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Patient holding nasal drug delivery device whilst reading graphical instructions for use

How to avoid negative transfer in medical device development

Published: June 2024

Scott Martin

Scott Martin, Design Consultant

Since learning to drive, I’ve always used a manual car, but in 2021, automatic cars outsold manual ones in the UK for the first time. It is a change that signals a significant transition in the automotive industry, reflecting broader trends in technology and consumer preferences, and can be attributed to increasing popularity of electric vehicles (EVs).

 

It is seemingly inevitable that one day I will need to drive an automatic, so I recently had a test drive, the experience was filled with unexpected stress. Even the simple act of moving forward a few feet made me feel like I had lost a crucial element of control, and when I came to a stop, my muscle memory instinctively told me to depress a non-existent clutch, this caused a fleeting moment of panic like taking an extra step on a staircase. This disorienting sensation highlighted the challenge of adapting to new mechanics after years of ingrained habits. The concept of negative transfer explains this challenge.

Negative transfer occurs when previously acquired knowledge or skills interfere with the learning or performance of a new task. This interference can manifest in various ways, such as the incorrect application of prior knowledge, confusion between similar concepts, or the formation of habits that prove counterproductive in the new context.

 
It’s a common occurrence in day-to-day life. For example, in music, mastering one instrument may impede progress on another if the techniques or fingering patterns are incompatible. Similarly, in sport, habits formed from a forehand swing in tennis may disrupt the learning process when starting golf.


Another common example of negative transfer is in smartphone apps, for example, if users are accustomed to the “swipe left to delete” gesture, they may mistakenly apply the same gesture in a new app, where “swipe left” initiates a different action, leading to unintended consequences.

Negative transfer in a medical device

In the context of medical devices, negative transfer can have significant implications. Healthcare professionals (HCPs) often rely on their expertise with specific devices and procedures, which become second nature over time. However, when transitioning to a new device or updated technology, this ingrained expertise can hinder adaptation.

 

It can also affect patient interactions. Patients who are familiar with certain home monitoring devices or wearable health technology might experience frustration and confusion when transitioning to newer models with different user interfaces or operational procedures.

person using autoinjector

An example is the case of an Epinephrine pen. While this device is designed to deliver life-saving medication in emergency situations, users accustomed to traditional syringes may struggle with its operation due to key differences in design and functionality.

 

Or consider an HCP highly experienced with a specific type of infusion pump, reassigned to a different department equipped with a newer model. Although their fundamental understanding of how infusion pumps operate remains intact, the differences in interface and controls between the old and new models can lead to critical errors.

 

For example, the old pump might have a rotary dial to set the infusion rate, while the new pump uses a touchscreen interface. If the HCP, out of habit, attempts to adjust the rate as they would on the older model, they might inadvertently set the wrong infusion rate or fail to confirm the new settings properly. This could result in the patient receiving an incorrect dosage, which might lead to underdosing, overdosing, or even toxic effects depending on the medication being administered.

Overcoming negative transfer

One strategy to avoid negative transfer is to use positive transfer to allow skills from old tasks to be successfully applied to new tasks, and that common interaction patterns are duplicated wherever possible. This necessitates insight into the user’s prior experiences, being aware of the current state-of-the-art and adopting ethnographic and contextual research as part of a human-centred approach to device development.

 

Another route to avoid negative transfer, that may appear obvious, is to steer clear of relying on current objects or interaction patterns altogether. However, this approach runs the risk of overwhelming users of a new device with an entirely unfamiliar or novel interaction methods, which may not be intuitive.

 

In both cases understanding the user is critical to developing the most appropriate solution.

Training

We can also minimise the impact of negative transfer by explicitly highlighting distinctions between the new and old tasks during training or on-boarding sessions. Additionally, encouraging learners to engage in deliberate practice, where they focus on identifying and rectifying errors through targeted feedback and reflection, can help refine their understanding and reduce susceptibility to interference from negative transfer.

 

This requires robust training plans and a method of safe practice. As with all learned skills the success relies on the quality of the training, here we must make sure that there is adequate time to learn the new process and put into practice what has been learned. Performing the new skill and getting the experiential aspects of the new skill help solidify theory, this is where bespoke training aids or demo devices can help.

Training devices

Demo devices provide the opportunity to mitigate the risk of negative transfer by allowing the user to experience a device without a drug or needle incorporated reducing cost and removing associated risks.

 
We can use a project from Shore’s portfolio as an example. We were approached by a client to develop a training app and partner device to coach HCPs in the preparation of a suspension.

 
When parenteral pharmaceutics are formulated as suspensions, they require vigorous shaking of a syringe to resuspend particles into a homogenous mixture before they’re administered. To train HCPs on an optimal shake, we developed a handheld trainer device, resembling a real syringe, along with an app providing real-time coaching.

The trainer device measures shake characteristics such as speed, orientation, direction, and duration, transmitting data to the app. The app uses gamification principles to offer feedback, guiding users toward the correct shake technique and rewarding successful shakes with encouraging animations and sounds. Allowing the HCPs to practice in this way not only combats negative transfer but ultimately reduces the risk of incorrect dosage.

 

While negative transfer poses a significant challenge in medical device development, especially during the onboarding of new devices, with awareness and strategic interventions, we can mitigate its effects, deliver better devices for users and ultimately better outcomes for patients.

At Shore, we have years of experience in user research, designing and developing new devices, and have provided excellent training solutions for onboarding.

 

If you’re looking to develop a new device, or training program while avoiding negative transfer, we’d love to chat. Contact us.

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