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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Designing reflection tools that people want to use: Motivational aspects of supporting collaborative reflection at work</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Michael Prilla</string-name>
          <email>michael.prilla@ruhr-uni-bochum.de</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Martin Degeling</string-name>
          <email>martin.degeling@ruhr-uni-bochum.de</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Ruhr-University of Bochum, Institute for Applied Work Science, Information and Technology Management Universitätstr.</institution>
          <addr-line>150, 44801 Bochum</addr-line>
          ,
          <country country="DE">Germany</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Based on two case studies this paper describes aspects of designing tool support for collaborative reflection that people want to use. These factors include the importance and proper application of user participation in design process, different ways of introducing collaborative reflection tools into the work of people, the importance of social procedure aligned to tool usage and features supporting the usage of reflection tools. The paper refers to case studies with an IT Consulting company and a hospital ward.</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>Introduction</title>
      <p>
        Reflection is a common and decisive task in most workplaces [
        <xref ref-type="bibr" rid="ref1 ref13 ref9">1, 9, 13</xref>
        ]. During
reflection, reconsider (mostly implicit) how they performed tasks, and rethink what they
can do better when doing them again. This includes going back to emotions and other
details of the situation. While reflection can be considered a valuable mechanism of
learning at the workplace [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ], it is also bound to human memory, which may fade or
be incomplete in terms of details needed to reconsider past experiences. Likewise, the
implicit nature of reflection often causes results from reflection not to be documented
or sustained in other ways, which in turn means that they are lost or at least not
successfully transferred to others.
      </p>
      <p>
        Employees wanting to reflect can therefore be supported by tools for reflection,
which enable them to complement their memory on past situations to reflect on and to
sustain insights stemming from reflection [
        <xref ref-type="bibr" rid="ref12 ref14 ref15 ref2 ref8">2, 8, 12, 14, 15</xref>
        ]. However, reflection is
deeply embedded and may occur in many different modes ranging from meetings to
spontaneous encounters on the hallway [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ]. This makes using tools difficult, as they
have to fulfil constraints posed by the diverse situations reflection is likely to happen
in (e.g. a tool has to be applicable for meetings and spontaneous talks) and factors
such as time pressure (e.g. supporting reflection while other tasks have to be
fulfilled). Therefore, besides specific questions concerning how to support reflection in
special situations with tools, we need to focus on question such as how to create
corresponding tools that fulfil these needs and how to motivate their usage. This paper
investigates these issues.
      </p>
      <p>The results presented in this paper draw on two case and design studies with
physicians and nurses in a German hospital as well as employees of an IT-Consulting
company. Based on an analysis of work done in these cases, we designed tools for the
respective cases. From this, we derived insights into the design of reflection tools that
people want to use and additional factors on the motivation of this usage.</p>
      <p>In what follows, we briefly sketch some background on reflection and existing
work on tools to support it (section 2). After that, we describe the cases and the tools
designed in each case (section 3). Then, we analyse and present a list of factors
leading to the design of reflection tools that people want to use (section 4).
2.</p>
    </sec>
    <sec id="sec-2">
      <title>Reflection, workplace learning and existing tools:</title>
    </sec>
    <sec id="sec-3">
      <title>Background and open issues on design and motivation</title>
      <p>
        Reflection is a process of going back to experiences (made in the past), attending to
these experiences (including emotions and insights during them), re-assessing these
experiences (based on current knowledge and an ex-post perspective on the
experience) and drawing conclusions for future behaviour from this process (see [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]).
      </p>
      <p>
        Reflection obviously is not a formal way of learning, but happens rather informally
and mostly implicit: it may occur while a task is carried out or after it has been
completed. In a similar distinction, Schön refers to this as reflection in action and
reflection on action [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ]. It has been recognized for many workplaces that reflection at
work happens frequently and is one of the decisive mechanism of improving work [
        <xref ref-type="bibr" rid="ref1 ref13 ref9">1,
9, 13</xref>
        ] and thus, support for reflection at work is crucial.
      </p>
      <p>
        Learning from reflection at work is a process of informally improving work
practice and can thus be considered workplace learning. This kind of learning is special
in that it differs from other forms of learning such as vocational training or courses in
schools and universities. According to Eraut, it happens in an unstructured and
complex context that has not been adapted or created with learning means in mind: “it is
usually the work that is structured and not the learning” [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ]. This means that there
usually is usually no dedicated, reserved space or time during the workday for
workplace learning such as reflection – it often has to happen during or in parallel to work.
      </p>
      <p>
        Reflection is mostly based on human memory, which may fade over time or may
be incomplete in terms of all the necessary details that have to be known of the
situation the experience stems from in order to re-assess it. Therefore, tools
complementing memory, e.g. by providing additional data on a given situation or making the
perspectives of others on this situation available, and supporting necessary tasks such as
communication and cooperation of reflection have been discussed intensively in
literature [
        <xref ref-type="bibr" rid="ref10 ref11 ref14 ref15 ref5 ref7">5, 7, 10, 11, 14, 15</xref>
        ]. However, besides insights on special purpose reflection
tools (e.g. [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ]) or generic tools stemming from cooperation and learning support in
general (e.g. [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ]), little is known on the design and application of tools supporting
reflection in practice.
      </p>
      <p>The questions stemming from this initial situation and its constraints – supporting
reflection as a task deeply interwoven with work, with little time and space to perform
it – are how to design tools that help people in reflection and how to motivate
people to use these tools for reflection. In this paper, we investigate these questions
with a focus on how to motivate reflection at the workplace, including methodological
aspects of designing and adapting reflection tools, characteristics and features of such
tools as well as integrating these tools work processes. This investigation draws on
use cases of reflection drawn from two different organizations (healthcare, IT
consulting) and on the design of two tools to support reflection in the respective organization.
3.</p>
    </sec>
    <sec id="sec-4">
      <title>Support reflection in practice - two design cases</title>
      <p>
        The following analysis of reflection in practice is based on two case studies we
conducted, including a hospital ward with focus on the physicians working there and a
sales department of a IT-Consulting company. We identified different modes of
collaborative reflection [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ] dependent on whether reflection happens spontaneously,
concurrent to work or planned within meetings. Each of this modes has different
settings and also different levels of reflection [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ] from discussions of concrete episodes
to more abstract reflection about processes.
3.1.
      </p>
      <sec id="sec-4-1">
        <title>The hospital case</title>
        <p>
          In one case, we worked with a hospital located in Germany. There, we observed and
interviewed physicians and nurses on a ward that is specialized on early-stage
treatment of patients that suffer from strokes. We observed one physician and one
caregiver for two days each, shadowed them throughout their shift and made notes on
things that happened, peoples they interacted with, artefacts they used and tasks they
carried out. The notes were afterwards digitalized and categorized based on a
grounded theory approach [
          <xref ref-type="bibr" rid="ref16">16</xref>
          ]. In addition, we interviewed 2 physicians and 2 nurses in
semi-structured interviews about their work and reflection practice.
        </p>
        <p>
          Based on the outcomes of this study [
          <xref ref-type="bibr" rid="ref12 ref3">3, 12</xref>
          ] we started a series of workshops to
elicit topics for collaborative reflection and requirements for tools supporting the
reflection on these topics. In total, we held five workshops with a differing number of
physicians. It turned out early that talks with relatives would be a suitable topic for
reflection: both in the workshops and our study, we found that talking to relatives is
not part of the normal training for physicians, but has to be learned ‘on the job’. These
talks are often emotionally challenging, as they have to convey bad news and at the
same time explain complex medical situations, which require relatives to pay
attention, as they may have to choose between different treatment options. To improve the
own performance within such talks is therefore motivated by the individual aim to
feel better and the idea that bettered informed relatives lead to better possibilities for
the upcoming treatment. Thus, together with the workshop participants we decided
that this would be a good topic to collaboratively reflect on.
        </p>
        <p>We agreed on a basic set of requirements for a tool to support reflection on such
conversations, covering the possibility to
• document the talks in a formal way as it is already required for patients folders,
• add additional information that help to rebuild the context of the experience in
form of text comments as well as short self-assessments guided by questions like
“how did you feel during the talk”,
• support sharing of those documentations with others and,
• provide means to comment on documentations others shared,
• support links between documents and articulation of outcomes in relation to
multiple documentation</p>
        <p>We implemented these requirements in the “Talk Reflection App” (see Figure 1),
which was designed for mobile devices to support the different modes of
collaborative reflection mentioned above, like reflecting ‘spontaneous’ independent from a
workstation computer. We used a prototyping approach throughout the five
workshops, in which the prototypes were improved iteratively between workshops (Figure
1 shows an early version and the current version of the app to demonstrate this). This
was done to give the physicians, who were not much tech-savvy, an early impression
what an app could do for them and to provoke concrete feedback for design.</p>
        <p>In the workshops, the physicians tested the prototypes, e.g. by documenting recent
conversations and talking about them afterwards, and developed ideas for new
features. This helped participants to get a common idea of the application and the way it
can be used during work. As one result, it turned out that the largest constraint of
physicians towards using a reflection support tool is time: Often there is a large
timespan between the conversation and the moment they are able to document or even
reflect on it, as they always have to immediately respond to emergencies and
therefore only have a loose daily structure. Therefore, we added a feature to export
documentation done with the Talk Reflection App to the hospital information system, in
which the physicians have to document conversations with relatives as well, in order
to save time by avoiding redundant tasks. Furthermore, using the prototypes led to the
idea of an additional section within the app, in which outcomes of reflection can be
noted down and related to specific tasks – the physicians insisted on having such as
feature present e.g. in meetings not to lose insights from reflection. This, according to
the physicians, helps sustain reflection results as general outcomes that can also be
shared with and understood by other physicians. In one workshop, we also discussed
the necessity to capture emotions during the documented conversations. The
physicians proposed to have short questions like “How likely is it that I will take this talk
home?” that they could answer whole creating documentations without much effort,
but as a casual part of the documentation work. This was implemented early on with
simple sliders to assess emotions (Figure 1, top) and later complemented a spider
graph representing the emotions for talk (Figure 1, bottom), thus supporting quick
comparison between documentations.</p>
        <p>Another interesting, non-technical outcome of the workshops was that the
physicians wanted the usage of the Talk Reflection app to be closely linked to meetings or
supervision, in which the documented conversations should be discussed among
them. We soon realized that they perceived this as a main motivating factor and
would more likely use the app if they knew that there was an event in which they
could reflect on documentations together.</p>
        <p>The development was concluded by a four weeks test of the application on iPad
devices during daily work to evaluate the utility and impact of the app. The evaluation
brought up additional requirements, but also showed proofed the applicability of the
general concept. Although physicians did not use the application as frequently as we
had intended, they agreed that the app raised awareness for and triggered reflection on
difficult conversations with relatives. For example, in one of the workshops
conducted during the evaluation, we observed how a discussion of documented conversations
led to plans for improving the situation in which those conversations take place.
Suggestions included using a separate room for off the ward to have a more private
environment as well as regularly have a supervisor to answer general questions about how
one could behave. In the end, the physicians agreed on freeing space for a dedicated
room to be used for such conversations.
3.2.</p>
      </sec>
      <sec id="sec-4-2">
        <title>The Consulting Case</title>
        <p>Our second case is an IT consulting company also based in Germany. Here we
worked with people from the sales department, who form a group consisting of about
20 people, of whom only a small part (about six) is working in the headquarters, while
the others are distributed throughout the country working closely with (possible)
customers. The whole group only gathers in a monthly meeting, in which general topics
like fairs, new developments of the product set or large pitches are discussed. Similar
to the approach at the hospital described above, we shadowed and observed two of the
sales consulting in the headquarters for two days and conducted three interviews.</p>
        <p>The main motivation for reflection at this case is closely related to the general goal
of the work of a sales consultant: Sales consultants want to convince customers to
choose their products over competitors. In our study, we found out that the main
artefacts used for this are (sets of) presentation slides, which guide discussions with
customers. Typical situations in which we found them reflect include the preparation of a
new presentation for a possible customer (sales pitches) e.g. by combining slides
already they had good individual experiences with or talking to colleagues about
presentations that did not went well. Often they refer to slides or make notes on them.
We also found that there are individual experiences connected to each slide and that
the consultants reflected on these experiences by collecting, discussing and
aggregating experiences, e.g. when it was mentioned several times that there is a lack of slides
about a certain topic or that a certain slide Y in the general product presentation could
not be explained properly to customers. We therefore decided to connect our
collaborative reflection support tool to the problem of discussion and reflection on slides.</p>
        <p>Since the development of a slide repository to support exchange and combination
of slides was already planned as an internal project, we decided to hook on this
development process and add features to support collaborative reflection to what was called
internally the “DoWeKnow App”. We therefore conducted a series of workshops, for
which we developed a process of reflection supporting and enhancing the work of
consultants around the slide repository, aiming at reflection on (the content of) slides.
This approach suited the consultants well, as they where used to think about their
work with a process in mind and also used models in their work with customers.</p>
        <p>
          Using the model we created, we conducted a process walkthrough [
          <xref ref-type="bibr" rid="ref6">6</xref>
          ] in the
workshop and derived requirements from discussions of certain model elements. Figure 2
shows the process model used for this walkthrough, which contains activity steps for
reflection tasks supporting the capturing of experiences with slides (yellow rectangles
with round edges), the reflection of slide content and the sustainment of results from
reflection (e.g. changing the content of a slide). The result this workshop was a
process model that was extended by comments (light green bubbles) containing the key
points of the discussion in the workshop.
        </p>
        <p>Figure 3 shows activity “recognize missing things or distinct features”, which is
part of the general process shown in Figure 2. The activity consists of the activities to
upload a slide, edit an existing slide and make colleagues aware of the change. During
the discussion of this step one of the consultants came up with the point that not
everybody should be allowed to edit or upload a slide. The participants proposed that a
separate role, the owner of a slide, should be responsible for this and take care of
“standard slides”, that is, those that give general information about the company.
Those slides should not be editable, instead everyone can propose new slides or
changes that than have to be approved by the owner. The big comment in Figure 3
shows how this was documented during the walkthrough.</p>
        <p>An interesting outcome of this workshop is that the system will not provide
enhanced communication support, as we were told that consultants are much more used
to discussing topics face-to-face or via phone than using forums or discussions
threads. Instead, articulation support will prompt only for short comments for
example after a user rated a slide, asking for a short reflection about experiences that
resulted to the voting. In addition, the consultants urged us to include mechanisms to
trigger actions from their activity in the repository such as informing the author of a
slide when changes are requested – they perceived such mechanisms as a prerequisite
to actively used reflection features in order to ensure that their contribution is
recognized, which was the main benefit in their eyes. Thus, we put more effort on
notification and awareness for changes within the repository such as new slides added. Such
notifications are also used when comments trigger a follow-up process not part of the
app such as e.g. new slides or a large number of comments about missing information,
which could result in an agenda topic about this slides in the next sales meeting.</p>
        <p>The process driven approach in the case of the consultants lead to a large set of
requirements for the internal project that is developing a slide-repository. Besides
features that will foster individual reflection we also derived an organizational process
that will lead to collaborative reflection based on information, ratings and comments
made within the repository.</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>Creating and establishing reflection tools that people want to use: Motivational factors</title>
      <p>The cases described above contain various insights on the creation of tools supporting
reflection at work and the motivation of their usage. This includes aspects of how to
design these tools, how to integrate them into the work of potential users and which
how to equip them with features and qualities that motivate usage. Below, we analyze
these insights as an answer to the questions raised in the introduction of this paper.</p>
      <p>Concerning the design of reflection tools, we regard participatory design to be a
success factor for the creation of reflection tools that people want to use. Examples
such as the need for documenting outcomes of discussion immediately as reported by
the physicians in case 1 and the emphasis that consultants put on notification
mechanisms for the reflection in case 2 show how important it was to integrate the potential
users of the tools early on in order to design the tools according to their needs.
However, choosing the right approach and artifacts for participatory design also
turned out to be a critical factor needed to tailor participatory design to the respective
situations: While in case 2, consultants were used to modeling tools and we could
conduct a model walkthrough with them, for case 1 we found it suitable to be more
concrete and align the design process to prototypes that potential users could try and
give feedback to in an early stage of development.</p>
      <p>The two cases show two different ways of integrating reflection into daily work
and tools used for it. In case 1, we combined reflection with a mandatory task
(documentation of talks) and added additional features (e.g. the self-assessment of
emotions during conversations). In case 2, we added reflection features to an
existing tool to improve the tool and its content by reflection. Both ways integrate
reflection into existing work, thus making it easy to use, and show the benefit of reflecting
and using reflection tools or features to people by supporting their needs (improving
conversations or presentations, respectively). Thus, we suggest that in order to
motivate the usage of reflective learning tools, designers should integrate them into the
work of people rather than creating standalone tools only serving reflection purposes.</p>
      <p>Regarding the design of features of reflection tools, we found casual usage of
reflection features to be an enabling factor of using reflection tools. In case 1, we made
the self-assessment of emotions during conversations as casual as possible, as
physicians had stated they would not take a lot of effort for this. In case 2, we made the
comment input field appear when consultants rate slides in order to make comments
causal (and thus, more likely). We regard casual features to be a key factor in
motivating the necessary steps of documentation and articulation in reflection, which might
not always show their benefit to users directly.</p>
      <p>Reflection tools must not be created without regarding the social system they are
embedded in. In contrast, there is a need to provide reflection tools with the careful
design of social processes that surround and support the usage of the tools. In case 1,
the physicians insisted of establishing regular meetings in which the documentation
and comments made with the Talk Reflection App would be used for reflection.
Likewise, in case 2, the sales consultants wanted to add notification mechanisms to
the DoWeKnow app in order to make sure that changes and comments were
recognized by responsible people and that their action would trigger a follow-up process.
Given these examples, we consider the anchoring of reflection and tools to support it
in organization (social) processes to be another factor influencing the uptake and
regular conduction of reflective learning at the workplace.</p>
      <p>Although this list is not exhaustive, it already informs designers how to create
reflection tools that users are motivated to use. However, we regard it as a starting point
for further work and invite interested researchers to join this work.</p>
    </sec>
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