BMJ Qual Improv Report 3: doi:10.1136/bmjquality.u205728.w2340
  • BMJ Quality Improvement Programme

Improving self-efficacy in spinal cord injury patients through "design thinking" rehabilitation workshops

  1. Joseph Langley
  1. Sheffield Teaching Hospitals NHS Foundation Trust
  1. Correspondence to
    Daniel Wolstenholme daniel.wolstenholme{at}
  • Received 14 July 2014
  • Revision requested 26 August 2014
  • Revised 29 August 2014
  • Published 16 October 2014


Advances in surgical and medical management have significantly reduced the length of time that patients with spinal cord injury (SCI) have to stay in hospital, but has left patients with potentially less time to psychologically adjust.

Following a pilot in 2012, this project was designed to test the effect of "design thinking" workshops on the self-efficacy of people undergoing rehabilitation following spinal injuries.

Design thinking is about understanding the approaches and methods that designers use and then applying these to think creatively about problems and suggest ways to solve them. In this instance, design thinking is not about designing new products (although the approaches can be used to do this) but about developing a long term creative and explorative mind-set through skills such as lateral thinking, prototyping and verbal and visual communication.

The principles of "design thinking" have underpinned design education and practice for many years, it is also recognised in business and innovation for example, but a literature review indicated that there was no evidence of it being used in rehabilitation or spinal injury settings.

Twenty participants took part in the study; 13 (65%) were male and the average age was 37 years (range 16 to 72). Statistically significant improvements were seen for EQ-5D score (t = -3.13, p = 0.007) and Patient Activation Measure score (t = -3.85, p = 0.001). Other outcome measures improved but not statistically. There were no statistical effects on length of stay or readmission rates, but qualitative interviews indicated improved patient experience.

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