Along with a poster presentation of work in progress at the EC-TEL conference in September, two Personas were created. Personas, in general, are developed personalities which describe specific demands, goals and characteristics of the targeted user group regarding their future system usage and are useful to support the system designers in achieving a unified feel for the potential end users. A Persona is defined as a precise description of such a user’s characteristics and what he or she wants to accomplish with the upcoming system. Therefore the presented Personas also aim at assisting the LL designers at developing the project’s learning solution, where character traits, work-related features or even technological affinity of the AP’s key informants are described and supported by quotes from the focus group interview transcripts.
Persona “Natasha” – The Information Hub
Natasha holds a degree in nursing and she also has received advanced training as nurse specialist in diabetes. She has worked for 30 years in the domain of diabetes and she also trains other nurses. “Natasha’s motto is “Never stop your professional development (learning).”
She is a senior practice nurse with a longstanding experience both in the field of diabetes as well as in the practice she is currently employed. She works closely with other nurses and acts in a coordinating role. She introduces new nurses and is the main contact person in case of questions. “I started working at this practice and since about 1998 in diabetes. I also do some teaching in diabetes.” Natasha mainly works in the practice. However, she also makes home visits to patients needing a special treatment or works alongside junior nurses. “Our practice is just one location.”
Natasha continuously has to acquire new knowledge, especially about new medications and new therapy guidelines. As she acts as a kind of knowledge hub for her organization Natasha has a special interest for background knowledge or further readings. “Your own personal reflection plays a part after the talk. And I think they do, email the presentation to everyone afterwards as well.” She is the first contact person for questions and hence she is confronted with non-routine cases in particular. These cases are triggers for learning to solve a concrete problem in many cases.
Her role requires a wide variety of knowledge about medications and therapy guidelines. She has in-depth knowledge in the domain of diabetes, which allows thorough conversations with a range of experts including general practitioners. Her past experience on how to proceed in difficult cases and how to diverge from standard routines if necessary is exceptional. “So you are looking at well what would be the best outcome for the patient … (…) but the same time you are aware of clinically of all the facts that are influencing and coming in as well.”
Due to her long work experience in the practice she also knows most of the pa-tients and their ailments. She also has a sound knowledge about other nurses in the district and their skills.“…cause the patient obviously needs to know… but also the team, because you need to all be singing from the same hymn sheet to say to him why you’re changing something or not changing something.” Natasha primarily uses Personal Information Management (PIM) elements, like E-Mail, contact information or calendar entries. “If we had to pass anything on we’d do it by email [NHS Intranet].” Moreover, newsletter, presentations or articles from medical journals are important.
She cares a lot for patients, takes on a patient-centric view. There’s nearly nothing she hasn’t come across. Hence, she is able to solve most of their problems based on her rich experience and knowledge. “I think often we look at what would be the best out-come for that patient? I think that’s where it ultimately ends as well. So you are looking at well what would be the best outcome for the patient. ”If Natasha comes across something fairly straightforward but outside her experience and needs information to solve it, her first approach is often to search the internet. “Sometimes I really go and just look at google if I am answering a patient’s query. So if they say, tell me the best way to get some vitamin C in a diet, something like that. I look it up and do some googling.” However, for more complex issues or cases where she is unable to quickly find information online then she would usually discuss this with a colleague (or someone from her personal network) and this discussion will often be face to face. “The thing you don’t get [using electronic communication] is that softer stuff … When somebody comes in and presents a patient, talks about a patient they know often whether that patient is gonna accept, what type of treatment they’ll accept, what type of person they are in terms of relationship, how compliant they are likely to be.”
Important tools Natasha uses in her daily working life are the patient record sys-tem, standard office software including email, PIM, instant messaging and the inter-net. Natasha is a mature authority and the major informant for all nurses in her practice but also for other nurses who have participated in her courses. Natasha has a pro-found knowledge and she likes to help other people. She is the one whom you would ask in case you run into a special case. “I would pass it [new information] to Natasha. So she would know the people who to involve and in all fairness I wouldn’t.” She also acts as a filter to manage the amount of information and ensure relevancy for her col-leagues. “The challenge within it is to not overload people who have not got a diabetes hat on in the practice. But also to try to keep them up to date”
She is keenly aware of the dangers of automatically sharing information without good cause. „I think it is important not to disseminate every piece of learning as well, because if it gets lost among the sea of emails and 90% of my emails are useless that I get.” Natasha has a good network and intensively maintains relationships to other people. “We attend a lot [of events]… and we get information and we try to share it amongst the team.“ She is known beyond the practice and respected as very reliable and wise woman. She has a comprehensive picture of ongoing activities in the field of diabetes and is constantly well informed. Natasha is highly motivated and she likes her tasks, her job and her colleagues. Several of her personal interests overlap with her job tasks and thus she is very interested in her work. She meets many colleagues in her leisure time and she acts as an opinion leader. Natasha is interested in the new technology, especially if she can use it to manage the constantly incoming information flow, and then help with the subsequent tailoring and dissemination to others.
Persona “George” – The Mature Authority
George holds a degree in medicine. He has performed the special trainings to be-come a GP and has worked for 20 years as GP. Additionally, he has a special interest and several trainings in the domain of diabetes. “I’m a GP partner here and have been working in diabetes for about twenty-five years. And I also led the redesign of the diabetes services which brought in the level one, two, level three configuration.” His motto is “don’t waste time, keep things in motion.”
George has an own office as GP partner he mainly uses for his paperwork. He uses the shared surgery rooms in the practice for appointments with patients. These work-places are equipped with all necessary medical equipment and one fixed computer. The rooms are assigned to GP´s for one surgery session only. Each GP has a mobile box for carrying the personal belongings to the surgery room. Consequently, the surgery room contains no personal equipment.
He usually gets triggers for learning during his consultation hours. New aspects of a treatment arise and he makes a note for an investigation later on. Due to the fact that a consultation session is tightly scheduled he has no time for an investigation during the consultation. Additionally, George checks the newsletters from the NHS and the Royal College of General Practitioners for new treatments and guidelines. “You cover out for example keep an eye on the BMJ, keep an eye on the NICE Guide and seeing what comes through on emails and if it hasn’t come across my radar I tend to dismiss it.” He also attends formal training, which facilitates meeting and networking with colleagues. George regularly reflects on his learning and a record of these reflections is required for his annual appraisal and the 5-year revalidation. George has deep medical knowledge and a rich stock of practical experience. He assesses formal documents or guidelines available on official webpages of the NHS or medical journals. Further he has a special interest in publications of medical journals and the newsletters from the Royal College of General Practitioners. Personal information management elements, like E-Mail, contact information or calendar entries are recognized as potentially problematic. “And then the way it seems to default to an email, which I like for randomness of the emails at the bottom where some read them and understood them, some read them and half looked at them and some just ignored them and delete.”
If George has a problem requiring external knowledge this is a unique case. First he is seeking for information and looks up the latest advice on the NICE website and searches for new publications in journals. After he found initial ideas George mostly asks one of his partners or other senior GP´s for their opinion. After having collected several opinions he makes a decision and finally asks other experienced colleagues for validation which makes him feel better about a decision. “If we saw a patient and I am thinking this is an interesting one. Where do we go next? I might decide to say, ok, I’ll task one my colleagues in the clinic. And say please look at these records and what are your thoughts on this. And then wait for response back and I take it up from there. Or in terms of a hospital consultant we might say, please can you look at these notes. I want to be sure what is the next. Can I get a response back about that.”
George is a very experienced GP with a high reputation in the community, and can be characterised as a busy expert. Hence, junior GP´s or nurses reprieve him with simple and trivial questions. Only if they consider a problem really unique and other persons asked for advice couldn’t give satisfying answers, they would ask him. “…you don’t get that softer stuff…” However, other senior GP´s or other partners contact him frequently. George then likes to discuss all facets of the problem and to balance every detail. He also contacts other experts from his network for further discussion. Overall, he is a very profound and constructive discussion partner if the problem is challenging for him. “…particularly those that are running a clinic elsewhere would task in, give a precise of the history and why they thought it was useful to use that in this case. And then I would review the record and say, yes, makes sense or probably need to see them or have you thought about this or this. That happens on a regular basis. On weekly basis I will certainly be receiving communications from specialist nurses and giving advice.”
He is a senior authority in the practice and he attaches importance that the hierarchy is maintained. Hence, he wants his communication filtered and prepared for him. “I think it is important not to disseminate every piece of learning as well, because if it gets lost among the sea of emails” He wants to spend his time as efficient as possible and avoid conversations and work which can be done by lower hierarchy staff. The most important tools he uses in his working life are office software and personal in-formation management (PIM). George finds it hard to decide to whom to cascade information and whom not to include – typically he reuses existing lists of employees or whoever he can instantly remember. “…most people decide who is on the email list by either what was on the previous email list or who they can remember. So this goes on in the new email list and you remember six or eight people and put a default or disseminate to someone else if I missed them.”
George has a high professional motivation arising from his responsibility for his job. He also wants to maintain his high reputation and has a very high responsibility for his patients. “We tend to try and coordinate our approach and then deliver it to patients.” Prestige is very important for George and hence he is always equipped with the newest stylish end user electronics. He is the first in the practice with an iPhone or an iPad. He also likes to experiment with different apps and programs to demonstrate his innovativeness. However, the design of the interface and the usability is very important for his acceptance and adoption.