Designing Global Surgical Technology: Benefits of a Participatory Design Approach for the Surgeon

Designing Global Surgical Technology: Benefits of a Participatory Design Approach for the Surgeon

Tim Ho , Millie Marriot-Webb, William Bolton, Noel Aruparayil, Peter Culmer
University of Leeds, Leeds, United Kingdom

Introduction: Participatory Design (PD) is an approach to technology development that aims to improve outcomes through close and equal involvement of stakeholders in the development process. This approach is increasingly prevalent in medical technology development – particularly in Global Surgery and low-resource healthcare interventions, where understanding of the clinical context is vital to design. It has been argued that PD projects should prioritize participant outcomes alongside project objectives to ensure project longevity and success, yet there is a paucity of research regarding the impacts on clinical stakeholders, and how to optimise their collaboration. Better understanding of the benefits for clinical stakeholders will help facilitate these aims and promote better collaborations.

Methodology: Clinical stakeholders, involved in the development of the “RAIS” (Retractor for Abdominal Insufflation-less Surgery) device, were identified for interview. Semi-structured interviews were conducted with each participant to ascertain their personal motivations, experiences of multidisciplinary and international collaboration, and to explore any opportunities or skills that were developed. Personal frustrations and barriers to collaboration were identified and solutions to these concerns explored.

Results: Stakeholders unanimously prioritised clinical results over personal enrichment as the primary motivation for participation, though academic and career opportunities were recognised as key benefits. A non-hierarchical relationship between clinical and design teams allowed the clinicians to contribute and influence the design process to meet their specific needs as the device’s intended users. The geographical distance between teams and the lengthy design process were major sources of frustration. However, effective communication channels, and integration into design considerations, reduced miscommunication and enhanced contributions from the surgical team who were able to provide more detailed and valuable feedback.

Discussion: This study aims to catalyse further research to determine the ideal participant and project outcomes and the optimal approach to facilitate these. Key considerations for innovators considering using a PD approach include:
Project Conception:
1. Prioritize input from a variety of stakeholders based in LMIC’s in the initial design phase
2. Collaborate with local stakeholders throughout the design process to ensure continuity
3. Establish stakeholder-specific goals as part of the project’s objectives
Communication:
4. Communicate interactively to understand the context and form collaborative relationships with stakeholders
5. Espouse an ethos of equal stakeholdership to facilitate bi-directional information flow, encourage feedback and ensure participant motivations
6. Validate interventions with stakeholders in the contextual environment
Sustainability:
7. Support the development of innovation networks and capacities within LMIC’s
8. Empower stakeholders to innovate, collaborate and disseminate their knowledge
9. Employ formal PD frameworks to guide long-term and sustainable stakeholdership