=Paper=
{{Paper
|id=None
|storemode=property
|title=Motivation and User Acceptance of Using Physiological Data to Support Individual Reflection
|pdfUrl=https://ceur-ws.org/Vol-957/matel11_submission_5.pdf
|volume=Vol-957
}}
==Motivation and User Acceptance of Using Physiological Data to Support Individual Reflection==
https://ceur-ws.org/Vol-957/matel11_submission_5.pdf
Motivation and User Acceptance of Using
Physiological Data to Support Individual
Reflection
Angela Fessl1 , Verónica Rivera-Pelayo2 , Lars Müller2 , Viktoria Pammer1 , and
Stefanie Lindstaedt1
1
Know-Center, Graz, Austria
2
FZI Research Center of Information Technologies, Karlsruhe, Germany
Abstract. While research comes up with new sensors and physiological
data is gaining more attention in private usage, sensors play no role in
professional learning. In this paper we shed light on the motivation to
use physiological sensors in the workplace. Three user studies have been
conducted in five companies to assess the motivation to (a) wear sensors
and (b) reflect on physiological data during work. Based on these studies,
we show that workers would be willing to use physiological sensors, but
the benefit of the awareness about the own physiological state is often
not clear or the usability of sensors is insufficient. Moreover, in stress
prone professions like emergency care there are already successful coping
strategies in place. Introducing physiological sensors has to provide clear
benefits by offering solutions to act on this awareness and focus on the
practicability of the sensors.
1 Introduction
The increasing number of applications [1, 14, 2] and research projects [7, 10] re-
flect that the interest in physiological data and awareness of the own body is
growing. There is now a wide variety of sensors capturing several physiological
signals e.g. electrocardiogram (ECG) [3], Electro-dermal Activity (EDA) [13] or
brain activity [5], but the majority of sensors are still limited to the use in a lab
and they have not yet been used in professional training or learning practices
in work environments. The absence of physiological data in this area is striking,
since professional training could benefit from raising the awareness of the own
physiological state. By providing data about e.g. their stress level to employees,
we want to trigger reflection processes, as described by Boud et al. in [9]. Em-
ployees could re-evaluate their experiences and relate them to their stress level.
We expect such learning by reflection about physiological data to have a strong
potential towards objectifying the assessment of (individual or organisational)
measures to increase work-life balance, as well as towards providing objective
data for analyzing the impact of workers’ physical well-being on work results.
Within this paper, we focus on the motivation and user acceptance of physiolog-
ical sensors in work environments and designed our user studies to answer the
following research questions:
1. Would potential users actually wear (=use) physiological sensors at work?
2. Do potential users see a benefit in analyzing physiological data?
Note that this paper integrates results that were reported in two separate
project deliverables of the MIRROR project ([11, 12]) and provides an additional
discussion that became possible through this integration.
2 Scope of Application
Five European companies in different sizes, from different sectors and countries
have been chosen to analyze the acceptance of physiological sensors at the work-
place. This wide selection of companies should help us to generalize our findings.
NBN The Neurologische Klinik Bad Neustadt (NBN) in Germany, deals with
neurological emergencies especially with the treatment of strokes. The target
group in the below-described studies are 70 staff members including physi-
cians, nurses and therapists.
RNHA The Registered Nursing Home Association (RNHA) is a group of reg-
istered nursing homes in the UK. The residents are elderly people, many
of them suffering from dementia. The target group in the below-described
studies are approximately 280 carers and nurses working at two elderly homes
of RNHA.
REG Regola (REG) is an Italian software company that provides IT solutions
for the health and emergency management sector. The target group in the
below-described studies are 17 employees of REG.
BT The British Telecom (BT) center in the Netherlands has 1500 large and
customized contracts that are managed by contract teams. The target group
in the below-described studies are 7 members of these contract teams.
INFOM The Infoman AG (INFOM) is a german IT consulting company with
the objective to analyse and optimise the marketing, sales and service pro-
cesses of their customers. The target group in the below-described studies
are 6 consultants and 4 sales persons working at Infoman.
3 Method and Samples
Our research followed a three step approach. In a first step, a questionnaire was
distributed in all testbeds, i.e. all the companies, to collect the specific attitude
towards the use of physiological sensors. In a second step, we equipped nurses and
physician of one testbed with sensors and interviewed them afterwards. Finally,
the results and the specific use of this data for reflection was discussed in three
focus groups.
3.1 Questionnaire
Method The general acceptance of sensors was evaluated in all testbeds. All
questions could be answered on a 5 point Likert-type scale (strongly disagree,
disagree, neutral, agree, strongly agree). A questionnaire with the following ques-
tions was sent to all members of the target group in four testbeds: (1) I would
be willing to wear sensors for a certain time. (2) I would wear such sensors only
if it was mandatory. (3) Wearing such sensors would be uncomfortable in my
job. (4) I would wear sensors if they help me with my daily work. (5) I would
wear sensors if they help others at work.
A shorter questionnaire with easier language was used for RNHA, due to the
specific nature of RNHA - mainly a lower level of education and concerns about
the level of literacy. The modifications were well received by the testbed and
likely lead to an increased response rate. Employees were asked (a) if they are
used to wear physiological sensors (e.g., to measure pulse, heart rate), e.g., as
bracelets or chest belts and (b) if they would like to wear physiological sensors
(e.g., to measure pulse, heart rate), e.g., as bracelets or chest belts.
Sample The longer questionnaire was sent to NBN (38 returned question-
naires), REG (13 returned questionnaires), BT (5 returned questionnaires) and
INFOM (3 returned questionnaires). The shorter questionnaire was sent to RNHA
(71 returned questionnaires).
3.2 User Study on Wearing Physiological Sensors during Work
Method This user study was composed of two phases. During the first four days,
the nurses and physicians were equipped with a physiological sensor. After one
week of data analysis, individual follow-up interviews were scheduled with the
participants. The selected sensor was the ambulatory measurement system from
Movisens [3], which consists of a breast belt and a small sensor that captures
four different measures: a single channel ECG, the acceleration of the sensor in
3 dimensions, temperature and air pressure. Observers followed a participant
during two consecutive whole shifts. The assignment of observers to participants
was made taking into account the diversity of the desired data pool. Concretely,
the criteria followed to choose the observed participants are different professions,
different shifts and different levels of work experience.
In the second part of the study, the follow-up interviews were based on prelimi-
nary findings of the observations. During the interview, participants were shown
the captured data and encouraged to analyze the data and remember certain
events. Finally, they were asked to judge the usefulness of this data for their
daily work.
Sample Four doctors and four nurses from NBN took part in the study. Five
of them were followed by observers. The participants included all age groups at
the stroke unit (22-44), men and women (3:5) and different levels of experience
(1.5-25 years).
3.3 Focus Group on ’Technology Support for Learning by Reflection
at Work’
Method In order to specifically explore user interests regarding technology sup-
port, we conducted three focus groups at NBN. A focus group is essentially a
group discussion with discussion impulses provided by a moderator. In the first
part of the focus group, the moderator asked the participants which kind of im-
age about learning by reflection they share in general and about their personal
attitudes towards using technological devices to support their work. Secondly the
moderator presented different types of triggers. These triggers focus on captur-
ing the learner’s physiological reaction to a situation or experience e.g. a device
called ’Fitbit’ [2], which monitors one’s own fitness (e.g. monitoring the steps or
calorie consumption of a user). The discussion resulted in information and data,
which could be interested for them to support learning by reflection during work.
Sample Three different focus groups were conducted at NBN, one group
with 3 physicians, one group with 4 nurses and one group with 4 therapists. The
participant’s ages range from 20-59, women and men (8:3).
4 Results
In this section we present the results along the different research methods, i.e.
the results of the questionnaire, the sensor study and the focus groups separately.
Results are conceptually integrated and discussed in Sect. 5 below.
4.1 Questionnaires
The results of the long questionnaire about the motivation of participants to
wear sensors are shown in Figure 1. Comparisons between different testbeds are
complicated because of the variance in participant numbers. However, two trends
can be identified in all testbeds:
1. Employees are neutral or would agree to wear sensors for a certain time.
2. Bad comfort is the most important argument for not using a sensor.
At RNHA, where a shortened version of the survey was conducted, sensors
were seen very critical. The average response for both questions was 2.18, where
2 means disagree. The questions at RNHA focused on the correlation between
the experience of using sensors and the actual acceptance. When looking at
the answers in detail there is a correlation (=0.75) between employees that use
sensors privately and the group that would wear a sensor.
4.2 User Study on Wearing Physiological Sensors during Work
General interest and sensor usage The general interest of the participants
about the use of sensors for tracking their work activities and doing a subse-
quent analysis was very positive. They were used to see physiological measures
and such curves in their patients’ monitors, but had not used them themselves.
The own physiological measurement at work was interesting for all of them and
the participants expressed their interest about recalling how were their work
days and what had happened. Most of them stated that this interest is much
higher when they had stressful days and that they would like to compare how
Fig. 1. Acceptance of sensors in testbeds.
the measures look like on different days.
The first reaction of the participants was diverse, but always in a positive way.
Some of them could quickly identify what was each measure; others were sur-
prised or showed curious about them.
’D4: Amazing, it is easy to understand.’
’D4: I don’t like staying in hospitals and going to the doctor. I am not the
type of person keen on trying new things out but it was actually interesting
for me. I would mainly like to know about activity and movement.’
In general the participants accepted the usability of the belt for the study but
all of them saw room for improvement. Hence, they would not like to wear the
sensor everyday. One participant described the belt as a badly fitted bra that is a
little bit inconvenient but still wearable.’ Regarding the usage of the sensors, all
participants stated that they would use the system. However, there were different
opinions concerning how often they would use them and which visualization they
would prefer.
’D1: How often I would use it [the sensor]... I can’t tell you... For example,
I would be more interested if I had a 24 hours shift with 10 admissions with
reanimation.’
Requests for additional features Participants suggested new features and
asked for additional sensors or the possibility to compare themselves with others.
’D4: It would be interesting to see the blood pressure too. It definitely helps me.
Blood pressure would show other things, but heart frequency is quite variable.
Together with blood pressure would be better.’
’D2: The comparison with the others would be interesting. Anonymously, of
course. If I had less activity in comparison to them, then I could say, I do
more or less. [I would like to know] If the others organize their day in the
same way as I do’
In contrast, another participant stated that he does not have the need to
know how his colleagues work.
Aversion and effects on coping strategies One participant mentioned that
awareness does not lead to solutions. In fact, it might even worsen the subjective
situation of the participant.
’D1: We have to hurry up. On duty you can’t do anything against it. What
could I do better? You don’t think. You are there, and you have to do it.’
Moreover, several participants reported that they are trained to leave the stress
behind when leaving the hospital.
4.3 Focus Group
Physicians were very sceptical of measuring their own physiological data, espe-
cially since it seemed unclear how they could/should act on the knowledge, e.g.
that they were stressed. Physicians were very clear in their opinion that their
tiredness or stress level is not allowed to interfere with or even influence their
work. If patients are waiting for a treatment, the physicians have to treat them.
Nurses were interested in data about stress level, sleep habits, blood pressure,
blood sugar, data from pedometers, etc. Nurses could imagine using this to find
out which situations they find stressful and how stress influences their bodies
(e.g. sleep). They would see this in the spirit of ”practice what you preach”,
since they often give advice to stroke patients on how to lead a well-balanced
life, e.g., sleeping, stress habits.
Therapists could imagine capturing physiological data to find out one’s own
stress level at work. On the one hand, they could try to learn from other col-
leagues who seem to deal better with stress situations. On the other hand, such
data could be used to prove to management levels that their work is stressful,
and to what degree. However, one therapist completely disagreed and did not
see the relevancy of capturing physiological data for learning purposes.
Both nurses and therapists would not want to always capture physiological data,
but would do this for a limited time period, and then analyse the data.
5 Discussion
We structured the discussion by the two research questions stated above:
Attitude Towards Wearing Sensors at Work The evaluation of the results
of the user studies shows that there is no unanimous opinion concerning the
physiological data. The questionnaire has shown that most of the participants
of the user studies are neutral or would agree to wear sensors during work. They
could imagine to learn from their own data and use this new gained knowledge
to help others more than themselves. Additionally they find it interesting to
compare (a) their captured data of stressful days with their data of average days
and (b) their data with colleagues.
However, participants in the focus group mentioned that they could not imagine
to wear such sensors every day. Wearing them during their work shifts would
need too much time and effort to settle the sensor down and take care of it.
Furthermore, this would produce too much data and create an information over-
flow for them. Participants could not envision what the captured data could be
used for and how they can benefit from it, because they are convinced that they
already know how they feel.
We therefore conclude that in order to make potential users capture physi-
ological data, we need to motivate them to try the sensors out. Additionally it
would be helpful to accompany users in the initial stages more intensively during
the introduction phase and as a result show them what they could learn from the
captured data or give them advice on how to react, e.g. on rising stress levels.
Benefit of Analyzing Physiological Data Related to Work Participants
stated that the captured data does not lead to any solution or does or even
cannot have any influence on their current work. The physiological data creates
awareness of issues but does not point to potential solutions. Off the shelf so-
lutions could be sufficient in many cases, e.g. relaxation exercises or breathing
techniques. More complex cases could be tackled by identifying the specific stres-
sor. Showing them which situations are very stressful for them, could make them
aware of such situations and could lead to reflect on how they could accomplish
such a situation more calmly next time.
6 Related Work
In athletic training, such reflection has long been considered as essential, for
instance when runners check their pulse either during running, or log their paths,
velocity, pulse to analyse their increasing performance over a longer time period
[6]. These sensors can be used in work environments with a high physical activity
to capture the activity.
The interest in physiological data has led to a growing number of commercial
tools [2, 5, 4]. They are useful for entertainment and sports but are not suited
to detect critical issues like stress. There are now first scientific approaches to
build products for daily use [15, 13, 3], but the current research is focussed on
improving the algorithms. Affectiva Q [13] and Movisens [3] are two companies
that focus explicitly on the practicability of the system.
First experiments with proximity sensors like the sociometric badge [8] have
shown the potential of sensors to alter work practices and behavior. Nevertheless,
there are no studies known to the authors that focus on using physiological sensor
systems at the workplace.
7 Outlook
In this paper we have shown the potential of physiological sensors to raise aware-
ness of employees towards their own stress level and their work-life-balance. Our
research has shown that employees need more support to learn from this data.
In MIRROR we aim at developing new methods to support the employees in the
reflection process.
Based on our findings, one can see that the integration of physiological data to
support workplace learning by reflection on the individual level is a challenging
research topic for the near future.
Acknowledgements
The project “MIRROR - Reflective learning at work” is funded under the FP7
of the European Commission (project number 257617).
The Know-Center is funded within the Austrian COMET Program - Competence
Centers for Excellent Technologies - under the auspices of the Austrian Federal
Ministry of Transport, Innovation and Technology, the Austrian Federal Ministry
of Economy, Family and Youth and by the State of Styria. COMET is managed
by the Austrian Research Promotion Agency FFG.
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