of proximal development. I also actively seek to use a situated view of leadership and try to see my students as individuals, and adapt my leadership based on the personal characteristics of the student, knowledge, situation and context. When problems occur, I try to discuss them with the student as soon as possible to collaborately find a good solution.

I often use strategies borrowed from the area of coaching in my supervision (I have been a coach as a part of my research projects, see Cajander et al 2010). As a part of this I avoid coming up with advice such as “you should now do XY & Z”, but rather try to coach the student to come up with their own solutions. I am completely convinced that I cannot know what would be the best solution or approach for them since research is complex, and I never have the full picture like they do. However, there are situations related to the research quality, for example, where the supervisors might indeed know possible ways forward that are unknown to the PhD or master student. Such areas might for example include where to find relevant literature or where to publish. Finally, my supervision is based on the growth mindset which is shortly described as “I/you don’t know this YET”, and I often talk about this mindset in relation to grit with my PhD students.

Master and bachelor students doing their thesis work in connection to my research are invited to participate in research projects, and are included in the conferences arranged etc. if they want to. I think that it is an important learning experience to be a part of the team in the project. Some of the students have indeed done wonderful work that has resulted in publications such as for example:

Other students have also won awards for being the best students, such as Viktor Kjellman and Johan Andersson and their master thesis on “Patient Empowerment and User Experience in eHealth Services: A Design-Oriented Study of eHealth Services in Uppsala” as in the blog post picture!

 

Why are Ambient Assisted Living Technologies so Difficult to Develop?

I was appointed as one of the external reviewer of Jean Hallewell Haslwanter´s PhD dissertation with the title “User-Centered Development of Sensor-based Systems for Older People”. I must say that this was indeed an interesting thesis to read and I strongly recommend it for anyone who is interested in healthcare technology and user-centered design.

Ambient Assisted Living (AAL) is a technology that has been proposed to help society with problems related to an ageing population, as it could support older people to live at home instead of moving into elderly homes. However, despite the fact that many IT projects and companies have been working with the development of this technology, and large amounts have been invested in AAL, few such technologies has reached the market. In her thesis, Jean Hallewell Haslwanter addresses the issue from a user-centered design perspective and her work aims at understanding why AAL technologies have proven so difficult to develop.

The thesis has a substantial empirical contribution as it studies the development of AAL systems. One interesting finding is that the complex and multifaceted descriptions of the users fade away as the project continues, and is replaced by stereotypes of older people. Other contributions include recommendations for practitioners working with development of AAL technology.

Jean Hallewell Haslwanter’s dissertation is a monograph, but she has 13 research papers that are previously published. Many of the papers are conference papers, of which many appear in highly ranked international conferences. There are also conference papers that have been turned into journal papers. If you are interested you can find these publications online at the link.

New Study : Managers and the Implementation of Medical Records Online

I am about to start a new study on the implementation of medical records online in different counties and regions in Sweden. This study is supported by INERA which is the coordinating organisation for you health services nationally in Sweden. It is also partly funded by my work in the NordWIT Centre.  The study is multidisciplinary, and there will be researchers coming from gender studies, medical Informatics and human computer interaction collaborating in the analyses and writing up of the data.

Next week I will do my first interviews, and later on we will distribute a survey to all regions and counties in Sweden. This study will focus on the implementation process and what happened in different parts of the country. The study will also focus on the experiences and careers of the managers and leaders who works with this.

The launch of medical records online for patients was indeed controversial in Sweden. Many physicians and nurses were worried that patients would read and become upset and anxious. Other concerns related to the work environment in healthcare, and the increased need of support from patients who might read their medical directors and be worried. At the same time many patients appreciated the system, and today the system is used by more than 1 million people in Sweden.

Sweden consist of autonomous County council and Regions when it comes to IT and eHealth. This means that they all individually decided what to show to patients, when to show it and also what not to show. In our study we will be investigating this process and what happened.

I am so thrilled about doing a study on my own again! Lately I’ve been supporting others very much, but now it’s finally my turn to do it myself again!

I will surely blog more about this in the future 🙂

Please Do Not Confuse Your Google Search With My Medical Degree – How Accessing Electronic Health Records (EHRs) and Online Searches can Support Information Needs and Increase Understanding for Patients and Relatives

Is there a power struggle in health care related to knowdledge? Yesterday I saw the below Tweet related to patient knowledge and medical knowledge. In the Tweet someone writes “Please do not confuse your 20 m of covering my disease at med school with my 5 year of living with it 24/7/365 and reading the literature”. Patients feel as if medical professionals do not listen to their stories.

Twitter medical records .png

My guess that this is a response to the medical professionals “Please do not confuse your Google search with my medical degree”. Here physchians feel that patients do not respect their medical knowledge. This view that Google might make us believe we understand more than we do has some evidence in science, as is for example discussed in an episode of the pod cast You are not so smart:

What effect does Google have on your brain? Here’s an even weirder question: what effect does knowing that you have access to Google have on your brain?

In this episode we explore what happens when a human mind becomes aware that it can instantly, on-command, at any time, search for the answer to any question, and then, most of time, find it.

According to researcher Matthew Fisher, one of the strange side effects is an inflated sense of internal knowledge. In other words, as we use search engines, over time we grow to mistakenly believe we know more than we actually do even when we no longer have access to the internet.

These two perspectives are indeed interesting to talk about, and one can wonder where they come from? There seems to be an ongoing power struggle in health care related to knowledge, and both patients and physicians feel as if the other party don’t really listen or understand.

In the middle of this power struggle the system Journalen where patients can read their medical recors was launched.  And of course we discuss mutual learning, and patient participation a lot in relation to DOME research.

I believe that the power struggle in health care is a no win situation. Most would agree that it is much better to aim at understanding and mutual learning.

Last year we also wrote a workshop paper with the title: “Please Do Not Confuse Your Google Search With My Medical Degree – How Accessing Electronic Health Records (EHRs) and Online Searches can Support Information Needs and Increase Understanding for Patients and Relatives”

The abstract for the paper is presented below, and the full paper is found on research gate: 

Patients’ use of eHealth services and other online sources to identify medical information has become increasingly popular. For many patients the Web is an important source where they can find information and advice about symptoms and treatments. The majority of patients sees the information on the Web as reliable and uses it to influence their healthcare. Healthcare professionals on the other hand remain skeptical about the advantages of the Web as a source of medical information for the layperson. Physicians have raised concerns about patients using online sources to find information about their health as they can misinterpret or misuse information. This can occur because patients may have inadequate health literacy and eHealth literacy or are not able to distinguish accurate from inaccurate sources. The aim of this position paper is to outline a critical incident that illustrates the patient perspective of searching medical information online in relation to the eHealth service Journalen where patients and relatives in Sweden can access their electronic health record online. The critical incident is based on a true story and describes how Steve received his cancer diagnosis, and how his wife Tina sought information on the Web to learn more about his condition. The case illustrates how reading the electronic health record and looking online for further information can improve patients’ understanding of their medical condition and empower them to make health decisions.

Flipped Gender Equality Coffee Discussion Based on TED talk

 

As you might know the flipped classroom is a phenomenon in teaching and learning. Some even present it as the silver bullet of all the problems we have in Higher Education.

At my department which we though that we’d try concept at our gender equality coffee break discussion (in Swedish fika) next week. It will be “a flipped gender equality fika”.

The plan is to watch this TED talk before the fika and discuss it during the fika:

https://www.youtube.com/watch?v=12t7PYilNQQ

The idea of the TED talk came up at our last meeting in the gender equality group, and one of the participants found this TED talk.

Here are two questions that we will discuss at the fika: 

– How can we (as a society) make such a creative idea work?
– What are the challenges for the parents and for the child?

As usual the fika is open to anyone at the Department of Information Technology.  We’ll see how many show up.

Perhaps this is an idea that you could copy in your organisation?

 

Radio Interview on Medical Records Online

I was interviewed on the P4 Västmanland radio the other day. The reporter was interested in patients reading their medical records online, and the research in the DOME consortium, and asked me questions such as:

  • Do patients contact health care with more questions?
  • What does reserarch say about getting cancer results, or other negative results from Journalen?

You find the interview 8 min into this radio program