design thinking in physical education

1st Edition

Threshold Concepts in Physical Education A Design Thinking Approach

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This innovative and user-friendly book uses a design thinking approach to examine transformative learning and liminality in physical education.  Covering theory and practice, it introduces the important idea of ‘threshold concepts’ for physical education, helping physical educators to introduce those concepts into curriculum, pedagogy and assessment. 

The book invites us to reflect on what is learned in, through and about physical education - to identify its core threshold concepts. Once identified, the book explains how the learning of threshold concepts can be planned using principles of pedagogical translation for all four learning domains (cognitive, psychomotor, affective and social).  The book is arranged into three key sections which walk the reader through the underpinning concepts, use movement case studies to explore and generate threshold concepts in physical education using design thinking approach and, finally, provide a guiding Praxis Matrix for PE Threshold Concepts that can be used for physical educators across a range of school and physical activity learning contexts.

Outlining fundamental theory and useful, practical teaching and coaching advice, this book is invaluable reading for all PE teacher educators, coach educators, and any advanced student, coach or teacher looking to enrich their knowledge and professional practice.

Table of Contents

Fiona C. Chambers is Head of the School of Education and Senior Lecturer in PE and Sport Pedagogy at University College Cork, Ireland and a Hasso-Plattner Institute-certified Design Thinking Coach.  Her teaching, research and civic engagement focuses particularly on the areas of physical education and sport pedagogy, mentoring, and social innovation. She is an Invited Member of UNESCO Scientific Committee for Physical Activity, as well as Secretary General for the Association Internationale des Écoles Superiéure d’Éducation Physique (AIESEP), and a Founder and Link Convenor of the European Educational Research Association (EERA) Network on Research in Sport Pedagogy. She is also co-founder of WickED, a platform using design thinking to develop educational solutions to complex societal challenges. 

Anna Bryant is Director of Teacher Education and Professional Learning at the Cardiff School of Education and Social Policy (CSESP), Cardiff Metropolitan University, UK. Anna has made a significant contribution to Health Physical Education, specifically, in the area of physical literacy and ‘Health and Well-being’. She has project led Cardiff Metropolitan University’s Sport Wales Physical Literacy Consultants and was an international panel member for the Australian Sports Commission’s Physical Literacy Project (2016-2017). Anna has been involved in providing academic consultancy to the Welsh Government on the new Health and Well-being Area of Learning and Experience (AoLE) and has played a central part in Cardiff Metropolitan University’s Welsh Government National Professional Enquiry Project (NPEP).

David Aldous is Senior Lecturer in Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, UK. The focus of his current research, innovation and teaching interests lies in using forms of sociological theory to develop critical understanding of how education, sport and community-based organisations are able to creatively respond to the reform of education, sport and health policy. He is currently lead for the Physical Health Education for Lifelong Learning (PHELL) research group at Cardiff Metropolitan University. Future research will continue to contribute towards interdisciplinary approaches that support local communities in understanding and addressing the social, environmental and health problems facing society in the early 21st century.

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Design and Design Thinking in STEM Education

• Published: 30 October 2019
• Volume 2 , pages 93–104, ( 2019 )

Cite this article

• Yeping Li 1 ,
• Alan H. Schoenfeld 2 ,
• Andrea A. diSessa 2 ,
• Arthur C. Graesser 3 ,
• Lisa C. Benson 4 ,
• Lyn D. English 5 &
• Richard A. Duschl 6  

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Design and design thinking are vital to creativity and innovation, and have become increasingly important in the current movement of developing and implementing integrated STEM education. In this editorial, we build on existing research on design and design thinking, and discuss how students’ learning and design thinking can be developed through design activities in not only engineering and technology, but also other disciplines as well as integrated STEM education.

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Introduction

In our first joint editorial (Li et al. 2019 ), we focused on the topic of thinking and uncovered new questions through a brief review of conceptions of thinking, how they were developed, and related research. We also proposed that thinking needs to be reconceptualized as plural, in contrast to traditional conception of thinking as a single individual-based cognitive process. Specifically, we indicated that thinking can be differentiated as multiple models with levels, and science, technology, engineering, and mathematics (STEM) education is positioned to develop students’ thinking with our newly proposed conception. In this editorial, we would like to extend the previous discussion to focus on design and design thinking, and take the position of viewing design thinking as a model of thinking that is important for every student to develop and have in the twenty-first century. Furthermore, we discuss ways that STEM education is positioned to provide diverse opportunities to facilitate students’ learning through design and develop their design thinking.

In the following sections, we start by discussing the conceptions of design and design thinking in general, followed by discussion of developing students’ design thinking, as a model of thinking, through design activities not only in technology and engineering, but also design activities and content learning in science and mathematics as well as integrated STEM education.

Everyone Designs and can Design

Design, if referring to formal and professional activity, becomes a term that is often reserved for some professionals, such as those in architecture, fashion, technology, and engineering. The identity development of professional designers and engineers builds on special training and years of practices, with their design activities often leading to valuable end-products. Clearly, design is not a type of activity that is commonly used in school education, except in art and vocational training, as many traditional school subjects like mathematics and science aren’t viewed as disciplines in which students design. The well-established knowledge structures and procedures in mathematics and science have long been perceived as important for students to acquire and use as (often disconnected and static) facts, procedures and skills (Banilower et al. 2013 ; Fisher 1990 ). Not surprisingly, design activity and design thinking have not been emphasized in traditional school education as they can be easily perceived as creating new terms and procedures, activities often viewed as belonging to professional mathematicians and scientists, not students.

In contrast, engineering and technology are the professional fields that take design as an important and distinguishing activity (e.g., Daly et al. 2012 ; Haupt 2018 ; Simon 1996 ). It is common and important for novices and experts alike to learn and think about design in the fields of engineering and technology, and to develop a design mindset. Thus, the recent introduction of engineering and technology in school education brings new perspectives about what students can and should learn and do, including design, and benefits students can realize from design activity, including the development of design thinking (ITEA 2007 ; National Research Council 2009 ). As design and design thinking also encourage different perspectives and approaches in viewing and solving problems, they are vital to creativity and innovation. The importance of design and design thinking has indeed been recognized in school education recently, especially in the current movement of STEM education (e.g., Honey et al. 2014 ; ITEA 2007 ; Katehi et al. 2009 ; NGSS Lead States 2013 ).

The above contrast in what students can be expected to learn and develop across different subjects suggests a subject fixation long in existence in school education. It is not because design and design thinking are not important for students to do and develop especially in the twenty-first century, but likely due to the fact that mathematics and science have historically been perceived as not the ‘right’ type of school subjects in which students design and develop design thinking. The development of students’ design thinking is thus left to those teachers of certain subjects such as engineering or art, but not for others in traditional school subjects like mathematics and science (Li et al. 2019 ). Such a perception needs to be changed!

If not restricted the meaning of design to formal activity in specific professional fields, design can take place in many different ways from time to time. In fact, we all carry out informal and formal designs in our daily and academic lives such as in travel planning, house decorations, hair styling, experimental design in research, and instructional design in school education. Design can simply mean a person’s approach to identifying and solving a problem in this human-made world. According to Cunningham, founder and director of “Engineering is Elementary” (EiE, http://www.eie.org ), children are born engineers, and they have innate enthusiasm toward designing and making their creations, taking things apart, and figuring out how things work (Cunningham 2009 ). In fact, one important category of EiE curriculum design principles is to demonstrate that everyone engineers and everyone can engineer (Cunningham and Lachapelle 2016 ). Consistently, we believe that everyone designs and everyone can design. Without close attention to children’s design ideas and intuition, we may lose opportunities to nurture their design thinking and creativity. It is imperative that school curricula and instruction integrate design in students’ subject content learning, not just in engineering and technology but also in other STEM subjects and beyond, and also help foster their design intuition and thinking early on (e.g., Center for Childhood Creativity 2018 ; Early Childhood STEM Working Group 2017 ).

Design Thinking as a Model of Thinking that is Important to Every Student

Studies on design and design thinking are not new, especially in engineering (e.g., Dym et al. 2005 ; Simon 1973 , 1996 ). However, the meanings of design and design thinking are still open to different interpretations in different professional fields (Exter et al. 2019 ; Johansson-Sköldberg et al. 2013 ; Kolko 2018 ; Wrigley and Straker 2015 ). As examples, design in business management often means deliberated and careful thinking and planning to be creative and innovative, but design in engineering can sometimes be routine and taken for granted (Johansson-Sköldberg et al. 2013 ). In education settings, design research calls for theory-based interventions that can produce results pertinent and documentable to a specific real context (Brown 1992 ; Cobb et al. 2003 ). The ambiguity over the meanings of design and design thinking itself historically has also contributed to the difficulty of operationalizing design concept for curriculum and instruction, even in the field of engineering (e.g., Dym et al. 2005 ). For example, engineering education in universities has evolved from being largely on an “engineering science” model as influenced by Simon’s work ( 1996 ), to being reflective practices often characterized by project-based learning (PBL) and cornerstone courses (Dym et al. 2005 ; Schön 1983 ).

To study and characterize design thinking in engineering and other fields, various approaches and perspectives have been developed and used, including (1) modeling design process (e.g., Dym and Brown 2012 ; Schön 1983 ; Simon 1996 ), (2) comparing experts and novices (e.g., Ahmed et al. 2003 ; Göker 1997 ; Kavakli and Gero 2002 ; Tang and Gero 2001 ), (3) identifying and specifying design thinking strategies, tactics and skills (e.g., Lawson 2006 ; Wendell et al. 2017 ), (4) examining specific cognitive features, such as cognitive load (e.g., Sweller et al. 2019 ) and metacognition (Desoete and Özsoy 2009 ; Kavousi et al. 2019 ; McLaren and Stables 2008 ), and (5) examining action and thinking in design teams (Hu et al. 2018 ; McNeill et al. 1998 ; Stempfle and Badke-Schaube 2002 ). Previous studies on design thinking have been fruitful, and also diverse in terms of different aspects or dimensions being focused on. For example, Razzouk and Shute’s review ( 2012 ) suggested that experts in design demonstrated performance different from novices in multiple ways, including efficiency and effectiveness based on their prior experience, metacognitive control, and the tendency of starting with solution assumptions rather than problem analysis. Such results help us develop a better understanding about not only the nature of expertise in design, but also possible ways of specifying levels of design thinking.

In their study of expert-novice architects in designing a museum building, Tang and Gero ( 2001 ) used a coding scheme that consists four levels: (a) the physical level, which refers to the instances that have direct relevance to the external world, comprising drawing, looking and moving actions; (b) the perceptual level, concerns the instances of attending to visual-spatial features/relationships in an automatic perceptual mechanism; (c) the functional level, relates to the instances of functional references mapped between visual-spatial features/relationships and abstract concepts, including meanings and functions; and (d) the conceptual level, which represents the instances that process abstract concepts and the instances that process physical and perceptual actions. According to Tang and Gero ( 2001 ), this four-level scheme was initially developed by Suwa and Tversky ( 1997 ) in their study of novice-expert architects’ design sketches. It can be classified into two distinguishable groups of actions: (1) lower level cognitive actions that reside at the physical and perceptual levels and refer to interaction with the external world, including actions for drawing, looking, and recognizing graphical features and spatial relationships; (2) higher level cognitive actions that stay at the functional and conceptual levels and refer to interactions with the designer’s internal world, including actions for functional reference, goalsetting, making decisions, and utilizing designers’ knowledge. Their study showed that while both the novice and expert produced large amounts of drawing, looking, moving, and perceiving actions with functional meaning attached to them, the expert produced statistically significant more of these actions than the novice.

The four-level scheme used in Tang and Gero’s study ( 2001 ) is mainly a coding framework for data analyses. Their results also show that both the novice and the expert demonstrated actions in all four levels, and their documented differences were mainly in terms of quantity, not quality. Although such a scheme may not be ready for use to characterize the level of development in design thinking, for example, from a novice to an expert designer, it suggests aspects that we can consider when thinking about students’ design thinking development. This is a topic area that would need more theoretical, empirical, and educational research.

School education differs from professional education in terms of emphasizing identity development in different professional fields such as architecture, fashion, and engineering. In school education, design has been increasingly recognized not only as an object for students to learn and experience (e.g., English 2018 ; McFadden and Roehrig 2019 ), but also a general framework for school education (e.g., Wright and Wrigley 2019 ) and an important approach for conceptualizing and developing integrated STEM education in K-12 schools (e.g., English 2016 ; Kelley and Knowles 2016 ). Likewise, design thinking has been studied not only as a complex and integral part of the design process in engineering (e.g., Dym et al. 2005 ) and school education (e.g., Strimel et al. 2019 ), but also as a general cognitive process involving creation, experimentation, feedback collection, and redesign that can take place in many different fields (Razzouk and Shute 2012 ) including business (e.g., Dunne and Martin 2006 ) and instructional design (e.g., Cook 2006 ).

To develop students’ design thinking, we need to take a broad perspective about design and design thinking that can capture both formal and informal design activities. Historically, thinking involved in design practices has been explored mainly through examining professional designers’ practices. Johansson-Sköldberg et al. ( 2013 ) named this type of thinking as “designerly thinking” and summarized related studies and theoretical perspectives into five categories of “design and designerly thinking” (p. 124): the creation of artifacts, a reflexive practice, a problem-solving activity, a way of reasoning/making sense of things, and the creation of meaning. They then reserved the term “design thinking” for the discourse where design practice and competence are used beyond the professional design context (including architecture and art), for and with people without a scholarly background in design, such as in management (p. 123). Design thinking can thus be viewed as a simplified version of “designerly thinking”, and is feasible for activities taking place in education, both for and with students. With the goal of identifying the features and characteristics of design thinking in school education, Razzouk and Shute ( 2012 ) offered a characterization of design thinking: “Design thinking is generally defined as an analytic and creative process that engages a person in opportunities to experiment, create and prototype models, gather feedback, and redesign.” (p. 330) This characterization provides us a valuable perspective about design thinking that goes beyond possible restrictions placed on design activity by disciplinary boundaries. Further in alignment with our discussion in the first joint editorial (Li et al. 2019 ), design thinking can and should be viewed as a model of thinking in school education to help nurture and develop for every student in the twenty-first century.

Given the relatively new recognition of the importance of design and design thinking in school education, there are many more questions than answers for researchers and educators alike. For example, how to characterize the levels of students’ design thinking and related development remains a challenge, particularly for those who care about the design of curriculum and instruction to develop students’ design thinking (e.g., Wrigley and Straker 2015 ). We would certainly view this challenge also as an opportunity for researchers and educators to study and understand the development of design cognition. Educational constructs can be conceptualized and developed in terms of different dimensions, such as the complexity of design tasks and the abstract level of concepts needed in the design process. Experimental studies can then be carried out to examine how different interventions may impact students’ development of design thinking (e.g., Dasgupta 2019 ).

Develop Students’ Design and Design Thinking in and through STEM Education

How design and design thinking can and should be taught or used has been an issue of importance in different professional fields. Different models have been identified and developed for different purposes including education (e.g., Wright and Wrigley 2019 ; Wrigley and Straker 2015 ) and assessment (e.g., Kretzschmar 2003 ). For example, Wrigley and Straker ( 2015 ) proposed an educational design ladder based on a study of what is taught (content) and how it is taught (assessment and learning modes) about design thinking in universities worldwide. Specifically, they collected and reviewed 51 courses about design thinking in different disciplines including business, management, innovation, and creativity, as selected from 28 universities internationally. Their review and analyses of these courses led them to propose the five pedagogical stages in the development of design thinking, ranging from low to high-order thinking skills anticipated for different levels of design thinking. These levels of design thinking are categorized as the foundational level, product level, project level, business level, and professional level. They further characterize these five levels of design thinking development in the cumulative nature of learning with Biggs’ Structure of the Observed Learning Outcome (SOLO) taxonomy ( 1996 ): (1) knowledge comprehension, (2) application, (3) analysis, (4) synthesis, and (5) evaluation. Given that the model is derived from reviewing professional courses about design thinking in universities, it is thus understandable that the depiction of different levels of design thinking tends to illustrate how a professional in design may be prepared through the ladder.

Students’ Learning through (Engineering) Design in STEM Education

In school education, existing studies have shown that students can learn through design and also develop their design thinking in and through STEM education. Specifically, with the recent introduction of engineering into school education, there are a fast growing set of programs and studies that document how engineering design can help engage students and facilitate their learning of STEM content (e.g., Engineering is Elementary (EiE). 2011 ; English and King 2015 ; Kelley and Sung 2017 ; Kelly and Cunningham 2019 ; McFadden and Roehrig 2019 ; Schnittka 2012 ; Strimel et al. 2018 ) and thinking development (e.g., Lubinski 2010 ; Uttal and Cohen 2012 ). For example, Kelley and Sung ( 2017 ) investigated how the use of engineering design helped grade 5 students to learn science. They found that student participants increased the amount of time spent on computational thinking by 34% when given a math-embedded design task. Pre- and post-tests showed that students gained significant science content knowledge, such as identifying the concept of conservation of mass on a multiple-choice test. At the same time, however, most of the students struggled to transfer it to a new situation. The acquisition of basic knowledge and practices in STEM is certainly not enough. Kelley and Sung ( 2017 ) thus concluded that elementary science teachers using engineering design as an approach to improve science learning also need to provide additional opportunities for students to improve their ability to transfer science and mathematical reasoning beyond the initial design tasks.

Kelly and Cunningham ( 2019 ) examined how engineering design provides unique ways to support students’ collaborative sense-making, reasoning with evidence, and assessing knowledge. They drew from EiE engineering curricular units and their implementation to identify epistemic tools, including the physical, symbolic, or discursive artifacts that facilitate knowledge construction, that helped facilitate students in three epistemic practices of engineering (1) constructing models and prototypes, (2) making trade-offs between criteria and constraints for engineering design challenges, and (3) communicating through uses of conventionalized verbal, written, and symbolic modes of disciplinary discourses. Their analysis of curriculum products, student work, and classroom discourse demonstrated how the use of these epistemic tools is important for engaging students in these epistemic practices, and also helps foster creating, sharing, and assessing knowledge claims. The results obtained by Kelly and Cunningham ( 2019 ) highlighted the importance of specific epistemic tools identified and used in engineering practices for K-12 education, and provide a ground feasible for comparing and connecting with what scientific practices aim to accomplish in knowledge learning and construction through the process (e.g., Duschl and Bybee 2014 ). It presents an important topic area for us to further identify, examine, and compare specific epistemic practices pertinent to different disciplines in STEM that can possibly be connected or integrated to facilitate students’ content learning and thinking development. Moreover, as STEM education is not culturally neutral (Early Childhood STEM Working Group 2017 ), how culture plays a role in design activity and different epistemic practices is also an important topic for improving students’ learning in STEM and their design thinking in a diverse classroom and across regions.

Rather than focusing on the use of engineering design, some researchers and educators tried to develop and use design as a general pedagogical approach to engage students and help them learn in STEM and STEAM (with art specifically included in STEM) (e.g., Chen and Lo 2019 ; English 2018 ; Orona et al. 2017 ). As part of a 4-year longitudinal study, English ( 2018 ) reported a 4th-grade classroom design-based problem solving activity that integrated the four STEM disciplines. With a focus on a shoe design task, students built upon their learning from an initial problem component that collected and analyzed data about shoe types, sizes, fabrics, corresponding foot lengths etc., and obtained further knowledge about natural and processed materials from the science curriculum and general information about shoe designers, manufacturers and their work. Students were then organized into small groups to design their own shoes. The process and results illustrated how student learning progressed from knowledge application and the use of a sequence of design strategies as beginning designers, redesigning, reconstructing, to informed designing. The process, guided by a conceptual framework adapted from Crismond and Adams ( 2012 ), was similar to the educational design ladder described above by Wrigley and Straker ( 2015 ). Along the process of design development, English also reported that students not only became more aware of the STEM knowledge they were using or needed to use, but also were able to make knowledge-based decisions and explanations. Different from the “progressivism” of immersion learning that was criticized by Gee ( 2005 ), design activity in these studies is structured and used with specific purposes and appropriate instructional support. The positive effects of design activities in STEM clearly require careful instructional designs with specific theoretical perspectives. Further efforts are needed to explore both specific mechanisms and pedagogical constructs for developing and using design activity to facilitate students’ content learning and thinking development.

Students’ Design Practices Benefited from Integrated STEM Education

Recent research suggested that the benefits of design in STEM education goes both ways: there are mutual benefits for design and integrated STEM education. In addition to what is discussed above that design can help students learn and develop design thinking, integrated STEM education can also benefit students in design practices (e.g., English 2018 ; Fan and Yu 2017 ).

Specifically, Fan and Yu ( 2017 ) conducted a quasi-experimental study that compared high school students’ learning outcomes between a group studying a STEM engineering module and another group studying a technology education module. While controlling for the content and other aspects of the two modules, they found that after 10 weeks of instruction, the students using the STEM engineering module significantly outperformed the students studying the technology education module in the areas of conceptual knowledge, higher-order thinking skills, and the engineering design project activity. Their further analyses revealed that the key differences in the application of design practice between these two groups included (a) their respective problem prediction and (b) their analysis capabilities. The positive effect of the use of an integrative STEM approach in high school technology education is well illustrated and documented in their study. Likewise, English’s study ( 2018 ), as discussed above, demonstrated the benefits for student learning in an integrated STEM curriculum and instruction. Although it was not conducted as a quasi-experimental study with a comparison group and different from Fan and Yu’s study ( 2017 ) that focused on engineering design, English also demonstrated such benefits for students in developing their design practices and design thinking.

Embed the Development of Students’ Design Thinking Not Only in Technology and Engineering, But Also in Mathematics and Science

One point that we would like to emphasize through this editorial is that everyone can design both informally and formally, and not only in engineering and technology but also in mathematics and science (i.e., change the subject fixation perception).

Designs in education research are not unfamiliar to education researchers (Burkhardt and Schoenfeld 2003 ; Cobb et al. 2003 ), nor are experimental designs in chemistry, physics and biology unfamiliar to scientists and science educators. We should help our students pay close attention to the design process, idea generation and their thinking, rather than focusing only on readily available facts and procedures.

The same applies to needed changes in viewing, teaching and learning mathematics, a subject that is typically perceived as non-experimental and different from the other STEM fields (e.g., English 2016 ). There are several ways for making such needed changes. For example, the use of project-based learning (PBL) in the current movement of STEM education can and should also be used in mathematics teaching and learning. Over the past several years, Teaching Children Mathematics , a National Council of Teachers of Mathematics (NCTM) professional publication focusing mainly on elementary mathematics teachers, has established a special section called iSTEM. It publishes examples of investigations, projects, and instructional activities associated with STEM, developed and used by and for teachers. For example, Orona et al. ( 2017 ) shared an example of how standard units of measure can be understood and used in the context of a design-based problem solving activity. The article started with the introduction of a multi-step engineering design process, then introduced how to apply it to a problem-solving activity in a second-grade mathematics classroom. With their initial learning of standard units of measurement and the engineering design process, students were then challenged to conduct an investigation to create a cutout of a giant’s head to match the giant’s hand-prints as provided. The students went through the whole process of questioning, brainstorming, planning, constructing, improving, and sharing. Specifically, students were challenged to find out the relationship between hand measurement and body or facial features, by looking at themselves and measuring and drawing. The process built on and expanded their knowledge of the engineering design process and standard units of measurement.

Indeed, design is not unique to engineering and technology. There are many other sources and materials that have been produced and shared to demonstrate the importance and use of design and design thinking in school education. For example, Educational Designer (see https://www.educationaldesigner.org/ed/ ) is an international free e-journal specifically on design and development in education. It was established in 2008 by the International Society for Design and Development in Education with the goal of promoting excellence in the research-based design, development, and evaluation of educational materials in the fields of mathematics, science, engineering, and technology. With the participation of mathematics educators in this society and journal, readers can find resources related to design in mathematics education in curriculum, instruction, research, and professional development.

It becomes clear and important to us, in school education, to take a broad perspective on design and design thinking and not restrict design as only belonging to professional fields such as architecture and engineering. While the introduction of engineering and technology in school education helped us to realize the importance of design and design thinking, it is at least as important for us to rethink how traditional school subjects like mathematics and science can and should be taught and learned. Design is not only a noun, but also a verb that can help bring changes to what school education can offer to our students. There is a rapidly growing number of studies, such as those we discussed above, that document how STEM education is well positioned to provide diverse opportunities to benefit students’ learning and design practices.

At the same time, design thinking, as a model of thinking, is important for every student to develop and have in the twenty-first century. Given the fact that previous studies mainly focused on professional designers and engineers’ cognition, studies on students’ design thinking and its development are still limited. Existing studies have illustrated that this is a rich and fruitful area for scholarly discussion and research (e.g., Kavousi et al. 2019 ; Strimel et al. 2019 ; Wind et al. 2019 ). Systematic studies on students’ design thinking and its development, especially in and through STEM education, would help provide important foundations for developing sound educational programs and instruction. This journal encourages submission of related research on design and design thinking in STEM education, a frontier in STEM education research that calls for new and robust scholarship (Li 2018 ).

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Home > Books > Contemporary Advances in Sports Science

Design Thinking Applications in Physical Activity and Exercise Literacy

Submitted: 24 March 2021 Reviewed: 29 March 2021 Published: 19 April 2021

DOI: 10.5772/intechopen.97479

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Various theoretical models of Health Literacy (HL) discuss its importance for behaviour change, supporting long-term health and disease prevention. During the 21st century Physical Activity (PA), Exercise and Sedentariness (SD) have received an increased priority over other health indices for quality of life purposes due to their central importance over metabolic conditions and their comorbidities. This review aims to conceptualise the main issues and challenges of Physical Inactivity (PI) and SD through the new proposals of Design Thinking (DT) which is considered one of the most promising pathways in health promotion. DT is prioritising empathy for service users, brings together collaborative multidisciplinary teams and provides the opportunity to assess various solutions via iterative practices. This chapter: A. provides a review over the efficacy of health promotion strategies during the current era and the urgency of behaviour change in PA and SD for various population segments. B. Explains how HL links self-care practices to PA and SD habits. And C. Presents DT as a new layout for supporting the exploration and feasibility of more active lifestyles for overall health and quality of life.

• Health Literacy
• Design Thinking
• Physical Inactivity
• Sedentariness

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Emmanouil georgiadis *.

• University of Suffolk, Ipswich, UK

*Address all correspondence to: [email protected]

1. Introduction

Newer definitions of human health adopt notions of a balanced, holistic and dynamic decision-making process via an ever-needing adjustment to environmental demands [ 1 ]. Such adjustment needs to be dynamic, supportive of own abilities and autonomy driven to stimulate personal goals and long-term adherence [ 2 ]. When it comes to personal impactful choices of health actions, dimensions of personal empowerment like recognition of the meaningfulness of health promoting behaviours, own competence, belief in personal impact and self-determination have been suggested to enhance health status reverting any negative effects involved -also- in chronic diseases [ 3 ].

Such Chronic Inflammatory Diseases (CID) are currently recognized as the leading cause of death world widely with more than 50% of deaths being attributable to inflammation-related diseases [ 4 ]. Such diseases are cancer, stroke, ischemic heart diseases, diabetes mellitus, autoimmune and neurodegenerative conditions, chronic kidney disease and non-alcoholic fatty liver disease (NAFLD). Evidence is mounting that those inflammation related conditions start in early years of life, persisting throughout life and resulting in increased morbidity and mortality with health promotion behaviours being able to counteract those conditions [ 5 ].

2. Recent theories of physical activity and exercise

Within the top priority of behaviours able to counteract CID are regularly practiced physical activity and exercise. Even though exercise promotion has been at the focus of various organisations for more than thirty years [ 6 ], physical inactivity (PI) and sedentary behaviours (SB) are abundant in modern societies. It is estimated that they are the fourth contributing factor to global mortality [ 7 , 8 ], causing -among other conditions- major modifiable cardiovascular diseases [ 9 ], diabetes [ 10 ], cancer [ 11 ], mental disorders [ 12 ], and specific illnesses such as Ischemic Heart Disease [ 13 ].

Further, PI and SB are currently considered among the most important modifiable factors for the prevention of cardiovascular conditions and other non-communicative conditions that contribute significantly to all-cause mortality in the global population [ 14 ]. It is estimated that 50 to 60% of selected cardiovascular conditions are currently attributed to PI [ 13 ], with the World Health Organisation (WHO) making the prevention of PI one of its key goals for reducing Noncommunicative diseases [ 15 ].

The current definition of PA is supportive of more than just the mere bodily movement that is produced by the contraction of skeletal muscles and the increases of energy expenditures resulting in significant health benefits. It is defined also by the psychological, social, political and situational phenomena related to the execution of physical movements and supporting a holistic definition of PA: “Physical activity involves people moving, acting and performing within culturally specific spaces and contexts, and influenced by a unique array of interests, emotions, ideas, instructions and relationships.” (p. 5) [ 16 ]. It is important to note that when an individual is deciding to move, is far more than a travelling set of muscles, joints and energy expenditure repositioning in space, but rather a unique collection of emotions, interests, ideas, instructions, and relationships. Given the importance of regular engagement with PA for sustaining a good quality of life and maintenance of physical and mental health [ 17 ] such definition highlights novel suggestions and approaches for PA promotion and enhancement (see below).

Any PA that is planned, structured, repetitive and purposeful to increase physical fitness or its components is related to exercise behaviours [ 18 ]. Incorporating daily exercise programs in one’s lifestyle is associated to reduced risks of morbidity and mortality across the lifespan [ 19 ]. Also, when exercise is part of therapeutic treatment of chronic conditions, contributes to better quality of life and prolonged duration of life [ 20 ].

Existing theoretical models are supporting a systematic approach towards the promotion of PA and exercise behaviours. In an attempt to create a better sense of those theories, their proposals and their applications, Rhodes [ 21 ] created the Multi-Process Action Control (M-PAC) Model with each theory placed at either, the reflective process (or else the intention formation phase), the regulation process (the adoption phase), or the reflexive process (the maintenance phase of exercise behaviour). Each of those phases is proposed to include separate stages of the exercise adoption, as social-cognitive theoretical applications are proposed to create an intention to become more physically active by enhancing the long-term utility of exercising, the expectation of positive emotional states during physical activity, the perception of physical and mental abilities to perform the requested exercise behaviours, and the environmental opportunity (i.e. time allocation) to perform physically active behaviours [ 21 ]. In the adoption phase, more behavioural methods are expected to create a change via techniques related to goal setting, positive feedback, relevant environmental cues, and self-talk. Finally, in the reflexive phase, associations, repetition and maintenance of environmental cues are expected to create long-lived habits contributing to a more active identity type [ 21 , 22 ].

Two main validation pathways can link to the M-PAC Model. The first one, is its ability to confirm already proposed components of the Behavioural Change Techniques (BCT) taxonomy [ 23 ], which is considered a comprehensive, hierarchical, reliable and generalizable catalogue of methods [ 24 ]. Michie et al. [ 23 ] created a catalogue of 16 separate clusters precising behaviour change interventions helping to sort out for the first time their active intervention ingredients based on inter-rater agreement. This catalogue provided a clearly defined set of active intervention types, which is considered complete until recently [ 25 ].

A second validation of the Rhodes [ 21 ] model was offered by the authors of the Health Action Process Approach (HAPA) [ 26 ]. Based on the HAPA model three levels of self-efficacy (SE) are needed to support behavioural change of PA and exercise behaviour: Action SE, linked to the creation of intention and preparation to engage to more active behaviours through the anticipation of positive outcomes, Maintenance SE, associated to behavioural techniques enhancing behavioural persistence and motivation over the needed behaviour change, and Recovery SE, reflected by the ability to resume behaviour after relapse and interruption. Both M-PAC and HAPA models support same stages and constructs denoting similar processes and corresponding to needed actions for optimal behavioural change.

Another important set of theories holding an ability to promote increased levels of PA and exercise behaviours are the dual-process frameworks [ 22 ]. They are models consisting on the one hand reflective processes including social-cognitive approach variables (such as intentions, expectations and values), and on the other hand non-conscious processes including other not so well tested PA determinants such as habits, automatic thinking processes and personal effectiveness evaluations [ 27 ]. The most recent addition to this type of theories is including also the emotional valence and its importance for future intentions to participate in PA and exercise behaviours (Affective-Reflective Theory, ART) [ 28 ]. This occurs through reflective and non-conscious processes based on emotions individuals acquire during their PA and exercise participation. It is a theory that uses previously psychophysiology findings and related theories such as the Dual-Mode Theory (DMT) [ 29 ] to suggest a varying core affect as a product of different sets of intensities during PA and exercise participation based on innate psychophysiology mechanisms (see [ 28 ], for details). ART enhances the motivational importance of affect in relation to exercise behaviour, and most importantly how exercise and the affective experiences they produce are encoded in associative memory (i.e. physical pain vs. pleasure when exercising) and the way such associations are gradually integrated into cognitive processes that could support regular exercise participation [ 28 ]. According to Rhodes et al. [ 22 ], the case of conflict between non-conscious (affective) and reflective (cognitive) influences, lead individuals to experience affectively charged motivational states “such as craving, desire or dread” (p.104). Even though there are points of skepticism around measurement of non-conscious processes and how those can alter via educational processes, the dual-process models like the ART theory hold important potential for the future as they are the first to challenge the significance of attitudes and self-efficacy for the change of PA behaviours [ 22 ].

3. Shifting the educational approach

Promoting participation in PA and exercise entails acquired perceptions of the body and already created associations between the body and the mind in relation to personal attitudes, beliefs and appreciations from previous attempts to become physically active [ 30 ]. During this process, various implicit and explicit mechanisms are underway creating a unique response for the individual.

Using modern psychoanalytic views of unconscious processes representing wishful, fearful, and associated notions, Bendor [ 31 ] examined the main reasons behind exercise avoidance resulting in physical inactivity in modern society. Based on the views of practicing psychoanalysts, his results supported that exercise avoidance comes as a product of fear of identity change, learned disregard of own body, and repressed traumatic associations to exercise. Bendor’s findings highlight the importance of unconscious processes over exercise adoption [ 29 ] in various populations in need and clearly call for the adaption of new exercise promotion and education methods [ 22 , 28 ].

When it comes to exercise adoption, negative sentiments, fear and/or unconscious processes have been uncovered in coronary heart patients populations [ 32 , 33 ], and community-dwelling osteoporotic older adults [ 34 ]. On the contrary, enjoyment and positive feelings are reported by young adult populations who actively participate in exercise behaviours [ 35 ] with positive feelings of valence and calmness supporting exercise participation in real life samples of healthy adults [ 36 ].

At the same time, very often messages calling for changing health behaviours (i.e. eating patterns, physical activity, smoking cessation) are based on appeals to personal responsibility, stigmatisation, controlling and inequality, that are ubiquitous around us [ 37 ]. This type of messages imply that illness or disable states are based on lack of responsibility, leading to blames of accusation to the sufferer (i.e. weak character) rather than social (lack of financial ability), environmental (i.e. relevant pollutants) or structural (i.e. disadvantaged working conditions) causes, contributing to the creation of stigma, fear and guilt [ 38 ]. The same type of messages are still making the most out of the exercise promotion campaigns aiming to change intentions and attitudes towards more active lifestyles based on cure and well-being rather than pleasures experienced during exercise [ 39 ].

Yet, it is not clear that those messages are capable of creating real change contributing to more active lifestyles [ 21 ]. Prioritising health over other behaviours by creating guilt and pointing out an inconsistency between personal standards and own behaviour having the goal of remorse and pointing out personal responsibility [ 40 ], seems to be successful in shifting health attitudes [ 41 ]. However, those changes are only related to initial stages of behavioural change, influencing attitudes and intentions to act towards more health-related behaviours, with their long-term effects still unexplored [ 40 ].

Criticism has been expressed in the past around the ways physical activity and exercise related concepts and resources have been conveyed to the general public in a non-understandable manner contributing to confusion as health related resources are not matching the recommended readability standards of the general public [ 42 ]. Same results were obtained from Thomas and Cardinal [ 43 ], showing that most of written PA educational resources are presented in a complicated and non-understandable format for the great majority of the American population. When it comes to PA and exercise literacy there seems to be an existing gap between what experts consider important to provide and the type of information required for the general public to change, becoming more physically active.

4. The importance of health literacy

Lack of knowledge of critical features that generate a health condition and low skills in obtaining, processing, understanding, and communicating health-related information are critical components for supporting health [ 44 ]. Hence, opportunities for health-related educational sessions are important for improving health status in various population segments.

Health Literacy (HL) is related to the capacities of people to appreciate, realise, and meet the complex demands of health in modern society and its requirements. In their seminal article, Sørensen, Van den Broucke, Fullam et al. [ 45 ] defined HL as “entailing people’s knowledge, motivation and competences to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve quality of life during the life course” (p. 3). Health literate individuals are in position to contextualise and appreciate personal needs supporting their health, their close ones and their community, understanding the most influential factors for retaining wellbeing and taking steps towards meeting those. It is about taking control and responsibility of one’s own health as well as the health of their loved ones and their community [ 46 ].

It can be easily confused with academic literacy and the notion of well-educated approach and familiarity with literature. However, during the second half of the 20th century the combination of literacy to health has been expanding denoting not just the potential of personal growth and individual transformation as a result of such procedure but also the contextual and social transformation with its capacity to influence economic growth, and social, political and cultural changes [ 47 ].

Four distinct abilities are being assigned to HL. These are, a. the ability to seeking, accessing and obtaining health information, b. the ability to comprehend health information that is accessed, c. the ability to interpret filter and evaluate health information and d. the ability to make a decision to maintain and improve health through conscious decision making [ 45 ]. These four types of ability highlight the importance of availability of needed resources, and the opportunity to appreciate connections among behavioural choices and health outcomes [ 48 ].

The need for HL supports recent models of health care reinforcing the importance of education and best practices starting from a micro level (self-care or else person-centred) which are based on 7 pillars of health promotion: 1. knowledge and health literacy, 2. mental well-being, self-awareness and agency, 3. physical activity, 4.healthy eating, 5. risk avoidance, 6. good hygiene, and 7. rational use of products and services [ 49 ]. One of these pillars having extended effects on quality of life, physical and mental health, reduction of premature mortality and avoidance of morbidity is regular participation in physical activity (PA) behaviours [ 50 ].

A perspective of the Rogerian proposal of HL is based on the view that a successful health education procedure needs to be mutli-dimensional, person-centred and based on a partnership between the eager professional to train and educate and the individual willing to act based on available resources while placing health as a priority [ 51 ]. An explanation of this standpoint defines that, “health education is a continuous, dynamic, complex and planned teaching-learning process throughout the lifespan and in different settings that is implemented through an equitable and negotiated client and health professional ‘partnership’ to facilitate and empower the person to promote/initiate lifestyle-related behavioural changes that promote positive health status outcomes” [ 51 ], (p. 133). This view suggests that boundaries and choices in each health promotion relationship are well-placed within each individual deciding the point the affiliation with the educator begins and ends, with related partnerships based on mutual responsibility, collaboration, freedom of choice, equity and autonomy [ 52 ]. When health education is lacking the above elements, is likely to fail to recognise and integrate the recipients’ preferences and requests risking being ineffective in the short or long term [ 53 ].

5. Design thinking in physical activity and exercise

Bringing the previous notions together, it seems that physical literacy contributing to more active lifestyles is requiring a new approach able to solve more complicated problems in human decision making and actioning. New perspectives in education have the potential to provide novel methods of exercise promotion and literacy helping inactive populations to change perspectives and start their participation in exercise programs. Such a framework recently presented as a method of exploring, defining, and solving complicated problems claiming to utilise user-centred or human centred design processes [ 54 ]. Started with Brown’s definitions [ 55 , 56 ] Design Thinking (DT) comprises of iterative processes of three to five phases: 1. The phase of inspiration (or empathising) with an effort to explore and redefine the problem based on the clients, their perspectives and needs, 2. The phase of ideation (or definition and ideation) where the formulation of the problem and its solution is defined, and 3. The implementation (or prototyping and testing) phase where potential solutions are created and assessed [ 56 ].

DT has been proposed as one of the best approaches in health promotion as it is prioritising empathy for service users, brings together collaborative multidisciplinary teams and provides the opportunity to assess various solutions via iterative practices [ 57 ]. The potential of DT in multiple health care settings has been assessed in the past via diverse models of applications and demonstrated promising results in relation to traditional interventions [ 58 ]. Results on its potential for multiple health care domains and across diverse patient population and conditions were confirmed with authors urging for the use of DT in interventions of overlooked approaches and populations.

The application of DT in disciplines like PA and exercise literacy can be a product of related steps and procedures pertinent to the population in focus and caring for particular -amid unmet- needs. Relevant knowledge of applying DT is listed in multitude of resources highlighting the importance of the method and the application of its protocol [ 59 ]. Connecting with the requests of the real user and the population in need is the first step in the DT methodology. Claiming expertise and knowledge of the scrutinised behaviour/phenomenon when the user is not available, can possibly lead to unproperly clarified problems and quick fixes based on preconceived notions (see “empowerment model for health”, [ 60 ]). Disciplines that have been scrutinising potential solutions effectively (i.e. medical treatments) supported by increased public attention and funding could generate a platform for creating diverse opinions on needs analysis [ 58 ]. The process of prototyping in a way that each potential solution is explored for its feasibility based on the elicitation of effective final results [ 56 ], is another step on the application of DT. The process of limiting solutions based on expressed ideas and their feasibility is another crucial area of DT [ 55 ]. Exchange of ideas is essential in DT and does not occur without trust, freedom of expression and undistracted collaboration among the team members [ 61 ]. Finally, having a basic appreciation of the protocol of DT and its needed steps can create a better engagement with team members ready to explore user needs, envision the ideal solution, realise its potential and endorse the answer that fits best to the initially proposed needs [ 55 ].

Testing DT protocol with the needs of the end user (i.e. unfit or obese individuals) in mind might hold the potential of more successful PA and exercise literacy helping to move way from proposals that have been shown limited success in the previous years with profound health and economic results [ 62 ]. Suggested tips that can enhance the implementation of DT for enhancing PA and exercise literacy are included in 12 tips presented by Wolcott, McLaughlin, Hubbard et al. [ 63 ]. These are separated based on the steps of DT protocol and relate to the preparation of DT (i.e. gathering resources and committing to its thinking patterns), engaging to the discovery of users’ needs (i.e. connecting to the real user and being observant of the real issues), exploring expressed ideas with a variety of means (i.e. visualisation of ideal solutions, utilising a number of mediums to scrutinise the feasibility of ideas), and encourage optimism while testing chosen solutions (i.e. flexibility when it comes to the chosen time and setting to reach a conclusion, allow space for failure and iteration of solutions).

A model of DT dealing with PA and exercise literacy can take the following form based on the suggestions of Brown [ 55 ], and colleagues [ 56 ]:

Inspiration phase; realising the needs of the individual user when it comes to human movement requires their inclusion in the process. Observation of the user or the direct involvement of users targeting the improvement of the context and needed set of skills is foundational in DT [ 64 ]. There is a need to reframe the problem and exploring it while moving away from pre-existing assumptions that lead to unsuitably specified problems and unfeasible answers [ 65 ]. The example of wearable technology as means to support increased physical activity patterns is an assumption made and failing to incorporate more active lifestyles [ 66 ]. Contrary, the idea of Augmented Reality to support PA literacy/education and more active lifestyles remains viable and untested to a large extend [ 67 ].

Equally important is the realisation of the experience of PA and exercise through the eyes of the stakeholders. Experts in academia very often assume knowledge based on prior theoretical conceptions and what has shown potential in the past [ 22 ] whereas, unique ways of thinking, personal strivings, psychological responses and thinking patterns of stakeholders cannot be predicted let alone assumed in terms of realising change [ 68 ].

During the phase of ideation, solutions to the problem start to emerge. Such process is important to continue involving both positive and negative experiences of the user while clarifying the direction of solution [ 55 ]. Testing prototype ideas through iteration and experimentation is an essential part of this process with triggered rounds of problem definition and experimental solution creation with the goal to synthesise information into illustrative models [ 69 ]. Iteration refers to testing possible solutions through trial-error procedures, mock-ups, timelines and prototype appraisals with the support of end-users and representative stakeholders [ 70 ]. Scrutinising and visualising a solution (i.e. self-caring message before putting on walking shoes) [ 71 ], and utilising previous knowledge and experience of people representing different organisations [ 72 ], is a central notion of design thinking.

Τhe implementation phase puts into final test the qualified prototype ideas through final series of iteration and experimentation aiming for synthesis [ 73 ]. Preparing a gestalt view on the proposed solution to the problem creates the opportunity for the users to be represented as a community testing assumptions and evaluating prototypes [ 74 ]. Through this process end-users have the opportunity to realise what each of the finalist proposals provides as a response to their recognised needs, offering feedback on the implementation of ideas [ 60 ]. This end result (i.e. new educational resources, holistic movement drills re-connecting mind–body) [ 75 ], provides the opportunity to move forward with new implementation of solutions and ideas around PA literacy that emanate from the users in need while implementing important theoretical positions produced via decades of systematic research and academic development [ 21 , 22 ].

6. Conclusions

To overcome currently overwhelming degrees of worldwide physical inactivity [ 76 ], requires looking to new definitions of the problem emanating from the actual users and their needs [ 55 ], helping us to redefine physical inactivity and our solutions to reverse this global trend. Wide examination of “prototypes” of solutions towards literacy and increased engagement with PA and exercise practices remains unexplored and profoundly based on socio-cognitive approaches (for an example see, [ 76 ]). At the same time, feasibility exploration of recently proposed PA and exercise literacy programs remains largely unknown [ 77 ]. Ideas like the application of virtual and augmented reality in the promotion of exercise [ 67 ], the role of mind–body interventions in prolonged exercise participation [ 78 , 79 ], and the potential of embodied creativity activities [ 80 ] are examples of such exploration requests. There is a clear need to explore user-friendly PA and exercise literacy solutions with an unknown capability for creating active lifestyle responses for populations in need. DT methodology provides new exploration affordances towards this remit [ 60 ].

In summary, HL is believed to be one of the most promising pathways to deal with CID in modern society [ 45 ]. Even though the existing theoretical models are supporting a systematic approach towards the promotion of PA and exercise behaviours, their educational applications are limited and still underdeveloped [ 21 , 22 ]. The need to overcome resistance to exercise adoption due to negative sentiments, fear and/or unconscious processes necessitates the adoption of new approaches to PA literacy. DT has been proposed as an effective approach able to provide new proposals to health promotion as it is prioritising empathy for service users, brings together collaborative multidisciplinary teams and provides the opportunity to assess various solutions via iterative practices [ 55 , 56 ]. Testing proposed solutions based on the needs of various populations (i.e. clinical, older adults) is the product of further scrutiny and exploration through the applications of DT.

Acknowledgments

Special thanks to Dr. Spyridoula Vazou for her valuable comments on the text.

Conflict of interest

The author declares no conflict of interest.

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Redesigning the Pedagogies of Physical Literacy: Using Design Thinking as an innovation approach

Clearly, physical literacy is a broad concept. Whilst the original term had strong philosophical orientations towards the concepts of phenomenology and existentialism, recent developments of the concept have largely focused on a more pragmatic interpretation in physical education, physical activity and sport; it appears that the application of the concept of physical literacy has led to a focus on learning more rudimentary skills. This has moved physical literacy away from its original and more holistic focus, intended by Whitehead (2007; 2013). The design challenge, therefore, is how to reimagine the pedagogy of physical literacy such that it remains relevant to its holistic origins. This is a complex problem to which we applied a human-centred innovation process called design thinking at a recent AIESEP workshop (with 92 stakeholders from 17 countries). In the workshop, teams innovated four new prototypes (solutions) in response to the problem statement. Across these prototypes, five core aspects of effective physical literacy pedagogy were identified using thematic analysis: (1) a life-long and life-wide focus; (2) Interdisciplinary design teams are needed to design and implement it; (3) the need for hybrid pedagogies i.e., both face-to-face and virtual; (4) space (virtual and physical) as an enabler; (5) how to nurture the symbiotic relationship between physical literacy and physical education. Further to this the D 3 Prism of Innovation Praxis (Chambers & Sammon, in press) provided a sophisticated framework for this design challenge. It is intended to develop an overarching (prototype) solution which embraces these five aspects at a follow-on AIESEP workshop in 2021.

De toute évidence, la littératie physique est un concept large. Le terme original présentait de fortes orientations philosophiques centrées sur les concepts de phénoménologie et d'existentialisme. Les développements récents du concept se sont largement concentrés sur une interprétation plus pragmatique de l'éducation physique, de l'activité physique et du sport. Il semble ainsi que l'application du concept de littératie physique s’est progressivement centrée sur l'apprentissage d’habiletés plus fondamentales. Cela a éloigné la littératie physique de son objectif original et plus holistique, voulu par Whitehead (2007; 2013). Par conséquent, le défi que présente la littératie physique consiste à savoir comment réinventer la pédagogie de sorte qu'elle reste pertinente par rapport à ses origines holistiques. Il s'agit d'un problème complexe auquel, lors d'un récent séminaire de l’AIESEP (avec 92 acteurs-clés issus de 17 pays), nous avons appliqué un processus d'innovation centré sur l'humain appelé ‘design thinking’. Au cours du séminaire, répartis en groupes, les participants ont imaginé quatre nouveaux prototypes (solutions) en réponse à l'énoncé du problème. À travers ces prototypes, cinq aspects fondamentaux d'une pédagogie efficace de la littératie physique ont été identifiés à l'aide d'une analyse thématique: (1) une priorité portée sur l’ensemble de la vie et  tous les domaines de la vie; (2) la nécessité d’équipes de réflexion interdisciplinaires pour la concevoir et la mettre en œuvre; (3) le besoin de pédagogies hybrides, c'est-à-dire à la fois en face à face et virtuelles; (4) l'espace (virtuel et physique) en tant que catalyseur; (5) le comment entretenir la relation symbiotique entre la littératie physique et l'éducation physique. Par la suite, le Prisme de la Pratique d'Innovation D 3 (Chambers & Sammon, sous presse) a fourni un cadre de référence pour ce défi de conception. Sur cette base, lors d'un séminaire de suivi organisé en 2021 par l’AIESEP, il est prévu de développer une solution globale (prototype) qui englobera ces cinq aspects.

Entrées d’index

Mots-clés : , keywords: , texte intégral.

Acknowledgement: Thank you all participants of the AIESEP Seminar who used design thinking to unlock key pedagogical considerations for physical literacy. A sincere thank you to Dr David Aldous and Dr Anna Bryant from Cardiff Metropolitan University in Wales for assisting in the smooth running of the workshop. Their help was invaluable.

1. Introduction: The Design Challenge

• 1 AIESEP is an international professional association which develops, disseminates and promotes high (...)

1 On 25th February 2020, the Association Internationale des Écoles Superièure d’Éducation Physique 1 (AIESEP) hosted a Specialist Symposium. Those who attended had answered the following AIESEP call:

Clearly, physical literacy is a broad concept. Whilst the original term had strong philosophical orientations towards the concepts of phenomenology and existentialism, recent developments of the concept have largely focused on a more pragmatic interpretation. From our vast experience educating professionals in the area of physical literacy in physical education, physical activity and sport, it appears that the application of the concept of physical literacy has led to a focus on more rudimentary skills which has moved physical literacy away from its original and more holistic focus intended by Whitehead (2007; 2010). AIESEP now wonder if it might be timely to pause and reflect on the nature and purpose of current interpretations of physical literacy and to examine how other newer and related ideas might provide an understanding of the complex interplay between the individual and his/her ecological environment in the physical education, sport and physical activity contexts. This AIESEP Design Thinking workshop is an opportunity to engage in a 'design sprint' to innovate and iterate new pedagogies to promote physical literacy in the 21st century PE, sport and physical activity contexts. We invite all those who have a vested interest in promoting physical literacy amongst children and young people to join us in this unique workshop setting. This symposium follows on from our Physical Literacy roundtable in AIESEP 2019 (Adelphi University, Garden City, New York) ... giving us the opportunity to continue this important conversation (AIESEP, 2019).

2 Our broad design challenge was ‘to redesign pedagogies of physical literacy’ – an educational challenge which is intergenerational, multi-sectoral and multi-cultural. For the purposes of clarity the definition of physical literacy is based on an adaptation of the United Nations Educational, Scientific and Cultural Organization’s definition of “literacy,” “physical literacy”, defined as:

The ability to move with confidence and competence using all the physical assets one has at their disposal at any given point in time across varying contexts. It involves a continuum of learning by enabling individuals to achieve their goals; to develop their knowledge, movement, and potential; and to participate fully in their community and wider society (Dudley, Cairney, Wainright, Kriellaars & Mitchell, 2017, p.6).

3 The term pedagogy is defined as the art and science of learning and teaching. It has been noted that the term physical literacy is a ‘hot topic’ and has had multiple interpretations depending on professional culture and context (Chambers, 2020) For this reason the pedagogy of physical literacy is termed a wicked problem. Rittel and Webber (1973) described such problems as ‘wicked’ as they lacked both definitive formulations and solutions and were characterised by conditions of high uncertainty and in Blackman et al. ’s (2006) words ‘no single solution applies in all circumstances’ (p.70). Therefore, Buchanan (1992) concluded linear analytical approaches were unlikely to successfully resolve them. According to Peters (2017, p.288), wicked problems have nine particular characteristics:

They are difficult to define;

They have no definite formation;

There is no stopping rule;

The solutions to wicked problems are good or bad, but not true or false;

There is no immediate or ultimate test for solutions;

All attempts for solutions come with a warning i.e. they may not be reversible or forgettable;

They have no clear solution or set of solutions; each wicked problem is unique;

A wicked problem may be a symptom of another problem; and

There are multiple explanations for a wicked problem.

4 It was clear that we needed an innovative approach which could handle this level of complexity (wickedness); an experimental approach which explores multiple possible solutions. More than this, it required a process that could provide space for stakeholders to become active players in tackling this design challenge: to redesign pedagogies of physical literacy. Design thinking appeared to be such an innovative approach.

2. What is design thinking?

5 Design is the third area of human knowledge that fuses with humanities and science (Archer, 1979), a powerful interconnected triad. ‘Design is ambiguous by nature – in fact ambiguity is the heartbeat of design’ (Chambers, 2020, p.43). To help tackle this design challenge - redesigning the pedagogy of physical literacy - we turned to a particular genre of design i.e., design thinking (Brown, 2008). According to Liedtka (2015) the defining pillars of design thinking are problem centeredness, nonlinearity, optionality, and the presence of uncertainty and ambiguity. Design thinking is universally used in innovation to solve intractable human-centred problems (Buchanan, 1992). In so doing, it engages creative multi-disciplinary, multi-stakeholder teams to use a systematic and collaborative approach to identifying and creatively solving problems (Luchs, Swann & Griffin, 2016, p. 2). Design thinking brings ‘ designers’ principles, approaches, methods, and tools to problem solving’ (Brown, 2008, p.1). Lockwood (2016) asserts that the design thinking process ‘ emphasises observation, collaboration, fast learning, visualization of ideas, rapid concept prototyping, and concurrent business analysis’ (n.p.). The design challenge redesigning the pedagogy of physical literacy was wicked (complex) as it is ‘not stable but continually evolving and mutating and had many causal levels’ (Blackman et al. , 2006, p.70) and adding to this complexity, there are intergenerational, multisectoral and multicultural stakeholders with a range of philosophical views.

6 The ultimate solutions to wicked problems are located at the sweet spot (i.e., design innovation) (IDEO, 2009) (Figure 1). The sweet spot is the intersection of three aspects: (1) what is desirable from a human point of view (using design thinking) with (2) what is technologically feasible (agile development) and (3) what is economically viable (lean thinking) (Brown, 2016). Design thinking attends to the desirability aspect of the solution and is the first comprehensive process. Once a solution has been identified through design thinking, designers look to feasibility using agile learning methods and then, viability of the solution using lean thinking . Lean thinking is a business methodology that aims to provide a new way to think about how to organize human activities to deliver more benefits to society and value to individuals while eliminating waste (Womack & Jones, 2003). One key element of lean thinking is flow. Flow in this context is a description of how people engage in the process from the beginning to the end. It involves continuous improvement which means iteration and evolution of ideas and processes. Agile learning ( Longmuß, Höhne, Bräutigam, Oberländer & Schindler, 2016) is then employed to ensure that the solution can be scaled or delivered continuously. It is ‘based on the principles of inquiry based learning on the part of the learner and a demand driven, empowering perspective of the learning coaches ("Give what is needed when it is needed")’ Longmuß et al. , 2016 p.3). T o begin, we used design thinking to grapple with our design challenge. There are three enabling factors for any design team (Figure 2) design thinking process, design thinking mindset and design thinking space. Each of these elements will be described in detail in the forthcoming sections.

Figure 1. Sweetspot of Design Innovation (Chambers, 2020 adapted from IDEO, 2009)

Figure 2. Enabling Factors for the Design Team (Hasso Plattner Institute, 2019)

3. The Design Thinking Process

7 The process of design thinking itself is a multi-stage iterative process that has been outlined by many different theorists (Table 1). There are three agreed design thinking spaces – Inspiration, Ideation and Implementation (Brown, 2008). Design thinkers move iteratively between these spaces to make sense of the problem, to ideate solutions and then to test these solutions (Borja de Mozota & Peinado, 2013). Put more succinctly, Inspiration is the problem or opportunity that motivates the search for solutions; Ideation is the process of generating, developing, and testing ideas; and Implementation is the path that leads from the project stage into people’s lives (Table 1). Theorists agree that all design thinking begins with compassion or empathy. This refers to a desire to truly understand the stakeholders for whom the problem pertains. Once this has been ascertained, the designers move into ideation to brainstorm solutions which can be tested in implementation phase. Regardless of the model, there is always to broad spaces i.e., Problem Space- Solution Space. Note in the case study workshop described here, we used the Hasso Plattner Institute six-stage model (Table 1).

Table I. Eight Models of Design Thinking (Chambers, 2020, p.45)

8 The Design Council (2005) developed a double diamond, a divergence-convergence model to showcase the Problem-Solution spaces more clearly. While they use different language (the four stages Discover, Define, Develop and Deliver), they argue for a particular way of conducting design whatever the model i.e.: (1) put people first; (2) communicate visually and inclusively, (3) collaborate and co-create and (4) iterate, iterate, iterate. During this iterative process, 80% of the design time is spent working in the problem space (or Inspiration Space) and 20% of the time working in the solution space (Ideation and Implementation). The Design Council (2019) have recently presented an ‘evolved double diamond’. This includes engagement and leadership as core to a sustainable design thinking approach. This more ecological view of design acknowledges what is needed to build a design environment that supports capability building and long-term impact. In so doing, it is important to call out the need for an ethical approach to design, whether the focus is on product, process or service.

9 Smirnow’s (2017) features of service design are very helpful here: (1) A strategic and systems approach that visualizes and addresses complex issues with a holistic view; (2) Human-centred research driven by design ethics with high levels of empathy; (3) Value exchange and gain for all stakeholders through shared information flows; (4) Situational, interaction-based learning facilitated by design tools and mutual reflection. Building on this, Smirnow (2017) calls out six design thinking principles which speak directly to the work of the Design Council in encouraging a more sustainable approach to the design process itself:

Design for Transition : To create engaging, safe spaces to critically reframe assumptions, beliefs and understanding during times of change, growth and transition, helping to overcome barriers that result from pre-established and deeply ingrained social roles, boundaries and hierarchies.

Accessible Mutable System : Not only the activities (but the system itself) should be accessible, open sourced and ‘hackable’ to tailor experiences to different contexts and levels of understanding/engagement.

Mutual Learning through Exploration : Teachers, staff and students engage simultaneously in learning to generate data with values beyond the individual social context within the University (or in other jurisdictions)

Facilitated Learning About Oneself and Others : Moments that enable and encourage ‘deeper learning’ for all participants. A variety of resources offered (and a clear ‘game plan’) allow for self-directed reflection.

Multiple Levels of Intimacy : The scale of reflection on both levels, individual and group, plays an important role in building trust and processing the key takeaways about research contingencies.

At Your Discretion : Openness and mutual learning are encouraged but, the disclosure of sensitive information happens only according to the comfort level of each individual.

10 These features and principles are the markers of a design thinking pedagogy which nurtures the (1) design thinking mindset, (2) design thinking process and empowers us to use space differently when engaged in innovative praxis i.e. (3) the design thinking space.

4. The Design Thinking Mindset

11 As stated earlier, the process of design thinking involves the “development of idea stages, applying an iterative process that forces solvers to move back and forth between inspiration, ideation and implementation” (Borja de Mozota & Peinado, 2013, p.1). Carlgren, Elmquist and Rauth (2016) put design thinking on three levels: (1) principles and practices, (2) mindsets and (3) techniques. Di Russo (2016) concludes that ‘most definitions present design thinking as a mindset, method, process, attitude or a combination of all four’ (p. 259). Hassi and Laakso (2011) identify it as a form of practices, cognitive approach and mindset (Figure 3).

Figure 3. Mindset of a Design Thinker (adapted from Hassi & Laakso (2011) by Chambers, 2018 )

12 Going deeper into the mindset component, Schweitzer, Groeger and Sobel (2016) identified eleven design thinking mindsets based on interviews with expert design thinking practitioners:

having empathy towards people’s needs and context,

embracing collaboration and diversity,

being inquisitive and open to new perspectives and learning,

being mindful of process and thinking modes,

embracing experiential intelligence,

taking action deliberately and overtly,

being consciously creative,

accepting uncertainty and being open to risk,

modelling behaviour,

having the desire and determination to make a difference, and

being critically questioning.

13 From this, it is clear that design thinkers are therefore comfortable with uncertainty and ambiguity. This is a key threshold concept in design (Meyer & Land, 2003) as it is both transformative and irreversible i.e. once known, it cannot be unknown. This disposition allows the design thinker to “infer possible new worlds” (Martin, 2009, p.65) or opportunities. Moreover, the cognitive approach embraces abductive reasoning . Shearer (2015) asserts that when using abductive reasoning, there is a need to understand how different kinds of conjectures might interact with one another during this part of the design development. The dictionary definition of conjecture asserts that this is a form an opinion or supposition about (something) on the basis of incomplete information. By doing this, it helps provide a way to help multi-disciplinary design teams collaborate. This helps to mitigate against false representations of reality.

14 On an individual/personal level, Windahl (2017, p.280) asserts the importance of curiosity, creativity and courage when desirability, rather than feasibility or viability, is the locus of innovation activities. She asserts that (1) curiosity ignites empathy and deep understanding of the human experience; (2) creativity awakens ‘logical leaps’ in understanding opportunities; and (3) courage enflames learning through iterations, which reduces cognitive bias. Curiosity has four dimensions (Merck, 2018) (Figure 4). These are openness to people’s ideas; joyous exploration; stress tolerance and deprivation sensitivity.

Figure 4. Dimensions of Curiosity (adapted from Merck, 2018)

15 According to Chambers (2020, p. 48):

it is this rounded view of curiosity helps to explain how curious people react with open, non-defensive attitudes and effortful thinking. Such a disposition can be of benefit in an ever-changing and unpredictable environment, as individuals are less likely to perceive change as stressful and more likely to adapt effectively. When partnered with creativity and courage, it becomes even more potent as it unleashes the design for impact.

16 This could be termed as a growth mindset (Dweck, 2012) wherein the design thinker perceives his/her ability not as fixed but flexible, and as something that can be developed through effort.

17 Groeger, Schweitzer, Sobel and Malcom (2019 (pp 2-3) purport that it is the design thinking mindset that enables innovation objectives to be achieved at a deeper and more sustainable level. The cookie-cutter, template driven model of design thinking achieves a more surface level of change. Nussbaum (2011) reported how some are so fixated on process that design thinking is turned into a rigid plan, which is implemented like any other efficiency‐based process (Nussbaum, 2011). The design thinking mindset is the secret sauce which ensures that the process is not driven by templates. It leads to a more sustainable solution. For designers, the space in which design thinking happens is really important. In fact, design is seen as an embodied practice in space.

5. The Design Thinking Space

18 The physical environment that we construct is as much a social phenomenon as it is a physical one (Proshansky, Ittelson & Rivlin, 1970). In fact, when generating ideas, it becomes really important to be very fluid and have the ability to move in and out of different concepts and different people’s voices as an idea is coming to fruition. Therefore, creating a space that allows movement and encourages an active posture really helps collaboration to move more smoothly, and can push creativity by allowing people to participate when they want, step out when they do not, and permit leadership to move throughout the group (Doorley & Witthoft, 2011). It affords designer autonomy as ideas bounce off people and the space in which they work. For this to happen, Lawson (2001, p.8), asserts that we often need to tell space how to behave, so that it serves our purpose. Norman (2002) describes how we do this by outlining space typologies - A space type being a dedicated space for a particular activity at a specific time. He outlines how space has an inherent affordance, in other words it is an enabler for the particular activity taking place in that space. Every time the configuration changes, so, too, does the space type. The more flexible the space – the easier the transition. According to Thoring, Desmet & Badke-Schaub (2018), there are five types of creative spaces:

(1) The personal space , for working and learning alone; (2) the collaboration space for working or learning together with co-workers, classmates or teachers; (3) the presentation space , for giving presentations, consuming lectures and displaying or examining creative work examples; and (4) the making space in which people are able to experiment, try things out, build stuff and make noise and (5) the intermission space for transition and recreation. The latter includes spaces not intended for creative design work but connect other space types: hallways, cafeterias, the outdoors – and provide spaces for breaks (my emphasis, p.64)

19 Thoring et al . (2018) have also added another qualitative aspect to this typology and that is ‘space quality’. This is linked to Norman’s notion of affordance – and is more nuanced. It measures the ability of a space to facilitate a specific purpose, independent from the space type. In their words, they highlight five qualities of a creative space: (1) space as a knowledge processor; (2) space as an indicator of culture; (3) space as a process enabler; (4) space as a social dimension; (5) space as a source of stimulation.

20 It is important to understand how the process, mindset and space in design thinking work together. Therefore in the next section we look to The D 3 Prism of Innovation Praxis (Chambers & Sammon, 2020).

6. The D 3 Prism of Innovation Praxis

21 In order to design an impactful solution, we need to embrace The D 3 Prism of Innovation Praxis was coined by Chambers & Sammon (in press). It explains the pedagogy and praxis of design thinking across the three core pillars: (1) design thinking process, (2) design thinking mindset and (3) design thinking space. It comprises three core fluencies: design fluency, digital fluency and data fluency. It is helpful in drawing attention to the potency of these three fluencies in driving innovation for impact. Sparrow’s (2018, p.54) work is helpful here in defining fluencies. Chambers and Sammon (in press) have augmented this work, re-presenting within their D 3 Prism:

Design fluency (presented here as a combination of Sparrow’s (2018, p.54) creation fluency, curiosity fluency and innovation fluency ).  Innovation fluency includes the realization that failure is a valu­able part of the learning process. To innovate, students need to take risks, fail, learn from those failures, and iterate the process to bring a new idea to fruition. For many years, educators have utilized metacognition in the learning process: learning how someone learns and reflecting on that learning are key to apply­ing what was learned to new situations. Creation fluency, or maker fluency, is a deep understanding of how to create and leverage knowledge to make something new. These creations can by physical or virtual and can include 3D printing and programming. Curiosity fluency involves having questions and a desire to answer those questions. It prepares students not to just Google an answer but to be aware they are capable of developing their own answers to questions. Opportunities for developing curiosity fluency include providing students with practice and deep immersion in design thinking throughout their education and with an unbound, rules-free environment to think differently about the challenges we face in the 21 st century.

Digital fluency (with Sparrow’s (2018, p.54) Communication fluency ). This is ‘the ability to leverage technology to create new knowledge, new challenges, and new problems and to complement these with critical thinking, complex problem solving, and social intel­ligence to solve the new challenges. Digital fluency also requires excellent communication skills, new media literacy, and cogni­tive load management to address the issues, and concerns we face today and in the future. It includes: Communication fluency , which is the ability to communicate new knowledge across diverse populations and to choose a medium that is appropriate and most impactful for a given audience. Digital storytelling is one means of communicating new research findings. Additionally, students can use virtual reality and augmented reality. Using VR or AR to tell a story, learners need to understand not only how the technology works but also the impact on the reader and the fact that this medium can change how a story might be told.

Data fluency. This is the capacity to use data sets to make informed decisions, along with the knowledge to push the boundaries of what the technology can do to process the data to ask new questions. If learners have access to cloud computing resources, data science knowledge, and big data sets, the types of questions they will ask will be bound only by their imaginations (Sparrow, 2018, p.54).

22 D 3 Prism for Innovation Praxis provides a pedagogical handrail for educators, which helps them to prepare our students for the 85% of jobs that will be available in 2030 that haven’t been invented yet (Dell, 2017).

23 In the next section, the design thinking workshop at the heart of this article is presented. This provides an opportunity to amplify the design thinking process, mindset and use of space and more particularly to highlight the fluencies at play during this very dynamic workshop.

7. Case Study

24 The design challenge was ‘to redesign pedagogies of physical literacy’ – an educational challenge which is intergenerational, multi-sectoral and multi-cultural. In this AIESEP symposium, the design thinking workshop format encouraged participants to work together through a number of phases to ‘redesign the pedagogy of physical literacy’. The spirit of the workshop was one of dynamism. It was fast-paced and relied on participants embracing a growth mindset, interacting with the space and following the Hasso-Plattner Institute (2018) six-stage design thinking process (Table I and Figure 5).

Figure 5. Six-Stage Design Thinking Process (Hass Plattner Institute, 2018)

7.1 Participants

25 There were 92 participants who self-selected to experience the symposium. They comprised: curriculum developers, Physical Education teachers, Physical Education Teacher Education faculty, academics, sports coaches, politicians, etc. They were drawn from 17 countries: Belgium, Canada, China, The Netherlands, England, Finland, France, Germany, Ireland, Italy, Japan, Luxembourg, Northern Ireland, Poland, Switzerland, Taiwan, and Wales. The participants had little to no experience of design thinking, but were experts in PE, PA and/or sport and in particular physical literacy. Participants were divided into Master-Teams A, B, C or D. These master-teams were then subdivided into four further sub-teams e.g., Master-Team A became sub-team A1, sub-team A2, sub-team A3, sub-team A4. Each team had an English-speaking leader. Master-Team and sub-team lists were on the walls outside the room. Participants were greeted by one facilitator to ensure that all located their sub-team space quickly.

7.2 Design Ethics

26 When working on a design challenge, it is important to remember those who will be most impacted by the solution i.e., the end-user. The design thinking coach and/or facilitator must attend to design ethics as this is a human-centred innovation. As such, particularly in relation to service design, design thinking is able to humanise and visualise complex systems through research and scenarios. It can create new relations and interactions between the main actors and can lead to new knowledge. In order to facilitate this, the design thinking coach and/or facilitator must behave in an ethical manner by being authentic; bringing awareness; knowledgeable about the subject matter; makes no assumptions, values every collaborator as an expert of their own lives, presents a willingness to learn and be respectful; and to be mindful of confidentiality of every conversation and how it informs the design proposal (adapted from Smirnow, 2017, p.40). These are crystallised in Smirnow’s (2017) six design principles. The workshop used these to inform the pedagogy of design thinking (Table II).

Table II. Design Principles and Pedagogy of Design Thinking (adapted from Smirnow, 2017)

7.3 Use of Space

27 Interestingly, the workshop space for the AIESEP design thinking workshop exhibited three creative space types: collaboration space; presentation space; and making space. The workshop space, both collaboration and presentation space (Thoring et al ., 2018) was a large bright room with movable furniture. Furthermore, it exhibited three of Norman’s (2002) five qualities of a creative space – it enabled knowledge processing, it was a process enabler and the space had a social dimension. It was organized into four zones according to the master-teams (A, B, C, D) with four tables per zone for the sub-teams (A1-A4; B1-B4; C1-C4; D1-D4). Each table had an allocated wall or window space for their work. Every sub-team was allocated markers, sticky notes, blue tack and A2 sheets of paper. The intermission space (Thoring et al ., 2018) was a bright room for drinks, snacks and lunch.

7.4 Design Thinking Process

28 In this seminar, we used a six-step design process (Figure 4) which was developed by the Hasso Plattner Institute. The steps fall into Problem Space (Compassion) and Solution Space . As stated earlier, it is important to spend as much time as possible in the problem space – 80% and then the remaining time in the solution space. The design thinking pedagogy enables this to happen. The process began with Compassion – namely, empathising with the case study (persona) and being inclined toward action (Figure 3 for an example persona).

29 There are three sub-phases in the compassion space – understand, observe and point of view (or synthesise) as outlined by Chambers (2018). Empathy is ‘I understand how you feel’, whereas compassion is, I understand how you feel and am driven to do something that has a positive impact on you . This involves trying to really understand the case at hand and to settle on a point of view or synthesis of the issue at the heart of the case. For the purposes of starting to imbue compassion in participants, it begins with focusing on the end-user in physical education and physical literacy – a composite case called John (Figure 6). Participants are urged to think about John throughout the workshop and how what they will design will impact on how we support John on his physical literacy journey in the context of physical education.

30 There were four design thinking challenges which were informed by the (1) original broader problem statement and (2) the Megatrends in Education (OECD, 2019). Each design challenge was assigned to a Master-team:

Master-Team A . Redesign online and offline pedagogies for children in a world where there is limited funding.

Master-Team B . Redesign pedagogies for physical literacy for children in a world where sustainability is a core value.

Master-Team C . Redesign learning spaces and pedagogies to promote risky play in a world which is uber safety conscious.

Master-Team D . Redesign a factfulness approach to physical literacy in a world where pupils live in an echo chamber.

Figure 6. Sample Persona (John)

31 The agenda for the day was agile, with process tasks designed for each iterative phase of the design thinking process, which would encourage curiosity, creativity and courage (Windahl, 2017).

7.5 Prototypes (Results)

32 In Table III, the design challenge and the resultant prototype are shown for each of the four master-teams.

Table III. The Workshop Point of View Design Challenges (using the Hasso Plattner Institute Six Step Model, 2018)

33 All four prototypes were thematically analysed using Voyant, a data analysis coding tool. During the data analysis process, five key themes were identified as core to effective physical literacy pedagogy. They are:

Life-long and life-wide physical literacy;

Interdisciplinary design teams are needed to innovate, implement and evaluate physical literacy pedagogy;

Hybrid delivery required i.e. both face-to-face and virtual;

The importance of space as an enabler for quality physical literacy pedagogy; and

The need to ensure that we map how physical literacy informs/and is informed by physical education i.e. the symbiosis of their relationship

34 In the discussion section, these themes will be further examined as they will provide a useful handrail when continuing to innovate a solution for the complex problem (reimagining a pedagogy of physical literacy).

8. Discussion

35 In using design thinking to solve such complex problem as the reimagining the pedagogy of physical literacy, it is important to acknowledge the iterative nature of the process. This workshop simply provided a one-day opportunity to begin this endeavour. To continue this important innovation journey, it is intended to innovate an overarching (prototype) solution which embraces these five aspects at a follow-on AIESEP workshop in 2021.

36 In defining their four prototypes, the teams provided a useful starting point for further iteration and testing. However, it is in fact the five features of effective physical literacy pedagogy that provide a north star in this next phase – These are powerful. We will now review each, presenting follow-on design nudges for consideration at the next workshop. Design nudges are considerations that might be made when iterating the solution prototype further toward the final Test phase of design thinking.

Five Features of Effective Physical Literacy Pedagogy with Follow-on Design Nudges

Life-long and life-wide physical literacy Follow-on design nudges: Does this mean that physical literacy is something that can be learned and augmented throughout a lifetime? What implications does this have for physical education/sport/physical activity? In the context of life-wide, the implication is that many can help to empower physical literacy at particular points in the life journey – who are these stakeholders and how can this manifest itself?

Interdisciplinary design teams are needed to innovate, implement and evaluate physical literacy pedagogy Follow-on design nudges: Consider who might be included or excluded from this group? On what basis are they chosen to be involved? How can you measure the impact of their insights?

Hybrid delivery required i.e., both face-to-face and virtual Follow-on design nudges: How can this work in practice? What are the ethical considerations of such a move? How can a teacher/coach ensure an authentic learning experience for the person?

The importance of space as an enabler for quality physical literacy pedagogy Follow-on design nudges: When you think of space, is it both virtual and physical? How can virtual space be an enabler? Are their ethical considerations?

The need to ensure that we map how physical literacy informs/and is informed by physical education i.e., the symbiosis of their relationship Follow-on design nudges: There seems to be confusion as to the place of physical literacy in the world of physical education? It would be helpful to tease this out with the design team and with end-users. During the process new and interesting insights may be uncovered which can help further the design solution.

37 As stated earlier in the paper, the design an impactful solution involves embracing The D 3 Prism of Innovation Praxis (Chambers & Sammon, in press). A review of how teams engaged with this follows.

D 3 Prism of Innovation Praxis

38 It was clear that teams did embrace the three fluencies to some extent. We will deal with these under the three facets of the prism:

39 Design Fluency. In the workshop, this was the most difficult element for teams. They struggled with being asked not to move to solution too quickly; to stay with the issue and interrogate that for a long period. In addition, it took some time to establish trust among team members. This impacted their ability to take risks when innovating. In addition, some team dynamics were difficult, which some more extrovert team members being very dominant in the discussions.

40 Digital Fluency. Some teams were very adept at this but it seemed to depend on the generations within that team and their familiarity with digital technology. The urge to use technology as a cure-all was tempered having a diverse group across multiple generations (McCrindle, 2019). This particular lens will be very important in the next phase of innovation in the 2021 workshop.

41 Data Fluency. As the teams were so diverse with a range of expertise, members did share their knowledge freely to interrogate the problem and then to build the prototype. It is clear that fluency can be further exploited at the next workshop using bigger data sets.

42 The focus of this first workshop was fourfold: (1) to bring a diverse range of stakeholders together from a range of cultures and standpoints, all of whom have a vested interest in physical education, physical literacy and education more generally; (2) to teach the process of design thinking to the participants; (3) to create a safe and empowering design thinking space for the workshop and (4) to empower teams to innovate solutions to the design challenge using design thinking. It is clear that this has been achieved to an extent. This was evident from Dr Margaret Whitehead’s comments in closing the workshop. Dr Whitehead, the theorist who proposed physical literacy addressed the group, commenting that it was the first time she had witnessed and been part of a cross-cultural, cross discipline design workshop which focused on the pedagogy of physical literacy. She supported the notion of creating a professional learning community which could develop from this event and who could develop pedagogies of physical literacy which could be applied in contexts around the globe. Participants were invited to take part in the follow-on seminar in AIESEP 2021 in Banff, Canada.

9. Concluding remarks

43 The case study showcases a unique moment in AIESEP history when 92 colleagues from 17 countries gathered to tackle a wicked problem for our profession over 6 hours. Reflecting on the impact of this experience, there are a number of key learnings which we will interrogate under three key headings (1) The D 3 Prism for Innovation Praxis; (2) Networks (3) Future directions.

The D 3 Prism for Innovation Praxis (Chambers & Sammon, in press). It provides one lens through which this case study can be examined. It is evident that this powerful pedagogical handrail helps in planning, implementing and evaluating the impact of this design thinking case study. All 92 participants were novice design thinkers. They were presented with opportunities to develop design fluency through engagement in the design thinking tasks – They learned to take risks and to fail and to iterate. They also had opportunities to reflect on how they and other members of the team learned. Further to this, teams were encouraged to become ‘makers’ in order to visualise their ideas and to prototype their solutions. In addition, they showed a level of curiosity not only in relation to the problem but also in relation to what each team member might bring to the team. It is important to say that a one-day design thinking experience will not develop fluency – it may simply awaken the learner to these possibilities. Speaking specifically about digital fluency , one team in particular was attentive to this acknowledging that many of their pupils were Generation Z or Generation Alpha (McCrindle, 2019). Teams used appropriate communication methods, but such skillsets could be deepened with greater immersive experiences in design thinking. The teams did not have an opportunity to engage in any meaningful way with data fluency . They were inhibited by the fact that this was a time-bound activity.

Networking opportunities. Many of the participants had never met before. The design thinking workshop provided a chance to work on a shared design challenge. It provided a chance for colleagues to build their professional networks and to debate important issues and to co-create a solution to the design challenge.

Future directions. It is clear that this was just be beginning of the design journey – As stated, it is intended that teams will meet again in AIESEP 2021 in Banff, Canada to continue prototyping, testing and iterating their solutions to the design challenge.

44 In conclusion, design thinking when presented as a component of the D 3 Prism of Innovation Praxis is a powerful process, mindset and learning space. As we live in such uncertain times, our profession need to be design thinkers and to be comfortable with ambiguity, to embrace the innovation bubble and to reimagine and redesign physical education for the future.

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1 AIESEP is an international professional association which develops, disseminates and promotes high quality research and praxis in PE, physical activity and school sport.

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Fiona C. Chambers , « Redesigning the Pedagogies of Physical Literacy: Using Design Thinking as an innovation approach » ,  eJRIEPS [En ligne], Hors-série N° 4 | 2021, mis en ligne le 10 juin 2021 , consulté le 14 septembre 2024 . URL  : http://journals.openedition.org/ejrieps/6208 ; DOI  : https://doi.org/10.4000/ejrieps.6208

Fiona C. Chambers

Sports Studies and Physical Education, School of Education, University College Cork, Ireland.

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Design Thinking in Education

Design Thinking is a mindset and approach to learning, collaboration, and problem solving. In practice, the design process is a structured framework for identifying challenges, gathering information, generating potential solutions, refining ideas, and testing solutions. Design Thinking can be flexibly implemented; serving equally well as a framework for a course design or a roadmap for an activity or group project.

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Design Thinking in Education: Perspectives, Opportunities and Challenges

The article discusses design thinking as a process and mindset for collaboratively finding solutions for wicked problems in a variety of educational settings. Through a systematic literature review the article organizes case studies, reports, theoretical reflections, and other scholarly work to enhance our understanding of the purposes, contexts, benefits, limitations, affordances, constraints, effects and outcomes of design thinking in education. Specifically, the review pursues four questions: (1) What are the characteristics of design thinking that make it particularly fruitful for education? (2) How is design thinking applied in different educational settings? (3) What tools, techniques and methods are characteristic for design thinking? (4) What are the limitations or negative effects of design thinking? The goal of the article is to describe the current knowledge base to gain an improved understanding of the role of design thinking in education, to enhance research communication and discussion of best practice approaches and to chart immediate avenues for research and practice.

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Universal Design for Learning in Physical Education

• By: Michelle Grenier and Lauren Lieberman
• February 1st, 2022

UDL is a way of thinking and acting that may change the way you approach student learning. Rather than thinking a student needs to change, UDL looks at the  learning environment . Consider what within the environment is a barrier to learning. Is it that space itself? Is it the equipment you are using? Perhaps it is the way the students are expected to learn. The learning environment can include other barriers such as the goals of the class, the way assessments are conducted, or the way the students are organized. See below for a diagram that outlines an ecological analysis of the learning environment (Haywood & Getchell, 2019). When considering implementing UDL in the classroom, it is important to look at the following elements.

UDL provides a framework for implementing strategies to reduce barriers to student learning. The main way to do this is to create a learning environment where students have what they need to flexibly meet the learning goals. When developing and planning your lesson, think about the students, the classroom environment, and the task you are teaching.

Three underlying components form the basis of UDL. These include Principle 1 : Multiple Means of Engagement – strategies for motivating and getting student “buy-in.” Principle 2 : Multiple Means of Representation – providing flexibility in the way information is presented through instruction, and Principle 3: Multiple Means of Action & Expression – designing options that align with student learning and performance .

What does UDL look like in the gymnasium? Universal design can be found just about anywhere in your gymnasium (Lieberman et al., 2020). For example, when students enter the gym, is there anything that prevents all students from being a part of the class? Are the doors wide enough to accommodate a chair? Can everyone sit together? Are you, as the teacher, using multiple ways to deliver instruction (verbal, visual, peer modeling) to support a variety of learning styles?

Universal Design for Learning looks different in each gymnasium, but there are commonalities. To start with, there’s always a focus on building expert learning for all. Other common elements of a UDL experience include:

• All learners knowing the goal
• Intentional, flexible options for all students to use
• Student access to resources from the start of a lesson
• Students building and internalizing their own learning (CAST, 2018).

As educators, we know that there are multiple ways students can perform a particular skill, especially given the range of abilities in any given class. Through careful planning of options that differ across students’ developmental levels and skill functionality, students may not always do the same task in the same way. But the framework for having clear goals and flexible options is consistent no matter the grade level or the content areas. Utilizing UDL supports student learning and participation across the psychomotor, affective, and cognitive domains. Removing barriers, offering choices, and options in the ways students can participate and express what they can do, will ultimately lead to better learning outcomes for our students.

Lauren and Michelle are two of four co-authors of the text Universal Design for Learning in Physical Education. For more information please contact [email protected]

References & Resources CAST. (2018). About. Retrieved from: http://www.cast.org/our-work/about-udl.html#.WukPFdMvxME

CAST. (2018). Universal Design for Learning Guidelines version 2.2. Retrieved from http://udlguidelines.cast.org

Haywood, K.M., & Getchell, N. (2019). Life span motor development (any edition).  Champaign, IL: Human Kinetics.

Lieberman, L.J., Grenier, M., Brian, A., & Arndt, K. (2020). Universal design in physical education . Champaign, IL: Human Kinetics. https://www.nchpad.org/1820/7004/Laying~the~Foundation~for~Universal~Design~for~Learning~in~Physical~Education .

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Design Thinking (DT)

What is design thinking (dt).

Design thinking is a non-linear, iterative process that teams use to understand users, challenge assumptions, redefine problems and create innovative solutions to prototype and test. It is most useful to tackle ill-defined or unknown problems and involves five phases: Empathize, Define, Ideate, Prototype and Test.

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Why Is Design Thinking so Important?

“Design thinking is a human-centered approach to innovation that draws from the designer's toolkit to integrate the needs of people, the possibilities of technology, and the requirements for business success.” — Tim Brown, CEO of IDEO

Design thinking fosters innovation . Companies must innovate to survive and remain competitive in a rapidly changing environment. In design thinking, cross-functional teams work together to understand user needs and create solutions that address those needs. Moreover, the design thinking process helps unearth creative solutions.

Design teams use design thinking to tackle ill-defined/unknown problems (aka wicked problems ). Alan Dix, Professor of Human-Computer Interaction, explains what wicked problems are in this video.

Wicked problems demand teams to think outside the box, take action immediately, and constantly iterate—all hallmarks of design thinking.

Don Norman, a pioneer of user experience design, explains why the designer’s way of thinking is so powerful when it comes to such complex problems.

Design thinking offers practical methods and tools that major companies like Google, Apple and Airbnb use to drive innovation. From architecture and engineering to technology and services, companies across industries have embraced the methodology to drive innovation and address complex problems. 

The End Goal of Design Thinking: Be Desirable, Feasible and Viable

The design thinking process aims to satisfy three criteria: desirability (what do people desire?), feasibility (is it technically possible to build the solution?) and viability (can the company profit from the solution?). Teams begin with desirability and then bring in the other two lenses.

© Interaction Design Foundation, CC BY-SA 4.0

Desirability: Meet People’s Needs

The design thinking process starts by looking at the needs, dreams and behaviors of people—the end users. The team listens with empathy to understand what people want, not what the organization thinks they want or need. The team then thinks about solutions to satisfy these needs from the end user’s point of view.

Feasibility: Be Technologically Possible

Once the team identifies one or more solutions, they determine whether the organization can implement them. In theory, any solution is feasible if the organization has infinite resources and time to develop the solution. However, given the team’s current (or future resources), the team evaluates if the solution is worth pursuing. The team may iterate on the solution to make it more feasible or plan to increase its resources (say, hire more people or acquire specialized machinery).

At the beginning of the design thinking process, teams should not get too caught up in the technical implementation. If teams begin with technical constraints, they might restrict innovation.

Viability: Generate Profits

A desirable and technically feasible product isn’t enough. The organization must be able to generate revenues and profits from the solution. The viability lens is essential not only for commercial organizations but also for non-profits. 

Traditionally, companies begin with feasibility or viability and then try to find a problem to fit the solution and push it to the market. Design thinking reverses this process and advocates that teams begin with desirability and bring in the other two lenses later.

The Five Stages of Design Thinking

Stanford University’s Hasso Plattner Institute of Design, commonly known as the d.school, is renowned for its pioneering approach to design thinking. Their design process has five phases: Empathize, Define, Ideate, Prototype, and Test. These stages are not always sequential. Teams often run them in parallel, out of order, and repeat them as needed.

Stage 1: Empathize —Research Users' Needs

The team aims to understand the problem, typically through user research. Empathy is crucial to design thinking because it allows designers to set aside your assumptions about the world and gain insight into users and their needs.

Stage 2: Define—State Users' Needs and Problems

Once the team accumulates the information, they analyze the observations and synthesize them to define the core problems. These definitions are called problem statements . The team may create personas to help keep efforts human-centered.

Stage 3: Ideate—Challenge Assumptions and Create Ideas

With the foundation ready, teams gear up to “think outside the box.” They brainstorm alternative ways to view the problem and identify innovative solutions to the problem statement.

Stage 4: Prototype—Start to Create Solutions

This is an experimental phase. The aim is to identify the best possible solution for each problem. The team produces inexpensive, scaled-down versions of the product (or specific features found within the product) to investigate the ideas. This may be as simple as paper prototypes .

Stage 5: Test—Try the Solutions Out

The team tests these prototypes with real users to evaluate if they solve the problem. The test might throw up new insights, based on which the team might refine the prototype or even go back to the Define stage to revisit the problem.

These stages are different modes that contribute to the entire design project rather than sequential steps. The goal is to gain a deep understanding of the users and their ideal solution/product.

Design Thinking Frameworks

There is no single definition or process for design thinking. The five-stage design thinking methodology described above is just one of several frameworks.

Hasso-Platner Institute Panorama

Ludwig Wilhelm Wall, CC BY-SA 3.0 , via Wikimedia Commons

Innovation doesn’t follow a linear path or have a clear-cut formula. Global design leaders and consultants have interpreted the abstract design process in different ways and have proposed other frameworks of design thinking.

Head, Heart and Hand by the American Institution of Graphic Arts (AIGA)

The Head, Heart, and Hand approach by AIGA (American Institute of Graphic Arts) is a holistic perspective on design. It integrates the intellectual, emotional, and practical aspects of the creative process.

More than a process, the Head, Heart and Hand framework outlines the different roles that designers must perform to create great results.

© American Institute of Graphic Arts, Fair Use

“ Head ” symbolizes the intellectual component. The team focuses on strategic thinking, problem-solving and the cognitive aspects of design. It involves research and analytical thinking to ensure that design decisions are purposeful.

“ Heart ” represents the emotional dimension. It emphasizes empathy, passion, and human-centeredness. This aspect is crucial in understanding the users’ needs, desires, and experiences to ensure that designs resonate on a deeper, more personal level.

“ Hand ” signifies the practical execution of ideas, the craftsmanship, and the skills necessary to turn concepts into tangible solutions. This includes the mastery of tools, techniques, and materials, as well as the ability to implement and execute design ideas effectively.

Inspire, Ideate, Implement by IDEO

IDEO is a leading design consultancy and has developed its own version of the design thinking framework.

IDEO’s design thinking process is a cyclical three-step process that involves Inspiration, Ideation and Implementation.

© IDEO, Public License

In the “ Inspire ” phase, the team focuses on understanding users’ needs, behaviors, and motivations. The team empathizes with people through observation and user interviews to gather deep insights.

In the “ Ideate ” phase, the team synthesizes the insights gained to brainstorm a wide array of creative solutions. This stage encourages divergent thinking, where teams focus on quantity and variety of ideas over immediate practicality. The goal is to explore as many possibilities as possible without constraints.

In the “ Implement ” phase, the team brings these ideas to life through prototypes. The team tests, iterates and refines these ideas based on user feedback. This stage is crucial for translating abstract concepts into tangible, viable products, services, or experiences.

The methodology emphasizes collaboration and a multidisciplinary approach throughout each phase to ensure solutions are innovative and deeply rooted in real human needs and contexts.

The Double Diamond by the Design Council

In the book Designing Social Systems in a Changing World , Béla Heinrich Bánáthy, Professor at San Jose State University and UC Berkeley, created a “divergence-convergence model” diagram. The British Design Council interpreted this diagram to create the Double Diamond design process model.

As the name suggests, the double diamond model consists of two diamonds—one for the problem space and the other for the solution space. The model uses diamonds to represent the alternating diverging and converging activities.

© Design Council, CC BY 4.0

In the diverging “ Discover ” phase, designers gather insights and empathize with users’ needs. The team then converges in the “ Define ” phase to identify the problem.

The second, solution-related diamond, begins with “ Develop ,” where the team brainstorms ideas. The final stage is “ Deliver ,” where the team tests the concepts and implements the most viable solution.

This model balances expansive thinking with focused execution to ensure that design solutions are both creative and practical. It underscores the importance of understanding the problem thoroughly and carefully crafting the solution, making it a staple in many design and innovation processes.

With the widespread adoption of the double diamond framework, Design Council’s simple visual evolved.

In this expanded and annotated version, the framework emphasizes four design principles:

Be people-centered.

Communicate (visually and inclusively).

Collaborate and co-create.

Iterate, iterate, iterate!

The updated version also highlights the importance of leadership (to create an environment that allows innovation) and engagement (to connect with different stakeholders and involve them in the design process).

Common Elements of Design Thinking Frameworks

On the surface, design thinking frameworks look very different—they use alternative names and have different numbers of steps. However, at a fundamental level, they share several common traits.

Start with empathy . Focus on the people to come up with solutions that work best for individuals, business, and society.

Reframe the problem or challenge at hand . Don’t rush into a solution. Explore the problem space and look at the issue through multiple perspectives to gain a more holistic, nuanced understanding.

Initially, employ a divergent style of thinking (analyze) . In the problem space, gather as many insights as possible. In the solution space, encourage team members to generate and explore as many solutions as possible in an open, judgment-free ideation space.

Later, employ a convergent style of thinking (synthesize) . In the problem space, synthesize all data points to define the problem. In the solution space, whittle down all the ideas—isolate, combine and refine potential solutions to create more mature ideas.

Create and test prototypes . Solutions that make it through the previous stages get tested further to remove potential issues.

Iterate . As the team progresses through the various stages, they revisit different stages and may redefine the challenge based on new insights.

Design thinking is a non-linear process. For example, teams may jump from the test stage to the define stage if the tests reveal insights that redefine the problem. Or, a prototype might spark a new idea, prompting the team to step back into the ideate stage. Tests may also create new ideas for projects or reveal insights about users.

Design Thinking Mindsets: More than a Process

A mindset is a characteristic mental attitude that determines how one interprets and responds to situations . Design thinking mindsets are how individuals think , feel and express themselves during design thinking activities. It includes people’s expectations and orientations during a design project.

Without the right mindset, it can be very challenging to change how we work and think.

The key mindsets that ensure a team can successfully implement design thinking are.

Be empathetic: Empathy is the ability to place yourself, your thinking and feelings in another person’s shoes. Design thinking begins from a deep understanding of the needs and motivations of people—the parents, neighbors, children, colleagues, and strangers who make up a community. 

Be collaborative: No one person is responsible for the outcome when you work in a team. Several great minds are always stronger than just one. Design thinking benefits from the views of multiple perspectives and lets others’ creativity bolster your own.

Be optimistic: Be confident about achieving favorable outcomes. Design thinking is the fundamental belief that we can all create change—no matter how big a problem, how little time, or how small a budget. Designing can be a powerful process no matter what constraints exist around you.

Embrace ambiguity: Get comfortable with ambiguous and complex situations. If you expect perfection, it is difficult to take risks, which limits your ability to create radical change. Design thinking is all about experimenting and learning by doing. It gives you the confidence to believe that new, better things are possible and that you can help make them a reality. 

Be curious: Be open to different ideas. Recognize that you are not the user.

Reframe: Challenge and reframe assumptions associated with a given situation or problem. Don’t take problems at face value. Humans are primed to look for patterns. The unfortunate side effect of these patterns is that we form (often false and sometimes dangerous) stereotypes and assumptions. Design thinking aims to help you break through any preconceived notions and biases and reframe challenges.

Embrace diversity: Work with and engage people with different cultural backgrounds, experiences, and ways of thinking and working. Everyone brings a unique perspective to the team. When you include diverse voices in a team, you learn from each other’s experiences, further helping you break through your assumptions.

Make tangible: When you make ideas tangible, it is faster and easier for everyone on the team to be on the same page. For example, sketching an idea or enacting a scenario is far more convenient and easy to interpret than an elaborate presentation or document.

Take action: Run experiments and learn from them.

Design Thinking vs Agile Methodology

Teams often use design thinking and agile methodologies in project management, product development, and software development. These methodologies have distinct approaches but share some common principles.

Similarities between Design Thinking and Agile

Iterative process.

Both methodologies emphasize iterative development. In design thinking, teams may jump from one phase to another, not necessarily in a set cyclical or linear order. For example, on testing a prototype, teams may discover something new about their users and realize that they must redefine the problem. Agile teams iterate through development sprints.

User-Centered

The agile and design thinking methodologies focus on the end user. All design thinking activities—from empathizing to prototyping and testing—keep the end users front and center. Agile teams continually integrate user feedback into development cycles.

Collaboration and Teamwork

Both methodologies rely heavily on collaboration among cross-functional teams and encourage diverse perspectives and expertise.

Flexibility and Adaptability

With its focus on user research, prototyping and testing, design thinking ensures teams remain in touch with users and get continuous feedback. Similarly, agile teams monitor user feedback and refine the product in a reasonably quick time.

In this video, Laura Klein, author of Build Better Products , describes a typical challenge designers face on agile teams. She encourages designers to get comfortable with the idea of a design not being perfect. Notice the many parallels between Laura’s advice for designers on agile teams and the mindsets of design thinking.

Differences between Design Thinking and Agile

While design thinking and agile teams share principles like iteration, user focus, and collaboration, they are neither interchangeable nor mutually exclusive. A team can apply both methodologies without any conflict.

From a user experience design perspective, design thinking applies to the more abstract elements of strategy and scope. At the same time, agile is more relevant to the more concrete elements of UX: structure, skeleton and surface. For quick reference, here’s an overview of the five elements of user experience.

Design thinking is more about exploring and defining the right problem and solution, whereas agile is about efficiently executing and delivering a product.

Here are the key differences between design thinking and agile.

Design Sprint: A Condensed Version of Design Thinking

A design sprint is a 5-day intensive workshop where cross-functional teams aim to develop innovative solutions.

The design sprint is a very structured version of design thinking that fits into the timeline of a sprint (a sprint is a short timeframe in which agile teams work to produce deliverables). Developed by Google Ventures, the design sprint seeks to fast-track innovation.

In this video, user researcher Ditte Hvas Mortensen explains the design sprint in detail.

Learn More about Design Thinking

Design consultancy IDEO’s designkit is an excellent repository of design thinking tools and case studies.

To keep up with recent developments in design thinking, read IDEO CEO Tim Brown’s blog .

Enroll in our course Design Thinking: The Ultimate Guide —an excellent guide to get you started on your design thinking projects.

Questions related to Design Thinking

You don’t need any certification to practice design thinking. However, learning about the nuances of the methodology can help you:

Pick the appropriate methods and tailor the process to suit the unique needs of your project.

Avoid common pitfalls when you apply the methods.

Better lead a team and facilitate workshops.

Increase the chances of coming up with innovative solutions.

IxDF has a comprehensive course to help you gain the most from the methodology: Design Thinking: The Ultimate Guide .

Anyone can apply design thinking to solve problems. Despite what the name suggests, non-designers can use the methodology in non-design-related scenarios. The methodology helps you think about problems from the end user’s perspective. Some areas where you can apply this process:

Develop new products with greater chances of success.

Address community-related issues (such as education, healthcare and environment) to improve society and living standards.

Innovate/enhance existing products to gain an advantage over the competition.

Achieve greater efficiencies in operations and reduce costs.

Use the Design Thinking: The Ultimate Guide course to apply design thinking to your context today.

A framework is the basic structure underlying a system, concept, or text. There are several design thinking frameworks with slight differences. However, all the frameworks share some traits. Each framework: 

Begins with empathy.

Reframes the problem or challenge at hand.

Initially employs divergent styles of thinking to generate ideas.

Later, it employs convergent styles of thinking to narrow down the best ideas,

Creates and tests prototypes.

Iterates based on the tests.

Some of the design thinking frameworks are:

5-stage design process by d.school

7-step early traditional design process by Herbert Simon

The 5-Stage DeepDive™ by IDEO

The “Double Diamond” Design Process Model by the Design Council

Collective Action Toolkit (CAT) by Frog Design

The LUMA System of Innovation by LUMA Institute

For details about each of these frameworks, see 10 Insightful Design Thinking Frameworks: A Quick Overview .

IDEO’s 3-Stage Design Thinking Process consists of inspiration, ideation and implementation:

Inspire : The problem or opportunity inspires and motivates the search for a solution.

Ideate : A process of synthesis distills insights which can lead to solutions or opportunities for change.

Implement : The best ideas are turned into a concrete, fully conceived action plan.

IDEO is a leader in applying design thinking and has developed many frameworks. Find out more in 10 Insightful Design Thinking Frameworks: A Quick Overview .

Design Council's Double Diamond diagram depicts the divergent and convergent stages of the design process.

Béla H. Bánáthy, founder of the White Stag Leadership Development Program, created the “divergence-convergence” model in 1996. In the mid-2000s, the British Design Council made this famous as the Double Diamond model.

The Double Diamond diagram graphically represents a design thinking process. It highlights the divergent and convergent styles of thinking in the design process. It has four distinct phases:

Discover: Initial idea or inspiration based on user needs.

Define: Interpret user needs and align them with business objectives.

Develop: Develop, iterate and test design-led solutions.

Deliver: Finalize and launch the end product into the market.

Double Diamond is one of several design thinking frameworks. Find out more in 10 Insightful Design Thinking Frameworks: A Quick Overview .

There are several design thinking methods that you can choose from, depending on what stage of the process you’re in. Here are a few common design thinking methods:

User Interviews: to understand user needs, pain points, attitudes and behaviors.

5 Whys Method: to dig deeper into problems to diagnose the root cause.

User Observations: to understand how users behave in real life (as opposed to what they say they do).

Affinity Diagramming: to organize research findings.

Empathy Mapping: to empathize with users based on research insights.

Journey Mapping: to visualize a user’s experience as they solve a problem.

6 Thinking Hats: to encourage a group to think about a problem or solution from multiple perspectives.

Brainstorming: to generate ideas.

Prototyping: to make abstract ideas more tangible and test them.

Dot Voting: to select ideas.

Start applying these methods to your work today with the Design Thinking template bundle .

For most of the design thinking process, you will need basic office stationery:

Pen and paper

Sticky notes

Whiteboard and markers

Print-outs of templates and canvases as needed (such as empathy maps, journey maps, feedback capture grid etc.) You can also draw these out manually.

Prototyping materials such as UI stencils, string, clay, Lego bricks, sticky tapes, scissors and glue.

A space to work in.

You can conduct design thinking workshops remotely by:

Using collaborative software to simulate the whiteboard and sticky notes.

Using digital templates instead of printed canvases.

Download print-ready templates you can share with your team to practice design thinking today.

Design thinking is a problem-solving methodology that helps teams better identify, understand, and solve business and customer problems.

When businesses prioritize and empathize with customers, they can create solutions catering to their needs. Happier customers are more likely to be loyal and organically advocate for the product.

Design thinking helps businesses develop innovative solutions that give them a competitive advantage.

Gain a competitive advantage in your business with Design Thinking: The Ultimate Guide .

The evolution of Design Thinking can be summarised in 8 key events from the 1960s to 2004.

© Interaction Design Foundation, CC BY-SA 4.0.

Herbert Simon’s 1969 book, "The Sciences of the Artificial," has one of the earliest references to design thinking. David Kelley, founder of the design consultancy IDEO, coined the term “design thinking” and helped make it popular.

For a more comprehensive discussion on the origins of design thinking, see The History of Design Thinking .

Some organizations that have employed design thinking successfully are:

Airbnb: Airbnb used design thinking to create a platform for people to rent out their homes to travelers. The company focused on the needs of both hosts and guests . The result was a user-friendly platform to help people find and book accommodations.

PillPack: PillPack is a prescription home-delivery system. The company focused on the needs of people who take multiple medications and created a system that organizes pills by date and time. Amazon bought PillPack in 2018 for $1 billion .

Google Creative Lab: Google Creative Lab collaborated with IDEO to discover how kids physically play and learn. The team used design thinking to create Project Bloks . The project helps children develop foundational problem-solving skills "through coding experiences that are playful, tactile and collaborative.”

See more examples of design thinking and learn practical methods in Design Thinking: The Ultimate Guide .

Innovation essentially means a new idea. Design thinking is a problem-solving methodology that helps teams develop new ideas. In other words, design thinking can lead to innovation.

Human-Centered Design is a newer term for User-Centered Design

“Human-centred design is an approach to interactive systems development that aims to make systems usable and useful by focusing on the users, their needs and requirements, and by applying human factors/ergonomics, and usability knowledge and techniques. This approach enhances effectiveness and efficiency, improves human well-being, user satisfaction, accessibility and sustainability; and counteracts possible adverse effects of use on human health, safety and performance.”

— ISO 9241-210:2019(en), ISO (the International Organization for Standardization)  

User experience expert Don Norman describes human-centered design (HCD) as a more evolved form of user-centered design (UCD). The word "users" removes their importance and treats them more like objects than people. By replacing “user” with “human,” designers can empathize better with the people for whom they are designing. Don Norman takes HCD a step further and prefers the term People-Centered Design.

Design thinking has a broader scope and takes HCD beyond the design discipline to drive innovation.

People sometimes use design thinking and human-centered design to mean the same thing. However, they are not the same. HCD is a formal discipline with a specific process used only by designers and usability engineers to design products. Design thinking borrows the design methods and applies them to problems in general.

Design Sprint condenses design thinking into a 1-week structured workshop

Google Ventures condensed the design thinking framework into a time-constrained 5-day workshop format called the Design Sprint. The sprint follows one step per day of the week:

Monday: Unpack

Tuesday: Sketch

Wednesday: Decide

Thursday: Prototype

Friday: Test

Learn more about the design sprint in Make Your UX Design Process Agile Using Google’s Methodology .

Systems Thinking is a distinct discipline with a broader approach to problem-solving

“Systems thinking is a way of exploring and developing effective action by looking at connected wholes rather than separate parts.”

— Introduction to Systems thinking, Report of GSE and GORS seminar, Civil Service Live

Both HCD and Systems Thinking are formal disciplines. Designers and usability engineers primarily use HCD. Systems thinking has applications in various fields, such as medical, environmental, political, economic, human resources, and educational systems.

HCD has a much narrower focus and aims to create and improve products. Systems thinking looks at the larger picture and aims to change entire systems.

Don Norman encourages designers to incorporate systems thinking in their work. Instead of looking at people and problems in isolation, designers must look at them from a systems point of view.

In summary, UCD and HCD refer to the same field, with the latter being a preferred phrase.

Design thinking is a broader framework that borrows methods from human-centered design to approach problems beyond the design discipline. It encourages people with different backgrounds and expertise to work together and apply the designer’s way of thinking to generate innovative solutions to problems.

Systems thinking is another approach to problem-solving that looks at the big picture instead of specific problems in isolation.

The design sprint is Google Ventures’ version of the design thinking process, structured to fit the design process in 1 week.

There are multiple design thinking frameworks, each with a different number of steps and phase names. One of the most popular frameworks is the Stanford d.School 5-stage process.

Design thinking is an iterative and non-linear process. It contains five phases: 1. Empathize, 2. Define, 3. Ideate, 4. Prototype and 5. Test. It is important to note the five stages of design thinking are not always sequential. They do not have to follow a specific order, and they can often occur in parallel or be repeated iteratively. The stages should be understood as different modes which contribute to the entire design project, rather than sequential steps.

For more details, see The 5 Stages in the Design Thinking Process .

IDEO is a leading design consultancy and has developed its own version of the design thinking framework and adds the dimension of implementation in the process.

IDEO’s framework uses slightly different terms than d.school’s design thinking process and adds an extra dimension of implementation. The steps in the DeepDive™ Methodology are: Understand, Observe, Visualize, Evaluate and Implement.

IDEO’s DeepDive™ Methodology includes the following steps:

Understand: Conduct research and identify what the client needs and the market landscape

Observe: Similar to the Empathize step, teams observe people in live scenarios and conduct user research to identify their needs and pain points.

Visualize: In this step, the team visualizes new concepts. Similar to the Ideate phase, teams focus on creative, out-of-the-box and novel ideas.

Evaluate: The team prototypes ideas and evaluates them. After refining the prototypes, the team picks the most suitable one.

Implement: The team then sets about to develop the new concept for commercial use.

IDEO’s DeepDive™ is one of several design thinking frameworks. Find out more in 10 Insightful Design Thinking Frameworks: A Quick Overview .

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What are the stages in the design thinking process?

• Brainstorm, Prototype, Design, Launch, Test
• Define, Ideate, Research, Design, Test
• Empathize, Define, Ideate, Prototype, Test

Why is empathy critical in the design thinking process?

• It allows designers to understand and address the real needs of users.
• It helps designers maintain control over the creative process.
• It makes sure the solution is inexpensive and easy to create.

What is the primary purpose of the prototyping phase in design thinking?

• To explore potential solutions and how they might work in real-world situations
• To finalize the product design for mass production
• To sell the idea to stakeholders with a high-fidelity (hi-fi) demonstration

What is a "wicked problem" in design thinking?

• Problems that are complex, ill-defined and have no single correct answer.
• Problems that are straightforward and have a clear, single solution.
• Problems that are tricky, but can be solved quickly with conventional methods.

Why is the iterative process important in design thinking?

• It allows design teams to use up all available resources.
• It allows for the improvement of solutions based on user feedback and testing.
• It makes sure the solution remains unchanged throughout development.

Better luck next time!

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Literature on Design Thinking (DT)

Here’s the entire UX literature on Design Thinking (DT) by the Interaction Design Foundation, collated in one place:

Learn more about Design Thinking (DT)

Take a deep dive into Design Thinking (DT) with our course Design Thinking: The Ultimate Guide .

Some of the world’s leading brands, such as Apple, Google, Samsung, and General Electric, have rapidly adopted the design thinking approach, and design thinking is being taught at leading universities around the world, including Stanford d.school, Harvard, and MIT. What is design thinking, and why is it so popular and effective?

Design Thinking is not exclusive to designers —all great innovators in literature, art, music, science, engineering and business have practiced it. So, why call it Design Thinking? Well, that’s because design work processes help us systematically extract, teach, learn and apply human-centered techniques to solve problems in a creative and innovative way—in our designs, businesses, countries and lives. And that’s what makes it so special.

The overall goal of this design thinking course is to help you design better products, services, processes, strategies, spaces, architecture, and experiences. Design thinking helps you and your team develop practical and innovative solutions for your problems. It is a human-focused , prototype-driven , innovative design process . Through this course, you will develop a solid understanding of the fundamental phases and methods in design thinking, and you will learn how to implement your newfound knowledge in your professional work life. We will give you lots of examples; we will go into case studies, videos, and other useful material, all of which will help you dive further into design thinking. In fact, this course also includes exclusive video content that we've produced in partnership with design leaders like Alan Dix, William Hudson and Frank Spillers!

This course contains a series of practical exercises that build on one another to create a complete design thinking project. The exercises are optional, but you’ll get invaluable hands-on experience with the methods you encounter in this course if you complete them, because they will teach you to take your first steps as a design thinking practitioner. What’s equally important is you can use your work as a case study for your portfolio to showcase your abilities to future employers! A portfolio is essential if you want to step into or move ahead in a career in the world of human-centered design.

Design thinking methods and strategies belong at every level of the design process . However, design thinking is not an exclusive property of designers—all great innovators in literature, art, music, science, engineering, and business have practiced it. What’s special about design thinking is that designers and designers’ work processes can help us systematically extract, teach, learn, and apply these human-centered techniques in solving problems in a creative and innovative way—in our designs, in our businesses, in our countries, and in our lives.

That means that design thinking is not only for designers but also for creative employees , freelancers , and business leaders . It’s for anyone who seeks to infuse an approach to innovation that is powerful, effective and broadly accessible, one that can be integrated into every level of an organization, product, or service so as to drive new alternatives for businesses and society.

You earn a verifiable and industry-trusted Course Certificate once you complete the course. You can highlight them on your resume, CV, LinkedIn profile or your website .

All open-source articles on Design Thinking (DT)

What is design thinking and why is it so popular.

• 1.6k shares

Personas – A Simple Introduction

• 1.5k shares

Stage 2 in the Design Thinking Process: Define the Problem and Interpret the Results

• 1.3k shares

What is Ideation – and How to Prepare for Ideation Sessions

Affinity Diagrams: How to Cluster Your Ideas and Reveal Insights

• 1.2k shares
• 2 years ago

Stage 4 in the Design Thinking Process: Prototype

• 4 years ago

Stage 3 in the Design Thinking Process: Ideate

Stage 1 in the Design Thinking Process: Empathise with Your Users

Empathy Map – Why and How to Use It

What Is Empathy and Why Is It So Important in Design Thinking?

10 Insightful Design Thinking Frameworks: A Quick Overview

Define and Frame Your Design Challenge by Creating Your Point Of View and Ask “How Might We”

Design Thinking: Get Started with Prototyping

• 1.1k shares

5 Common Low-Fidelity Prototypes and Their Best Practices

Design Thinking: New Innovative Thinking for New Problems

The History of Design Thinking

Test Your Prototypes: How to Gather Feedback and Maximize Learning

The Ultimate Guide to Understanding UX Roles and Which One You Should Go For

• 11 mths ago

Stage 5 in the Design Thinking Process: Test

What Are Wicked Problems and How Might We Solve Them?

• 10 mths ago

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Physical Education Research Digest

Critical Thinking: Creating Meaning in Physical Education (PE) by Denise Dewar and Sue Weir

Denise and Sue are seconded teaching fellows at the University of Edinburgh. While working in schools, they both encountered initiatives aimed at the development of thinking skills. These experiences evolved into a project about ‘critical thinking’ and exploring how these ways of working could be fostered in PE settings and beyond. This blog reports on key insights from their collective self-study that has tracked the impact of their efforts to introduce critical thinking to undergraduate PE students. As part of the PERF’s Practitioner Inquiry (PINQ) Project, their research has been guided by LaBoskey’s key elements for self-study (2004).

Critical Thinking: Creating Meaning in Physical Education (PE)

Critical thinking is an amorphous term (Tan, 2017). It has numerous interpretations on both its definition and on the processes involved in developing critical thinking.  Most definitions highlight the connections to the upper three levels of Bloom’s (1956) taxonomy: analysis, synthesis and evaluation. These forms of thinking skills have been associated with a number of ‘Critical thinking’ learner dispositions including; open and fair mindedness, flexibility of thought, inquisitiveness and willingness to take risks (Lai, 2011).

Within the PE literature, critical thinking is a term first popularised by McBride (1992). He viewed PE as an ideal setting to develop critical thinking, which he defined as:

Reflective thinking that is used to make reasonable and defensible decisions about movement tasks or challenges (p112)

The short term focus within this quotation can be seen in the way in which any critical thinking is applied to the immediate tasks and challenges within a class situation.  Our own efforts, however, have been geared towards viewing critical thinking from both a short and long term perspective.  As can be seen in the figure below (click on image to enlarge), pupils not only respond to unique movement problems and reflect on and justify the decisions they make in class, but are also encouraged to view PE critically as part of their overall physical activity habits and lifestyle.

One key driver for connecting with these longer term ambitions comes from Dewey’s (1933) work on ‘deep’ learning. He explores the connection between ‘thinking’ and ‘meaning’ to create what he termed ‘profound learning’.  More recent research with a focus on ‘meaning’ has identified personal experience as a central feature. In the PE context, Beni et al (2016) explain how pupils with personalised experiences can feel more ‘meaningful’ connections to learning tasks, which are more likely to commit to a physically active lifestyle.

Our knowledge of critical thinking initially developed through our reading and shared discussions with each other and with critical friends.  Knowledge and understanding was further developed by piloting with the undergraduate PE teachers through lectures, seminars and practical workshops.   Our lecture to second year students was included as a key part of the curriculum course and was followed by a seminar which allowed students to discuss their understanding of critical thinking and explore ideas for their teaching of core PE.  Within practical workshops, fourth year students reflected on their own wider experiences of dance and chose a ‘purpose’ best suited to them, the students created a group performance based on these personal experiences.   They then performed the dance, evaluated the performance collectively and then reflected on the thinking involved in the creative process.

Data were gathered through a mixed methods approach: pre and post workshop questionnaires with students together with our own individual and shared reflections with two experienced teacher educators acting as critical friends throughout the research process.  In both years of the project we were surprised by the decisions students made when presented with choices in the lesson.   This reinforced our belief in offering pupils opportunities to not only make decisions but also justify these decisions to gain more insight into them (McBride, 1992).   Also, in the second year of the project, we felt we were more explicit in teaching thinking skills and dispositions within the workshops and using the language of thinking from the literature.  The importance of reflection time was highlighted in collective reflections, as we felt students needed time to make sense of the task and the thinking process.

Student Experiences

From data collected following the second year of workshops all students were able to identify when they used thinking skills and dispositions within the session.  We felt this indicated a deeper understanding of the concepts and tied in with our own reflections of being better able to ‘model critical thinking’ (McBride, 1992, p 118).

In harmony with our reflections, students also highly valued pupil reflection as a key component of critical thinking, with over half (52%) indicating that this would be an area of their own practice they would like to enhance.

Most students (93%) thought the session was made ‘meaningful’ with most of them connecting this to being given choices throughout the session, being able to express themselves freely and the nature of the session being sociable and enjoyable.

Concluding thoughts

As an ongoing longitudinal study, we have had some valuable findings so far.  The responses from the students have been encouraging, particularly as all students recognise the importance of critical thinking within PE.   In addition, as we have grappled with the key critical thinking concepts, our shared reflections have helped us make more sense of the non-linear nature of the design and enactment process of this type of project.

In the future, we will continue to integrate key components of critical thinking in the gymnastics element of curriculum and pedagogy course for year 2 and will reflect individually and collectively on the enactment process.  In addition, we will continue to share our critical thinking journey with other practitioners as part of the PINQ project and more widely.

Beni, S, Fletcher T and Ni Chronin, D (2016) Meaningful Experiences in Physical Education and Youth Sport: A review of literature, Quest, DOI: 10.1080/00336297.2016.1224192

LaBoskey, V. K. (2004). The methodology of self-study and its theoretical underpinnings. In J. J. Loughran, M. L. Hamilton, V. K. LaBoskey & T. Russell (Eds.), International handbook of self-study of teaching and teacher education practices (Vol. 2, pp. 817-869). Dordrecht: Kluwer Academic Publishers

Lai, E.R. (2011) Critical thinking: a literature review. Research report. Pearson.

McBride, R. 1992. Critical thinking—An overview with implications for physical education.  Journal of Teaching in Physical Education , 11: 112–125.

Tan, C (2017) Teaching Critical thinking: Cultural challenges and strategies in Singapore. British Educational research journal, 43:5 988-1002

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Complexity Thinking in Physical Education

DOI link for Complexity Thinking in Physical Education

Get Citation

In the past two decades, complexity thinking has emerged as an important theoretical response to the limitations of orthodox ways of understanding educational phenomena. Complexity provides ways of understanding that embrace uncertainty, non-linearity and the inevitable ‘messiness’ that is inherent in educational settings, paying attention to the ways in which the whole is greater than the sum of its parts. This is the first book to focus on complexity thinking in the context of physical education, enabling fresh ways of thinking about research, teaching, curriculum and learning.

Written by a team of leading international physical education scholars, the book highlights how the considerable theoretical promise of complexity can be reflected in the actual policies, pedagogies and practices of physical education (PE). It encourages teachers, educators and researchers to embrace notions of learning that are more organic and emergent, to allow the inherent complexity of pedagogical work in PE to be examined more broadly and inclusively. In doing so, Complexity Thinking in Physical Education makes a major contribution to our understanding of pedagogy, curriculum design and development, human movement and educational practice.

TABLE OF CONTENTS

Chapter | 13  pages, reframing curriculum, pedagogy and research, the complexity of intervention, chapter | 15  pages, introducing conditions of complexity in the context of scottish physical education, complexity, equity and critical approaches to physical education, chapter | 12  pages, affordance networks and the complexity of learning, intentionality, coordination dynamics and the complexity of human movement, chapter | 14  pages, ongoing adaptation as a feature of complexity, “another damned, thick, square book”, enabling constraints, effective learning design for the individual, chapter | 16  pages, a nonlinear pedagogy for sports teams as social neurobiological systems, chapter | 17  pages, emergence in school-integrated teacher education for elementary physical education teachers, the complex thinking paradigm in physical education teacher education, modification by adaptation, thinking about complexity thinking for physical education.

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Let’s make creativity and innovation part of your standard operating procedures. With our design thinking courses, you can bring new ideas and fresh perspectives to your team, your department, or your entire company. We’ll show you how design thinking can (and will) unlock your creativity so that you can repeatedly come up with innovative ideas and solutions to problems (big and small) that you face in your life and your work. Through online content, hands-on assignments, ongoing coaching, and proven frameworks, you'll learn how to practice and champion design thinking in any role you're in.

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Introduction to Design Thinking

Jeremy Utley and Justin Ferrell will introduce you to design thinking, as they teach it every day here at the Stanford d.School. Get started in your design thinking journey and prepare for further, more hands-on courses.

Achieving Innovation through Inspiration

Inspiration isn’t something you wait for. It’s something you work for. Gain the critical tools you need to seek the inspiration that will turn unknowns into radically new products and services.

Empathize and Prototype: A Hands on Dive into the Key Tools of Design Thinking

Master techniques for gaining empathy with customers and immediately put them to use in a series of hands-on exercises that guide you from synthesis to prototyping and testing.

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Follow along with hands-on exercises that lead you from ideation to prototyping and presentation. You'll learn how to lead innovation and brainstorming sessions in your company.

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Participate in monthly “Activation Hours” where you’ll join our program instructors live, as they walk you through new, supplemental creativity and design thinking content. In the discussion sessions, you will meet and collaborate with your fellow learners.

Dr. Kathryn Segovia of the Stanford d.school will guide you through a series of coaching lessons between each course that will help you build your daily creative practice and form a lifelong routine that fosters innovation.

Chats with David Kelley

Throughout the program, David Kelley invites you into his personal design studio for a series of chats on different aspects of creativity and design thinking, from the origins of design thinking to strengthening your creative muscles and building creative confidence.

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View and complete course materials, video lectures, assignments, and exams, at your own pace. You also get 1 year of email access to your Stanford teaching assistant.

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David Kelley

Donald W. Whittier Professor Mechanical Engineering

David Kelley's work is dedicated to helping people gain confidence in their creative abilities. He employs a project based methodology called Design Thinking within both the Product Design Program and the Hasso Plattner Institute of Design.  Design Thinking is based on building empathy for user needs, developing solutions with iterative prototyping, and inspiring ideas for the future through storytelling.  The Product Design program emphasizes the blending of engineering innovation, human values, and manufacturing concerns into a single curriculum. Kelley teaches engineering design methodology, the techniques of quick prototyping to prove feasibility, and design through understanding of user needs.

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Hasso Plattner Institute of Design at Stanford

Justin Ferrell joined the d.school in 2012 to redesign and direct its fellowship program. A career journalist specializing in organizational behavior and design, Justin worked for seven years at The Washington Post, most recently as the director of digital, mobile & new product design. He brought mobile designers and programmers into the newsroom, and enabled collaborative teams of reporters, editors and developers to create groundbreaking work. Also a prolific visual storyteller, Justin designed several award-winning projects — including the investigative series “Angler: The Cheney Vice Presidency,” winner of the 2008 Pulitzer Prize for National Reporting. He has spoken on creative culture and human-centered design in many venues, from the SXSW Interactive festival in Austin, to the Norwegian Research Council in Oslo, to the U.S. Embassy in Dublin, to Education City in Doha, Qatar. Justin teaches Stanford graduate courses in design thinking, creativity and organization design. He also teaches executive education at the Stanford Graduate School of Business, and his consulting clients have included Hewlett-Packard, IDEO and Citi Ventures. He has led many innovation workshops, including sessions for Alestra, Facebook, Google, Knight Foundation, Nokia, SAP, the U.S. Department of State, The United Nations and the World Economic Forum.

Perry Klebahn

Adjunct Professor, Director of Executive Education

When it comes to startups, corporations and executive leadership, Perry’s seen just about everything. He's a seasoned entrepreneur, product designer, chief executive and co-founding member of the d.school faculty with over 20 years of experience. He also loves math, motorcycles and making things. Perry brought two out of three of those interests to bear when he created a new category of sportswear by way of a high-performance shoe — a snowshoe — for his product design master’s thesis. He went on to found the Atlas Snowshoe Company, which remains the leader in snowshoe design and technology. Perry sold Atlas and became the head of Sales and Marketing for the clothing brand, Patagonia in 2000. He then went on to be named the CEO of the iconic bag company, Timbuk2 in 2007. Both opportunities gave him extensive experience in brand turn-around, design and innovation. Despite his years running startups and corporations, Perry’s true calling is teaching. He leverages the breadth and depth of his experience as he pushes his students to bring rigor and precision to their fast-paced design work. His students often tell him that, while they were intimidated by him during the course, they're grateful for the pressure he placed on them to exceed their own expectations. Perry is a founding teaching team member for the d.school’s startup gauntlet class, Launchpad, the innovation leadership course, d.leadership and the week-long executive education intensive, Bootcamp. He is also on the teaching teams for the personal development course, Designer in Society and the organizational change course, d.org. In every class, Perry guides his students to look back in order to discover what to do next and works from the unshakeable belief that it’s always possible to see a problem differently.

Perry is an Adjunct Professor and Director of Executive Education at the d.school. He holds a B.A. in Physics from Wesleyan University (1988) and a Master’s degree in Product Design from Stanford University (1991).

Jeremy Utley

Adjunct Professor

Jeremy never expected to be a designer. On his 10th birthday, his father asked him what he wanted to be when he grew up. Jeremy replied,”I want to be one of the people who carry boxes with handles.” A little over a decade later, Jeremy became a briefcase-carrying management consultant focusing on economic development. Then, in 2008, d.school derailed him completely. His time as a student and a fellow at the d.school showed him that “how” he worked was more important than “what” he did. Today, Jeremy is dedicated to helping others along the same path to becoming a designer. He helps people change their deeply-engrained behaviors and discover, as he did, that it is possible for them to make a difference. He does this through teaching as well as through growing alongside his students to become better in his own life and work every day.

Jeremy is the Director of Executive Education at the d.school. He is a graduate of The University of Texas at Austin’s Red McComb’s School of Business (2005) and the Stanford University Graduate School of Business (2009).

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Design and implementation of college students' physical education teaching information management system by data mining technology

Affiliation.

• 1 School of Physical Education, Wuhan University of Science and Technology, Wuhan, China.
• PMID: 39247331
• PMCID: PMC11378959
• DOI: 10.1016/j.heliyon.2024.e36393

This study intends to improve the efficiency of physical education teaching management, accelerate the normal teaching process, and meet the modern management requirements that traditional teaching management methods cannot meet. Based on data mining technology, this study designs a college student physical education teaching information management system, and makes a detailed design of each functional module. The main task of this study is to investigate how to effectively integrate data mining techniques with existing university student physical education teaching databases. Then, this study finds useful data information from massive data information to provide information support for university student physical education teaching. In order to effectively mine the relevant information of the data, the student evaluation module in the system is designed based on decision trees, and the teacher-student related data analysis module in the system is designed based on association rules. The research results indicate that 1039 records and 8205 student records are extracted from the teaching management database as mining objects. Rule 1: The support rate for "a professor's degree is a doctoral degree" is 20.4 %, indicating that there are 20.4 % of records in the teacher database that "the title is a professor and a doctoral degree"; the confidence level of Rule 1 is 78.2 %, indicating that 78.2 % of professors have a doctoral degree. Through the analysis of the rules that evaluate teaching as good, it can be found that the three attributes of professional title, education level, and teaching experience are the most important relevant factors affecting teaching effectiveness. Research has shown that the longer and richer the teaching experience, the stronger the teaching ability. Secondly, the mining results obtained through data mining techniques are analyzed. The maximum difference between the original algorithm's support mining results and the true values is 0.08, while the maximum difference between the improved algorithm's support mining results and the true values is 0.01. Compared to the original algorithm, the improved algorithm's mining results are accurate and effective. The application of data mining ideas in this system has laid a solid foundation for the development of physical education and teaching. Moreover, a three-layer system architecture model is adopted to better adapt to the development of school physical education, which is beneficial for later system maintenance and greatly reduces the work pressure of teachers. The system has been successfully launched and running in universities, and it is in good working condition.

Keywords: College physical education; Data mining technology; Information management system; Physical education teaching; System design.

© 2024 The Author.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Decision-making function of college students'…

Decision-making function of college students' PE management.

Business process of college PE…

Business process of college PE teaching management decision-making system.

E–R diagram.

Login process.

Flow of the login function.

Query process of the student…

Query process of the student grade database.

Schematic representation of the B/S…

Schematic representation of the B/S model used in the system.

Support of different rules.

Confidence in different rules.

Comparison of improved algorithm support…

Comparison of improved algorithm support and true value.

Comparison of original algorithm support…

Comparison of original algorithm support and true value.

• Tan P., Wu H., Li P., Xu H. Teaching management system with applications of RFID and IoT technology. Educ. Sci. 2018;8(1):26.
• Zheng Y., Wang J., Doll W., Deng X., Williams M. The impact of organisational support, technical support, and self-efficacy on faculty perceived benefits of using learning management system. Behav. Inf. Technol. 2018;37(4):311–319.
• Deng L., Li D., Yao X., Wang H. Retracted article: mobile network intrusion detection for IoT system based on transfer learning algorithm. Cluster Comput. 2019;22(4):9889–9904.
• Al Janabi S. Smart system to create an optimal higher education environment using IDA and IOTs. Int. J. Comput. Appl. 2020;42(3):244–259.
• Al Obaydi L.H. Using virtual learning environment as a medium of instruction in EFL context: college teachers' attitudes. Intensive Journal. 2020;3(2):18–30.

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• Open access
• Published: 13 September 2024

Application of AI-empowered scenario-based simulation teaching mode in cardiovascular disease education

• Koulong Zheng 1 , 2   na1 ,
• Zhiyu Shen 1   na1 ,
• Zanhao Chen 1   na1 ,
• Chang Che 1   na1 &
• Huixia Zhu 1  

BMC Medical Education volume  24 , Article number:  1003 ( 2024 ) Cite this article

Metrics details

Cardiovascular diseases present a significant challenge in clinical practice due to their sudden onset and rapid progression. The management of these conditions necessitates cardiologists to possess strong clinical reasoning and individual competencies. The internship phase is crucial for medical students to transition from theory to practical application, with an emphasis on developing clinical thinking and skills. Despite the critical need for education on cardiovascular diseases, there is a noticeable gap in research regarding the utilization of artificial intelligence in clinical simulation teaching.

This study aims to evaluate the effect and influence of AI-empowered scenario-based simulation teaching mode in the teaching of cardiovascular diseases.

The study utilized a quasi-experimental research design and mixed-methods. The control group comprised 32 students using traditional teaching mode, while the experimental group included 34 students who were instructed on cardiovascular diseases using the AI-empowered scenario-based simulation teaching mode. Data collection included post-class tests, “Mini-CEX” assessments, Clinical critical thinking scale from both groups, and satisfaction surveys from experimental group. Qualitative data were gathered through semi-structured interviews.

Research shows that compared with traditional teaching models, AI-empowered scenario-based simulation teaching mode significantly improve students’ performance in many aspects. The theoretical knowledge scores( P  < 0.001), clinical operation skills( P  = 0.0416) and clinical critical thinking abilities of students( P  < 0.001) in the experimental group were significantly improved. The satisfaction survey showed that students in the experimental group were more satisfied with the teaching scene( P  = 0.008), Individual participation( P  = 0.006) and teaching content( P  = 0.009). There is no significant difference in course discussion, group cooperation and teaching style of teachers( P  > 0.05). Additionally, the qualitative data from the interviews highlighted three themes: (1) Positive new learning experience, (2) Improved clinical critical thinking skills, and (3) Valuable suggestions and concerns for further improvement.

The AI-empowered scenario simulation teaching Mode plays an important role in the improvement of clinical thinking and skills of medical undergraduates. This study believes that the AI-empowered scenario simulation teaching mode is an effective and feasible teaching model, which is worthy of promotion in other courses.

Peer Review reports

Introduction

Cardiovascular diseases, including myocardial infarction and arrhythmia, frequently manifest abruptly and progress rapidly, placing individuals in critical situations. In addition to the physical distress, the substantial rates of disability and mortality linked to these conditions impose a significant burden on both families and society. Furthermore, the presence of commodities such as diabetes and chronic obstructive pulmonary disease in many cardiovascular disease patients adds further complexity to treatment strategies [ 1 , 2 ]. In light of this context, the importance of internship training in cardiology is underscored [ 3 ]. In China, when medical students enter their fourth and fifth years of undergraduate study, they will be placed in hospitals for a clinical internship lasting one to two years. Internship plays a critical role in the development of medical students, facilitating the transition from theoretical knowledge to practical application and fostering the growth of clinical reasoning and skills [ 4 ]. Nevertheless, the prevailing mode of internship education primarily relies on conventional instructional approaches, which prioritize teacher-led dissemination of knowledge through lectures and demonstrations [ 5 , 6 ]. Although these methods are successful in facilitating knowledge acquisition, they are inadequate in motivating students, promoting clinical reasoning, and cultivating the skills necessary to manage emergency situations, particularly when dealing with critically ill patients. As a result, it is essential to implement a shift in teaching methodologies, specifically within the realm of cardiology internship training.

In recent years, the rapid development of Artificial Intelligence (AI) technology has led to the emergence of various products profoundly impacting various aspects of people’s lives [ 7 ]. Generative AI, a type of AI based on deep learning, involves training large-scale language models to generate new text, images, or other types of data. Notably, models like OpenAI’s ChatGPT use deep learning algorithms trained on extensive datasets to generate human-like responses in conversation. In the realm of education, generative AI exhibits tremendous potential. Firstly, it can offer personalized learning experiences by tailoring learning paths based on individual student needs and proficiency levels, enhancing learning effectiveness and making education more targeted and efficient [ 8 , 9 ]. Secondly, generative AI plays a crucial role in automatic assessment and feedback, providing students with immediate and constructive feedback, promoting better understanding and mastery of knowledge. Additionally, through simulated dialogues, role-playing, and other mode, generative AI can help students improve communication and problem-solving skills, offering new possibilities for flexible, intelligent teaching mode and driving innovation and progress in education [ 10 ].

Scenario-based simulation teaching is an instructional method that involves simulating real-world situations for teaching purposes, commonly used in clinical education. In this approach, students are placed in virtual or real scenarios where they face specific problems, challenges, or tasks, engaging in practical activities and decision-making to proficiently apply knowledge [ 11 ]. This teaching method emphasizes practicality and interactivity, allowing students not only to apply theoretical knowledge in simulated situations but also to actively participate in discussions, collaborate on problem-solving, and enhance their practical application and teamwork skills [ 12 ]. Research indicates that scenario-based simulation teaching stimulates student interest, increases motivation, and fosters critical thinking and innovation by integrating theoretical knowledge into practice [ 13 ].

Nowadays, with the rapid development of science, new technologies such as Virtual Reality and Augmented Reality have brought significant changes to clinical medicine. For example, clinical scenario simulation surgery allows doctors to create a virtual surgical training platform. This allows them to practice complex surgical skills in a safe, repeatable practice environment [ 14 , 15 , 16 , 17 ]. While studies have demonstrated the effectiveness of scenario-based simulation teaching in clinical courses [ 11 , 12 , 13 , 18 ], there is currently no research on the application of generative AI in simulating clinical scenarios related to cardiovascular diseases. In this study, we aim to investigate the effectiveness of the AI-empowered scenario-based simulation teaching mode in cardiovascular disease education. Our goal is to explore the impact of this innovative teaching model on clinical interns, focusing on their basic knowledge, clinical operation ability and clinical critical thinking ability.

Experimental design

A combination of quasi-experimental research design and descriptive qualitative research methods was employed to form both a control group and an experimental group. Our study integrated Kolb’s experiential learning model into the experimental group’s teaching methods to enhance the learning process [ 19 , 20 ]. Kolb’s experiential learning model involves providing learners with real or simulated situations and activities. Under the guidance of teachers, learners participate in these activities to gain personal experience. They then reflect on and summarize their observations, developing theories or conclusions, which are ultimately applied in practice (Fig.  1 ).

Kolb’s experiential learning model

Study participants

A total of 66 first-year students from two classes in the clinical major at Nantong University were selected as the study participants. Inclusion criteria comprised: (1) absence of current physical or mental abnormalities; (2) full-time undergraduate students in medical majors; (3) no prior experience using the AI platform for medical course learning before the experiment; (4) voluntary participation in the study with the signing of an informed consent form. The control group consisted of 32 students, following a traditional teaching model, while the experimental group comprised 34 students undergoing scenario-based simulation teaching mode empowered by AI.

All students entered university directly through the national college entrance examination (gaokao) after completing 12 years of education. After inclusion, an assessment of the characteristics of the two student groups, including age, gender in pre-professional courses, revealed comparable learning abilities between the two groups ( P  > 0.05). Both groups received instruction in internal medicine. The students in both groups used the ninth edition of the textbook “Internal Medicine,” edited by Ge Junbo and others and published by People’s Medical Publishing House, and were taught by the same instructor.

Teaching interventions

Teaching mode of control group.

The control group adopted the traditional teaching model, and the course arrangement was divided into two parts: theoretical classes and practical classes. In weekly theoretical classes, teachers use PPT to impart knowledge according to the teaching objectives and syllabus. The contents of these theoretical courses include basic knowledge of cardiovascular diseases, pathophysiology, diagnostic methods and treatment principles. Teachers help students understand complex medical concepts through detailed explanations and illustrations, and answer students’ questions in class to ensure they master the necessary theoretical knowledge.

In the practical class, the teacher led the students to conduct practical training based on the teaching content of the previous theoretical class. Practical classes were usually conducted in simulated wards or clinical skills laboratories. Teachers first demonstrated the operations on a standardized patient(SP), including specific operating steps such as cardiac examination, auscultation, and electrocardiogram interpretation. Teachers explained in detail the key points and precautions of each operation link, and demonstrated on-site how to communicate with patients to improve students’ clinical operation skills and doctor-patient communication abilities.

After the demonstration, students were divided into groups for operational exercises, with teachers guiding them, correcting mistakes in a timely manner and providing feedback. In this way, students not only consolidated theoretical knowledge, but also enhanced practical operational abilities and developed clinical thinking and decision-making abilities. In addition, practical courses also emphasized teamwork and communication skills. Students simulated real clinical environments through group discussions and role-playing to improve their overall quality and professional abilities.

Formation of teaching research team

The team of this study was composed of 2 chief physicians, 3 attending physicians, 2 resident physicians, 5 teaching assistants, and 4 graduate students. This team consisted of teachers with more than five years of teaching experience. Before the lectures, they all underwent training in scenario simulation teaching mode and were proficient in using ChatGPT.

Implementation plan for educational reform

The teaching model of the experimental group innovatively incorporated generative artificial intelligence technology, providing students with a brand new scene simulation teaching experience. In this teaching model, teachers first provided an in-depth explanation of theoretical knowledge to ensure that students could master the core points of the course, such as the characteristics of different types of arrhythmias in electrocardiograms. These points are the basis for understanding the complexity of cardiovascular disease and are the knowledge that students must skillfully apply in subsequent simulation practices.

Students then watched a video simulating scenarios related to cardiovascular disease. These videos not only vividly reproduced clinical scenes, but also contained rich medical information and situational challenges, which greatly stimulated students’ interest in learning and enthusiasm for participation. While watching the video, students were encouraged to play the role of doctors and use the theoretical knowledge they had learned to conduct detailed analysis and inferences on the signs, symptoms, and pathogenesis shown in the video.

Students needed to use critical thinking to identify the occurrence and development of the disease from the patient’s clinical manifestations and, at the same time, master the key points of diagnosis and the basic principles of treatment. This process not only exercises the students’ clinical thinking skills but also deepens their understanding of the disease diagnosis and treatment process.

After the scenario simulation, students participated in group discussions to share their observations and analyses, complementing each other and improving their understanding of the disease. This interactive learning method promoted the exchange of knowledge and the collision of ideas, helped students examine problems from different angles, and improved their problem-solving abilities.

Finally, students would complete thinking questions related to the course content, consolidate the knowledge they have learned, and test the learning effect. Students could ask ChatGPT questions at any time, and when they had more questions, they could get help from their teachers. Except for learning theoretical knowledge, all clinical practice processes were consistent with those of the control group.

Establishment of experimental group

Reasonable grouping is an important prerequisite for team learning. To enhance group learning and achieve optimal learning outcomes, each group had a maximum of 6 students. Therefore, before class, teachers determined the groups based on students’ average GPAs to ensure that each group had similar overall learning abilities. Eventually, the students in the experimental group were divided into 6 groups. Based on feedback from teachers on student performance, adjustments to group members were made in the first week. In each group, one student was selected as the group leader, responsible for organizing group activities. Clear division of team roles ensured the participation of each member and promoted cooperation within the group.

Preparation of scenario simulation videos

Writing scenario simulation scripts.

The cardiovascular teaching research group wrote script stories based on teaching objectives and typical cardiovascular cases, enriching the background and character features of the plot to make it as close to real clinical situations as possible.

Breaking down script scenes

In the production of clinical case scenario simulation videos, the breakdown script played a crucial role, providing guidance and basis for AI drawing for each scene. By inputting the case directly into ChatGPT and instructing, “How many scenes can this script be broken down into for animation video creation?” ChatGPT would then offer a breakdown of scenes as an example, subject to review by the teachers for alignment with educational goals and accuracy.

Animation drawing

By inputting the prompt “I need you to act as the Midjourney command optimization master, generating scene descriptions for the above scenes separately, I want Midjourney to draw them, please provide concise descriptions in both Chinese and English,” specific instructions would be obtained. This prompt asks ChatGPT to generate a concise description for each scenario. These descriptions should include necessary details to help Midjourney draw the scene accurately. Each scene description was reviewed, and then each English description was input into Midjourney to generate animation materials. These materials were imported into editing software to complete the production of video content, with subtitles automatically generated and added to the video.

Question bank compilation

In the process of compiling a question bank for cardiovascular teaching, ChatGPT generates questions based on the plot content of the script when prompted with the instruction, “This is a case in cardiovascular teaching, what questions can be given to students?” ChatGPT would write questions based on the relevant plot content of the script. The teacher could continue to instruct to change the format and description of the questions and could also request answers and scoring criteria for the corresponding questions.

Synthesis of scenario simulation teaching videos and classroom teaching

The assessment of question and answer accuracy and scientific validity, the adjustment of question difficulty in alignment with teaching objectives, and the precise placement of questions within the video were carried out to finalize the production of cardiovascular scenario simulation teaching videos. Subsequently, these videos were integrated into the class app for classroom instruction. Feedback from both students and teachers was solicited to enhance the content and quality of the scenario simulation teaching videos(Fig.  2 ).

Flow chart of research on teaching reform programmes

Data collection

Post-class test.

Students in both the experimental group and the control group took the post-class test, and the test content and grading criteria were exactly the same. The theoretical knowledge level and practical operational ability were each scored out of 100 points, with higher scores indicating more vital student abilities. The theoretical knowledge assessment used exam questions prepared by the teaching team, while practical operational ability used a “Mini-CEX” scoring sheet customized for cardiovascular medicine. The Mini-CEX evaluation form was adapted by the teaching and research team from a scale for assessing clinical skills written by John J Norcini et al. [ 21 ]. It is designed according to the characteristics of cardiovascular medicine. It mainly evaluates clinical history recording, electrocardiogram interpretation, humanistic care, Clinical diagnosis, communication skills and overall competency. There were five parts in total; each part had four questions, and each question adopted Likert’s five-point scoring system. The Cronbach’s alpha of the scale was 0.90, and the Cronbach’s alpha of each dimension was 0.753–0.772.

Clinical critical thinking scale

Based on Robert Ennis’s critical thinking framework and related theories, relevant questions were adapted according to the experimental purpose and subjects [ 22 ]. The final clinical critical thinking scale consisted of four dimensions, including logical reasoning, central argument, argumentation evidence and organizational structure, with a total of 5 questions in each dimension and 5 points in each question, for a total of 100 points.

Overall teaching satisfaction survey

The teaching and research team developed a teaching satisfaction questionnaire. Students completed the Teaching Satisfaction questionnaire on the WJX.cn at the end of the final exam. The questionnaire included six aspects: teaching scene satisfaction (Q1  ∼  Q4), course discussion satisfaction (Q5  ∼  Q8), group cooperation satisfaction (Q9  ∼  Q11), individual participation (Q12  ∼  Q14), teaching content satisfaction (Q15  ∼  Q18), and teaching teacher satisfaction (Q19  ∼  Q20). Each question was set on a scale of 1 to 5 (strongly disagree to strongly agree on five scales). Final satisfaction (%) is score/total score (100 points) *100%. After analyzing the preliminary collected data, Cronbach’s alpha coefficient was 0.85, indicating high internal consistency and reliability.

Qualitative assessment - semi-structured interviews

At the end of the course, we conducted a semi-structured interview to survey students in the experimental group and teachers on their evaluation of the use of AI in teaching cardiovascular disease. In selecting interviewees, we considered the gender and age and then conducted purposive sampling among the experimental group to ensure a diversity of opinions.

In order to fully understand the teaching effect and the real experience of teachers and students with the application of AI teaching mode, the research team first conducted preliminary interviews with two students and determined the final outline of the interview: (1) How do you feel about the learning of this teaching mode? (2) Do you think your learning/teaching style has changed since before? (3) What are your suggestions for the future development of this teaching mode?

A researcher who was well-versed in interviewing techniques was assigned to conduct the interviews independently. The interviews were conducted during the week following the course in a quiet and relaxing session to avoid errors as much as possible. Based on their final test results, they were divided into three grades, with three boys and three girls randomly selected from six groups from three different levels. Each interview lasted approximately 20 min. The students’ conversations were recorded using a voice recorder, and the research team pledged to keep them confidential. Recordings of the interviews were transcribed verbatim within 24 h of the end of the conversation.

Data analysis

Data entry and analysis were performed using Rstudio software (version 4.3.1). The following R packages were utilized: “stats”, “car”, “doBy”, and “ggplot2”.

For quantitative data, independent sample t-tests were employed to analyze differences between groups. For qualitative data, the chi-square test was utilized. A significance level of P  < 0.05 was considered statistically significant, indicating differences between groups.

Baseline comparison between two groups

The experimental group consisted of 34 students aged 22–24 years (mean age 23.03 ± 0.626). The Control group comprised 32 students from clinical professional classes, with ages ranging from 21 to 25 years (mean age 23.14 ± 0.976). Before the class, we assessed the basic clinical knowledge of the two groups of students, and the results showed that there was no significant difference in the demographic characteristics of the two groups ( P  > 0.05), and we found that there was no significant difference between them, which was comparable (Table  1 ).

Final scores between two groups

Statistical analysis of examination scores for two groups revealed that students in the experimental group had an average score of 83.26 on the theoretical final exam, whereas students in the control group had an average score of 79.56. The scores of the control group were significantly lower than those of the experimental group ( p  < 0.05). Regarding Mini-CEX examination scores, students within the experimental group attained an average score of 76.24, which was notably greater than the average score of 70.19 achieved by students in the control group ( p  < 0.001). Furthermore, the clinical critical thinking proficiency of the experimental group surpassed that of the control group, as indicated by statistical significance ( p  < 0.001) (Table  2 ).

Satisfaction survey

After investigation and recovery, a total of 66 students completed the satisfaction questionnaire, and 66 valid questionnaires were recovered, with a total completion rate of 100%. As shown in the questionnaire results (Table  3 ), it can be seen that the overall satisfaction of experimental group in teaching scene, individual participation and teaching content is higher than that of control group, and the difference between the two groups is statistically significant ( P  < 0.05). There were no significant differences in other aspects ( P  > 0.05).

Qualitative data analysis

In summarizing the interview findings, three primary themes emerge for analysis: (1) A new learning (teaching) experience; (2) Enhancement of clinical critical thinking ability; (3) Suggestions for improvement.

Theme 1: a new learning (teaching) experience

“In the past, we have always learned knowledge from books. Some things are very complicated and not easy to understand. With the help of AI, I think a lot of complicated knowledge has suddenly become simple and clear.”(S1).

“It is a very unimaginable experience. Through the scenario simulation course, I can intuitively see the physiological changes of the heart and blood vessels, and many theoretical knowledge are easier to understand.”(S2).

“The scenario simulation course enables us to visually see the electrophysiology and pathophysiological changes of the heart and blood vessels. Seeing the complete process makes it easier to remember and understand.”(S3).

“I’ve seen a lot of animations during the learning process, and through this method, I have a better understanding of clinical analysis and judgment.”(S4).

“I think the course preparation process is very easy, with the help of ChatGPT, many educational resources can be found quickly, and I am even more incredible that it can produce a complete clinical simulation video! I believe I will be able to perform better in the field of clinical teaching in the future!”(T1).

Theme 2: enhancement of clinical critical thinking ability

Leveraging AI in medical and educational fields, students can utilize AI interactive platforms to simulate disease processes, enhancing their understanding of cardiovascular diseases and developing critical thinking and problem-solving skills.(S1).

“With AI assistance, my knowledge becomes more systematic and detailed. For example, when learning about acute myocardial infarction, I saw numerous relevant images such as anatomical slices of coronary arteries, their distribution, and corresponding myocardial perfusion areas, which enhances our analytical and judgment abilities.”(S2).

“During leisure time, I can use AI interactive platforms for learning and engage in question-and-answer conversations with AI, which makes self-directed learning more effective and motivating.”(S5).

“I could see the students’ progress in their learning from the exercise tests at the end of the lesson and the final Mini-CEX exam. Through the communication and discussion with them after the lesson, I found that they became more logical in their thinking about the problems, and their ability to analyse the conditions during the Mini-CEX exam was greatly improved.”(T2).

Theme 3: concerns for improvement

Regarding the application of AI in cardiovascular medicine education, students and teachers actively provided some suggestions.

“This teaching format and content are vivid and illustrative. However, I feel that some content, when interacting with AI, cannot answer my questions well.”(S3).

“With this mode of teaching, I feel that I have a higher level of mastery of this course than any other subject and am more interested and motivated to learn. I have been very willing to use ChatGPT in other courses to assist me in my studies, but I felt slightly uncomfortable communicating with the AI as opposed to the teacher.”(S4).

“This way of preparing teaching materials and the mode of lectures is indeed very innovative, with the help of ChatGPT, my pre-course preparation process will be relatively easier, and the use of it in the classroom has also greatly improved the motivation of students. However, I am concerned that the drawbacks of AI, such as academic honesty and accuracy of answers, will also have an impact on the final teaching results, so we teachers should be cautious about AI.”(T2).

With the rapid development of technology and AI, the form of medical education is undergoing continuous changes [ 23 , 24 ]. Traditional teaching mode, characterized by inefficiency and dull content, no longer meet the needs of modern medical education. This is particularly evident in the teaching of cardiovascular system diseases [ 25 ], where the content is complex and difficult to remember, often leading to a lack of student engagement and understanding during clinical practice, thereby impacting the cultivation of clinical thinking skills [ 26 ]. Currently, AI is widely applied across various fields, and research shows that it plays a crucial role in education [ 27 , 28 ], including personalized learning, intelligent tutoring, instructional design, and student assessment, greatly enhancing learning outcomes and promoting educational innovation. Moreover, studies have also shown the widespread promotion and application of scenario-based teaching models in clinical practice teaching [ 29 , 30 , 31 ].

In this study, the scenario-based teaching model is implemented based on ChatGPT 3.5. We believe that the scenario-based teaching model based on generative AI is an important mode and development direction for educational practice reform. ChatGPT, with its outstanding adaptability, versatility, efficiency, intelligence, and comprehensive coverage, has become a favored choice for many developers and is widely used in the education sector [ 32 , 33 ]. Through clever integration with the scenario-based teaching model, a new teaching experience is created.

For teachers, ChatGPT provides powerful support, significantly improving lesson preparation efficiency. Teachers can use ChatGPT’s intelligently generated dialogue scenarios to present abstract and difficult-to-understand concepts in vivid and interesting scenarios, making it easier for students to understand and remember. Additionally, teachers can adjust the generated dialogues according to students’ learning situations, personalize teaching, and improve teaching effectiveness. For students, in the scenario-based teaching model, they feel as if they are in a vivid teaching theater. They take on detective roles, cultivating clinical thinking and case analysis skills as they solve problems. ChatGPT’s intelligent dialogue can also customize learning plans based on students’ learning styles and progress, improve memory efficiency through mnemonic devices, and stimulate their interest in learning and self-directed learning motivation.

The findings of the study indicate that students enrolled in AI-assisted teaching programs exhibit higher scores in theoretical knowledge, Mini-CEX examination performance, and clinical critical thinking skills compared to their counterparts in traditional teaching settings. These results suggest that a hybrid teaching approach may enhance students’ comprehension of knowledge and proficiency in clinical procedures, this is consistent with the findings of Yujiwang et al [ 34 , 35 , 36 , 37 ]. The possible reason is that in the interaction of scenario simulation, students can independently explore the process of illness and take the initiative to find and solve problems. According to Kolb’s experiential learning model [ 19 , 20 ], experience to reflection to abstract concepts to practice, and finally to experience, interlocking and progressive, prompting students to understand knowledge from scenario simulation, then apply it to practice, and then find problems, which not only improves their independent learning ability, but also improves their critical thinking ability. Additionally, student interviews revealed that the new teaching method facilitates their exploration and identification of clinical issues, thereby preparing them effectively for future clinical practice.

Through an analysis of students’ teaching satisfaction questionnaires, it was found that the experimental group exhibited significantly higher levels of satisfaction in teaching scene, individual participation, and teaching content compared to the control group. These results suggest that the mixed teaching mode utilizing the AI platform may be more feasible and suitable for practical teaching in cardiovascular internal medicine. Although we found no statistically significant differences in course discussion, teamwork, and instructor teaching style, this may be due to the following reasons. First, the small sample size and short duration of this study limited the power to detect significant differences. Future research could improve this by increasing the sample size and extending the duration of the study. In addition, traditional teaching methods are already relatively mature in these aspects, and student satisfaction in these three aspects is already at a high level, and may not show significant advantages in the short term. At the same time, teaching satisfaction is affected by many factors, and a single change is not enough to significantly improve overall satisfaction. Therefore, we will continue to optimize the new AI-powered teaching model and strengthen its integration with course discussions and teamwork. We look forward to seeing more significant effects in future research.

Moreover, students say that the teaching method of scenario simulation not only helps them systematically understand and master the content of the course, but also stimulates their interest in independent learning and improves their ability to discover and solve problems. The vast majority of students hold a positive attitude towards the AI empowered scenario-based simulation teaching mode, and some students also put forward their own views on this teaching mode, mainly focusing on the accuracy and understanding of AI. This also provides us with valuable suggestions for the improvement of further study.

This study also has the following limitations: (1) The number of participants in the survey is relatively small, resulting in insufficient data and interview views collected; (2) In this study, we used version 3.5 of generative AI ChatGPT. However, it is worth noting that a more advanced version 4.0 of ChatGPT is already available on the market. Therefore, the version we use does not fully represent the highest computing power of AI technology.

In comparison to the conventional teaching methodology, the novel teaching mode demonstrates clear benefits. Findings from examinations, assessments, satisfaction surveys, and interviews suggest that this innovative teaching method offers a more efficient means for interns to gain contemporary professional knowledge and enhance their clinical practice proficiency. Additionally, the cultivation of clinical critical thinking and problem-solving skills through this approach is expected to greatly support their long-term career viability. The utilization of an AI-empowered scenario-based simulation teaching mode has the potential to enhance students’ engagement and motivation, as well as improve their problem-solving skills in clinical settings. Consequently, the implementation and dissemination of our AI-empowered scenario-based simulation teaching mode in cardiovascular medicine practice teaching is recommended.

Data availability

Our research encompasses sensitive personal identity information of students. Due to the potential risk of breaching individual privacy, the datasets analyzed in this study cannot be made publicly accessible. We emphasize that the data remains confidential and is not open to the public. However, if you have a compelling need for access, please reach out to the corresponding author at [email protected] to request the data.

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Innovation and Entrepreneurship Training Program for College Students in Jiangsu Province (202313993027Y). Teaching Reform Research Project of Nantong University (2023B10).

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Koulong Zheng, Zhiyu Shen and Zanhao Chen contributed equally to this work.

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Koulong Zheng, Zhiyu Shen, Zanhao Chen, Chang Che & Huixia Zhu

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KLZ and HXZ designed the trial. KLZ prepared the clinical cases. HXZ collected the data. HXZ and ZYS analyzed the data. HXZ, ZHC and CC wrote the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Huixia Zhu .

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Zheng, K., Shen, Z., Chen, Z. et al. Application of AI-empowered scenario-based simulation teaching mode in cardiovascular disease education. BMC Med Educ 24 , 1003 (2024). https://doi.org/10.1186/s12909-024-05977-z

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Received : 15 February 2024

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DOI : https://doi.org/10.1186/s12909-024-05977-z

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