Better Outpatient Services for
Older People (BOSOP) was a one-
year project with a local hospital to
bring together 12 older patients and
caregivers, some patient advocates
from a voluntary organization,
nine hospital staff, and designers.
The process involved a gradual
buildup of the team through
small incremental events to build
mutual trust and understanding.
The aim of the project was to
share experiences and co-
design service improvements.
The research team was keen
to emphasize participants’
shared ownership of the project.
Initially members of the research team met patients and advocates to talk to them,
reassure them, and gather stories of their experience. Then two half-day events were
held, one for patients and caregivers and one for staff, to share their experiences
and stories among themselves. The staff and outpatients then came together to
exchange stories. In a final phase, participants then formed two co-design teams to
discuss those areas and to propose improvements. Participants’ understanding of
the project and their roles in it as agents of change evolved only gradually throughout
the project, and the process was marked by dissensus and consensus. For example,
initially when patients shared their experiences, staff became defensive, identifying
resource limitations and logistical demands rather than listening to how patients
felt. The design team regularly restated the aim of understanding what it feels like
from the other person’s perspective. Time working on the project and small victories
along the way helped build up a level of trust and common ground between staff and
patients, including moments of sharing frustrations. (For more detail see )
Dissensus is the engine of creativity.
Participatory projects reconfigure what
is sensible to create space for dissensus,
making previously unimaginable
possibilities for action thinkable.
Why is HCI interested in
participatory projects? HCI as a
discipline has always thrived on
dissensus. Initially, psychologists
and computer scientists challenged
unquestioned assumptions about how
to design and develop technology and
how to make sensible constructs like
the user and usability “new subjects
and new heterogeneous objects” .
Later work challenged unquestioned
assumptions about distinctions among
designers, users, and technology. There
has also been an impetus to explore new
ways of doing research and constituting
the interdisciplinary field, and to bring
new disciplines into dialogue. Learning
with and from participants and from a
variety of disciplines has been an engine
of change within HCI as its digital
imaginary has evolved. The idea of HCI
as an interdiscipline captures something
of the way in which it dwells in between
other disciplines to form a fluid and
responsive practice . Its community
exists in a kind of outside belonging —
neither computer science, psychology,
engineering, design, art, nor science.
Outside belonging is a dissensual
existence, and it is one of HCI’s major
strengths when dealing with the social
contexts out of which thinking and
feeling emerge, and when designing on
the threshold between the individual
and the collective.
The research presented here was supported
by the RCUK SIDE Digital Economy Research
Hub (EP/G066019/1), the RCUK New Dynamics
of Ageing Programme (ES/F015925/1), The UK
NIHR CLAHRC-South Yorkshire UCHD project,
and the AHRC Creative Exchange Research
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[A]Part: The Politics and Aesthetics of
Participation in Experience-Centered
Design. MIT Press, 2015.
IMAGE BY BOSOP PROJECT
2. Vines, J., Clarke, R., Wright, P.,
McCarthy, J., and Olivier, P. Configuring
participation: On how we involve people
in design. Proc. of CHI 2013. ACM, New
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3. Cooke, B. and Kothari, U. Participation:
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4. Civic Alliance to Rebuild Downtown
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Reconfigurations: Plans and Situated Actions
(2nd edition). Cambridge Univ. Press, 2007.
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Rancière, J. Dissensus: On Politics and
Aesthetics. Bloomsbury, 2010.
8. Blackwell, A.F. HCI as an interdiscipline.
Proc. of the 33rd Annual ACM Conference
Extended Abstracts on Human Factors in
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9. Clarke, R., Wright, P., and McCarthy,
J. Sharing narrative experience: Digital
stories and portraits at a women’s centre.
CHI 2012 Extended Abstracts of ACM
Human Factors in Computing Systems
Conference. ACM, New York, 2012,
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A., Jarvis, N., Reynolds, P., Gaver, B. Age
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11. Wallace, J., Wright, P., McCarthy, J.,
Green, D., Thomas, J., and Olivier, P. A
design-led inquiry into personhood in
dementia. Proc. of CHI 2013. ACM, New
York, 2013, 2617–2626.
12. Wolstenholme, D., Cobb, M., Bowen, S.,
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Australasian Medical Journal 3, 8 (2010),
Pete Wright is professor of social
computing at Open Lab ( www.openlab.ncl.
ac.uk), Newcastle University, U.K., and co-director of the EPSRC Centre for Digital Civics
( http://digitalcivics.org.uk). His research
area is the human-centered and participatory
design of digital systems. With John McCarthy,
he is best known for Technology as Experience
(MIT Press, 2004), Experience-Centred Design
(Morgan Claypool, 2010), and Taking [A]Part
(MIT Press, 2015).
John McCarthy ( http://patlab.ucc.ie/
people/professor-john-mccarthy/) is professor
of applied psychology at University College
Cork, Ireland, where he leads the People
and Technology Group. His current research
includes (i) developing dementia-friendly
research communities that do experience-centered design with people with dementia and
their carers and (ii) exploring digital publics as
expression of civic engagement.