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Co-designing tourism experience systems: A living lab experiment in reflexivity.

Stakeholders must purposely reflect on the suitability of process models for designing tourism experience systems. Specific characteristics of these models relate to developing tourism experience systems as integral parts of wider socio-technical systems. Choices made in crafting such models need to address three reflexivity mechanisms: problem, stakeholder and method definition. We systematically evaluate application of these mechanisms in a living lab experiment, by developing evaluation episodes using the framework for evaluation in design science research. We outline (i) the development of these evaluation episodes and (ii) how executing them influenced the process and outcomes of co-crafting the process model. We highlight both the benefits of and an approach to incorporate reflexivity in developing process models for designing tourism experience systems.

Self-reflexive video games as playable critical thought

PhotoReflexivity

This paper describes the development and results of the pedagogical photo-based method PhotoReflexivity. This method is designed to support reflexivity for students in design education, which guides them in better understanding and situating themselves in the outside world. To uncover the value of this method, mixed research methods including iterative prototypes were deployed in real-world learning scenarios with design students. Attitudes, behaviour, and reflexive conversations were analysed, from which design patterns and recommendations were derived. It is argued that PhotoReflexivity fills a gap in design education by aiming for extensive and transformational outcomes associated with reflexivity, which previous research has considered hard to achieve. It does so by providing pragmatic technologies and materials to support 1) sharing and collaboration, and 2) verbalising reflexive thoughts. By facilitating reflexivity, students might become more autonomous and responsible design professionals.

Games on Games. Game Design as Critical Reflexive Practice.

Perspectives on goal setting: Video-reflexive ethnography with speech–language therapists and clients

Background: Goal setting is an essential step in the clinical reasoning process of speech and language therapists (SLTs) who provide care for children, adolescents and adults with communication disorders. In the light of person-centred care, shared or collaborative goal setting between the SLT and client is advised in (inter)national guidelines. SLTs face challenges in implementing (shared) goal setting as theoretical frameworks and practical interventions are scarce and less applicable to use with a wide range of communication vulnerable populations. Aims: A first step in developing theory and practical interventions is to explore first-hand experiences of SLTs and clients about day-to-day goal-setting practice. This study was guided by the following research question:What are the perspectives and needs of SLTs and persons with communication disorders regarding (shared) goal setting in routine SLT services? Methods & Procedures: The qualitative study was carried out in the setting of routine speech–language therapy services in community practices, primary education and neurological rehabilitation in the Netherlands. Data collection followed the principles of video-reflexive ethnography, using video footage of goal-setting conversations to facilitate semi-structured, reflexive interviews.Data analysis was based on reflexive thematic analysis. A total of 12 interviews were conducted with client–SLT dyads, covering perspectives from children, parents and adults with a range of communication difficulties and their SLTs. Outcomes & Results: Data analysis resulted in four themes, of which two contain subthemes. Each theme represents a central organizing concept found in SLT and client interviews. The themes were identified as: (1) goal setting is a complex process; (2) goal talk needs to be communication accessible; (3) communicative participation goals are hard to grasp; and (4) the importance of relationships. Topics such as power imbalance, communication vulnerability, effective communication strategies, and motivation and trust are explored under these themes. Conclusions & Implications: SLTs are encouraged to view shared goal setting as a process that needs to be explicitly planned and communicated with clients regardless of their age or communication vulnerability. SLTs have expert knowledge and skills when it comes to supporting communication and applying these skills during goal talks might strengthen shared goal setting and foster a therapeutic relationship. There is a need to concretely conceptualize and embed shared goal setting in policy and clinical guidelines. The themes reported have tentative clinical implications for developing such policy, and shared goal-setting interventions for SLT practice, under the condition that SLTs and people with communication disorders are continuously involved.

The paradoxes of communication and collaboration in maternity care

Background: Research on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders – parents – as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, we examined their interactions in the clinic, looking for “good practice”. Methods: We used the video-reflexive ethnographic method in 9 midwifery practices and 2 obstetric units. Findings: We conducted 16 meetings where participants reflected on video recordings of their clinical interactions. We found that informal strategies facilitate communication and collaboration: “talk work” – small talk and humour – and “work beyond words” – familiarity, use of sight, touch, sound, and non-verbal gestures. When using these strategies, participants noted that it is important to be sensitive to context, to the values and feelings of others, and to the timing of care. Our analysis of their ways of being sensitive shows that good communication and collaboration involves “paradoxical care”, e.g., concurrent acts of “regulated spontaneity” and “informal formalities”. Discussion: Acknowledging and reinforcing paradoxical care skills will help caregivers develop the competencies needed to address the changing demands of health care. The video-reflexive ethnographic method offers an innovative approach to studying everyday work, focusing on informal and implicit aspects of practice and providing a bottom up approach, integrating researchers, professionals and parents. Conclusion: Good communication and collaboration in maternity care involves “paradoxical care” requiring social sensitivity and self-reflection, skills that should be included as part of professional training.