October 2009

Prototype testing at a large scale requires a careful choice of words.

Let’s work backwards:
Implementation: contains the assumption that the set of concepts has been tested and proven and is worth committing to at full-scale.

Piloting: The set of concepts has been developed, tested in small parts, and is now ready to be tested at full scale.

Field Testing: The pieces are ready to be tested in context. Participants will use parts, some in combination, but the ideas are still being developed.

Prototype Testing: Each individual part will be developed, refined and used in small tests.

These are all terms that refer to testing ideas in context. There may be some usability testing, or other types of tests that happen before bringing the ideas into context.


There is a complexity to systemic design challenges that is becoming clearer to me as we move through the hands-on phase of prototyping in context with nurses. The experience I am leading in this project has many experiences nested inside it. And it is useful to imagine how this project might be different if we realized the nestedness of these experiences in planning the phases.

Most of our energy, and the weight of the work, has been on “transforming” the 4 new hires within the client’s innovation group. This is a huge learning experience for them, and we wanted them to feel inspired and in-control of what they were learning, constructing the experience themselves. Which has, actually, made their experience rather self-centered–which is a wonderful way to be for people who are learning.

But the experience that is nested within their experience, is that of participatory design. The fundamental belief of the innovation group is that the ideas are developed by, with and for the end-user, in our case: the nurses. Which is a very un-self-centered approach. Egoless, even. And I think that we didn’t move into that mode of thinking soon enough. Now it is difficult for the team to give up their own needs for the needs of the nurses, and they continue to have the attitude of learners, without having the service mentality that comes with consulting and developing alongside the hospitals.

And to go one last step further, the ultimate experience that is nested within that participatory design process is that of the nurse in his or her daily work. The nurses are participating in designing something that will soon become a process that they need to follow as a requirement of their job. Thank goodness they have a chance to influence it and have their voices heard. But it needs to be more than a fun and engaging process. It requires them to think critically about what they can change and what they can sustain in their work.

So it seems that each of these experiences needs it’s own ground-rules and structure. And in thinking about a next project, it would interesting to try to identify all of them up front, and perhaps begin with the central experience as the starting point. Rather than working from the outside-in, as we have for this project.