Stephen B. Wilcox, Ph.D., FIDSA
I thought I would begin this blog with a discussion of a New Yorker article.
What does this have to do with medical-device usability? Let me explain.
I’ve spent the last 25 years or so mostly working with medical-device development teams in new product development, and I can report that one thing nearly every team does at some point is “brainstorm”. The purpose of brainstorming is to add the magic of “new ideas” to the mix. No matter how careful you are; no matter how much intellectual horsepower you bring to the table; no matter how sophisticated your “NPD methodology” is, developing new products still needs that spark of innovation—new ideas—to maintain a competitive edge. And the received wisdom is that brainstorming, to be effective, must conform to certain rules, the two most important of which are as follows:
- That it should be done in group sessions (to provide “synergy” so that the sum of the ideas is more than what the same people can collectively come up with on their own).
- That there are no “bad ideas”, i.e., that criticism should be withheld during the sessions, at least until a later stage when the ideas are culled, evaluated, etc.
Regarding the latter, the notion is that an idea may start out bad, but it may serve as the catalyst to a good idea, so cutting out the bad ideas too early may also eliminate good ideas that might follow from them. Furthermore, criticism is thought to limit ideas by instilling fear of contributing.
Now, I’ve participated in a lot of brainstorming sessions, and I’ve never heard anyone question this methodology. I’ve never heard anyone say, for example, “This is dumb; we’d be better off sitting at our desks and seeing what we can come with on our own”. And since being critical is probably about as basic to human nature as overeating, every session I’ve been in has included at least one reprimand from the leader when someone commits the sin of being too critical. The reprimandee inevitably sheepishly admits his or her wrongdoing and promises not to transgress in the future.
Now, back to the New Yorker. So I’m sitting on the train reading the New Yorker (for those of you who don’t live in the Northeast, the train is this multi-car tracked vehicle that many of us take to work so we can arrive relaxed from reading the New Yorker instead of already frazzled, before the workday even begins, from fighting rush-hour traffic), something that is normally a diversion from my workaday world. But, lo and behold, what do I find? An article by Jonah Lehrer, called "Groupthink: The Brainstorming Myth" that makes a compelling case that what we all believe—that the best way to generate ideas is through brainstorming—is actually a myth. As Lehrer puts it, “But there’s a problem with brainstorming. It doesn’t work”.
The article summarizes the actual empirical evidence regarding brainstorming. It turns out that there’s quite a bit of it. A number of academic researchers have been studying brainstorming by comparing the actual results (defined as the number of good ideas, measured in various ways) of different methods. Lehrer summarizes these studies and argues that the two key axioms of brainstorming—that group sessions generate more good ideas than the same people working alone and that criticism stifles good ideas—are simply false.
As an example, Lehrer describes a study conducted at Yale, back in 1958:
Forty-eight male undergraduates were divided into twelve groups and given a series of creative puzzles. The groups were instructed to follow Osborn’s guidelines. As a control sample, the scientists gave the same puzzles to forty-eight students working by themselves. The results were a sobering refutation of Osborn. The solo students came up with roughly twice as many solutions as the brainstorming groups, and a panel of judges deemed their solutions more “feasible” and “effective.” Brainstorming didn’t unleash the potential of the group, but rather made each individual less creative.
Other research has found that eliminating criticism from sessions actually reduces the quality of the ideas. Lehrer summarizes the findings of Charlan Nemeth, a psychologist at Caifornai State University, Berkley, who has been studying brainstorming as follows:
According to Nemeth, dissent stimulates new ideas because it encourages us to engage more fully with the work of others and to reassess our viewpoints.?"
It turns out that the rules for brainstorming were simply made up by Alex Osborn, an advertizing executive. He wrote a book about how to be more creative called Your Creative Power, published in 1948. Lehrer refers to the book as “an amalgam of pop science and business anecdote.” Chapter 33 of the book, “How to Organize a Squad to Create Ideas,” laid out the rules for brainstorming that everyone’s been using all these years.
Lehrer’s article suggests that maybe those of us working to develop new medical devices (along with everyone else) need some new ideas about how to generate new ideas.
Stephen B. Wilcox, is a principal and the founder of Design Science (Philadelphia), a 25-person firm that specializes in optimizing the human interface of products—particularly medical devices. Wilcox is a member of the Industrial Designers Society of America’s (IDSA) Academy of Fellows. He has served as a vice president and member of the IDSA Board of Directors, and for several years was chair of the IDSA Human Factors Professional Interest Section. He also serves on the human engineering committee of the Association for the Advancement of Medical Instrumentation (AAMI), which has produced the HE 74 and HE 75 Human Factors standards for medical devices.