Healthcare is undergoing a paradigm shift from a paternalistic model, where healthcare professionals (HCPs) made decisions on behalf of patients, to a patient-centered approach that recognizes patients as active partners in care.

Shared Decision-Making (SDM) has emerged as a cornerstone of this transition, aiming to align treatment decisions with patients’ values, preferences, and lived experiences. For patients with esophagogastric cancer, SDM is particularly beneficial: treatment and care options are limited, invasive, and burdensome, yet differ substantially in side effects and impact on quality of life. Decisions in oncology care are preference-sensitive, emotionally charged, and made under conditions of uncertainty and stress. These factors make it essential to include the patient’s perspective in decision-making to ensure decisions are aligned with what the patient values most.

However, individuals with Limited Health Literacy (LHL) face significant barriers to meaningful participation in SDM. These barriers stem from challenges in processing medical information, expressing personal values, and navigating increasingly digitalized healthcare systems. Without tailored support, these patients risk exclusion from the decision-making  process, which increases the chances of decisional regret and reinforces health disparities.

 

This thesis explores how esophagogastric cancer patients with LHL can be better supported in healthcare decision-making. Conducted in collaboration with Amsterdam UMC, the project employed systemic, service, and human-centered design methodologies. A multi-layered research process combined literature review, patient journey mapping, a case study of an outpatient clinic, an extensive co-creation study involving individuals with LHL, and expert consultations. These steps revealed systemic barriers to SDM, including fragmented communication practices. Co-creation identified several needs of the target group, including a desire for more balanced communication in which HCPs allow time for pauses and actively encourage patients to ask questions.

Building on these insights, iterative idea development, prototyping, and co-creation with individuals with LHL was employed, alongside evaluation with HCPs and experts. This led to the development of a modular communication tool aligned with the project’s design goal:

“To support patients with LHL  in articulating their values and information needs, while enabling healthcare professionals to actively elicit these insights and tailor their way of informing and supporting accordingly”

 

Perspective Mapping, the developed tool, facilitates relational, stepwise consultations. It helps HCPs elicit and incorporate patient values, clarify treatment trade-offs, and co-construct summaries that feed into multidisciplinary meetings. Its modular structure allows flexibility, supports reflection, and enables patients to build communication skills transferable across their care trajectory.

 

Evaluations highlighted the concept's potential to reduce uncertainty for patients, strengthen trust, and align treatment decisions more closely the patient’s perspective. However, for sustainable adoption of the tool, and for any implementation of a communication intervention in that matter, the importance of  seamless integration into clinical workflows is underscored.

 

This thesis offers both a practical design intervention and a conceptual reframing of the challenges limiting communication between HCPs and esophagogastric cancer patients with LHL. It emphasizes SDM as an integrated, continuous process rather than an isolated event. By addressing the communication needs of patients alongside the workflow requirements of HCPs, the project advances the development of more equitable and patient-centered oncology care decisions.

The assignment for this graduation project was to develop a tool for residents to “step into each other’s worlds”. The project is a side track of the Bubble Games project, here VR technology is used to let people step into each other’s world to understand each other better. My challenge was to develop such a tool, but without using VR technology. Through research about the neighbourhood, including interviews with residents and professionals, the assignment was reformulated into developing a tool that guides residents of Woonontwikkeling Vredeoord to open up to the different flavours of living in together in their neighborhood.

Throughout the project, stakeholders were actively involved. During the design phase, multiple prototypes were created and tested with residents. A brainstorming session with residents helped defining the concept direction, resulting in Babbeloord.

Babbeloord is a phonecell where users are guided through different tasks via a phone. First, you discover your own needs regarding living together in the neighbourhood through the fundamental needs cards on the wall. Then, they are asked to explain their needs, to then listen to the stories of their neighbours. At the end, a question is asked about what they have learned from this chat (Babbel), encouraging residents to reflect. This question is also displayed on a mirror hanging on the third wall of Babbeloord. Follow-ups take place after two and six months to inform residents about the insights gathered and how they will be used.

Babbeloord encourage residents to think about what they believe is important about living together. Babbeloord also provides valuable insights for the municipality. Since Babbeloord was designed for and with residents, it fits well within the neighborhood. The stories collected can provide new entry points for the municipality to act upon. Babbeloord was evaluated in the neighbourhood and validated with two residents who participated in this test. Furthermore, it was discussed with professionals working in the neighbourhood and colleagues from the municipality. These chats provided valuable insights for recommendations on the future use of Babbeloord.

The automotive industry is undergoing a transformation fueled by advancements in digital technologies and connectivity. As vehicles evolve, the way we interact with them is changing, driven by a new era of Human Machine Interface (HMI) design, and the introduction of autonomous driving. Designing a car is no longer just about the vehicle. It is about energy, data, services, connectivity, entertainment, and the relation between them. This project addresses these changing dynamics, and aims at developing a design proposal for the future of the in-car interaction within a 2035 Chinese urban context, for the Swedish-Chinese Lynk & Co Design.

Uitvoeringsinstituut Werknemersverzekeringen (UWV) is a Dutch government organisation that assists Dutch citizens who are unemployed or unable to work by finding employment and by providing benefits.

For various reasons, it can happen that a client is overpaid and needs to repay the excess amount to UWV. If the excess amount cannot reasonably be deducted from the client's monthly benefit, UWV's internal department, Verwerking Financiële Verplichtingen (VFV), handles the repayment process and assists clients in finding suitable payment options.

In addition to being unemployed, some of UWV's clients have financial debt that affects their ability to take action and be in control of their finances. These clients, in particular, face great difficulties during the repayment process with VFV. UWV would like to better serve these clients by giving them more control over their financial situation. While UWV has already conducted research on how clients experience the repayment process and is already developing digital services to support them, further insights were needed on how to address these clients' needs, how to develop solutions that serve these clients in a supportive and inclusive manner, and how to address their underlying needs.

In this design project, I used a User-Centered Design approach to gain a deeper understanding of the underlying needs of clients with financial debt and the difficulties they encounter during the repayment process. I discovered that clients with financial debt can perceive the initial notice about the repayment as a great and unexpected shock. These clients have an unmet need for more personal and proactive support from UWV. They do not feel seen and heard during their interactions with VFV and UWV's general helpdesk, and they lack perspective throughout the lengthy repayment process.

Through various design activities, including a co-creation session with clients from UWV, I designed a service concept tailored to the needs of VFV's clients with financial debt. This concept offers clients a kinder, softer introduction to the repayment process from VFV and provides personalized and proactive support through face-to-face or online service meetings with a designated employee from VFV. For this service concept, I designed four service touchpoints: an invitation card to kindly and personally invite the client to the meeting, a checklist for clients to prepare for the meeting in manageable steps, a note-taking sheet for clients to record expectations and agreements made during the service meeting, and several card designs to provide clients with a monthly overview of their payments to UWV.

Once UWV further develops and implements this service concept, I expect that clients with financial debt will feel more supported, seen, and heard by employees of VFV. Furthermore, I expect clients to be more inclined to get in contact with VFV due to the kind invitation beforehand and the personal relationship built with their designated contact at VFV after the service meeting. Consequently, this service is also expected to work preventively to avoid bigger financial problems in the future as a result of clients staying in contact with VFV.

This graduation project explores the social-emotional context of inclusive outdoor play. The objective is to enhance participation in outdoor play for children with disabilities by focusing on inclusion. To achieve inclusion in play, the needs of all users in an outdoor play area must be addressed. This project examines themes and elements that facilitate small contact between children with and without disabilities, aiming to increase participation in outdoor play.

Context
There is a recognised need to promote outdoor play among children with disabilities, as it has a positive effect only impacts their physical, social, emotional, and cognitive development. However, children with disabilities engage in outdoor play less frequently than typically developing children, because of various barriers they experience.

Collaboration with ‘Samen Spelen??’
This project involves a close collaboration with the client ‘Samen Spelen??’. The multiprofessional team from the consortium ‘Samen Spelen??’ at ‘Hogeschool Utrecht’ are developing two toolkits for child therapists to facilitate inclusive outdoor play for children with physical disabilities (4-12 years old) and their parents. One toolkit focuses on the physical context, the other on the social context.

Research approach
To explore the social-emotional context, several research and design activities were conducted: starting with literature research and attending inclusive play activities. This was followed by participation in two generative sessions with children and an interview with an orthopedagogue to gain more insights into the emotional context.

3 found main themes
The findings from these activities led to three overarching main themes that have an influence on the social-emotional context of inclusive outdoor play. These themes formed the basis of three conclusion posters. The 3 themes and their related posters:
Theme 1: ‘The environment: people and place’
Poster 1: ’Influence of the environment and bystanders on outdoor play and making contact’
Theme 2: ‘Inclusive outdoor play activities’
Poster 2: ‘Influence of the activity on participation and making contact’
Theme 3: ‘Children’s inner world’
Poster 3: ‘Connection & experiences of a child with a disability’
 
Small contact & Design goal
The principle ‘Small contact’, identified on the third conclusion poster, was selected as the main focus of this project. Small contact refers to safe, accessible, and natural contact, without the need for full play. The facilitation of small contact creates openness to explore contact with others and children’s own ways of participating.

To grasp the focus in one sentence, a design goal is created:
'My design goal is to facilitate/create small equal contact between children with disabilities and children without disabilities that do not know each other, at an outside play area in their neighbourhood, which positively influences the participation of children with a disability'

Insights and conclusions
Based on this design goal, various brainstorming cycles were conducted, resulting in three concepts:
‘Kijk Kameraden’, ‘Spelen met Schaduw’ and ‘Stoepkrijt Ontdekking’. ‘Kijk Kameraden’ focuses on making (eye) contact through the use of reflections and mirrors. With ‘Spelen met Schaduw’ children can play by creating shadows and reacting to the shadows created by others. ‘Stoepkrijt Ontdekking’ encourages children to leave traces in the neighbourhood that help them and others to get to know the area, play opportunities and each other.

Testing prototypes of these concepts with children in context provided insights into themes and elements that facilitate small contact between children. These themes are:
1.Indirect intimate contact: Indirect direct contact through objects by exploring one of the senses: seeing
2.Indirect interplay: Indirect play through objects that can be manipulated from a small distance
3.Intermingled play: Intermingled play among children using the same objects
4.Leaving and following traces: Indirect contact through traces that indicate the visibility of other children’s play in the neighbourhood
These themes and their corresponding elements are presented in the poster ‘Small contact’.

The results can be utilised by ‘Samen Spelen??’ to develop their toolkits. The use of these results can help encourage child therapists to stimulate children with physical disabilities to make small contact with new children, without the need for adult facilitation of play activities and making contact.

As new technologies will allow for a new kind of driving there is room for implementing innovative interior architecture in future luxury cars. The main goal for this master thesis was to find out what a user truly needs in a Mercedes EQ interior for a level 4 autonomous driving vehicle in a context around the year 2035. Furthermore, the design brief specified a sustainability frame as a key part of the design scope.

Problem
One might think it is easy to imagine a vehicle that operates fully autonomously and in which a user is totally irresponsible for driving the vehicle. But before we arrive at this point, we will see cars transitioning from the way they are now through a stage in which a user is partly responsible for driving yet can partly disengage driving obligations in specific situations. Also, with the automotive industry being under increasing pressure to become sustainable and classic status obtaining features such as big engines mismatching this goal, Mercedes stated the desire to have the user gain status through being sustainable in a luxury vehicle.

Analysis
To deliver a fresh insight to the industry and client it was chosen to use the Vision in Design-method. This method was fitting for envisioning a well-argued future context and to map likely behaviour of the Mercedes driver but also other people involved in this future context. Different attitudes in luxury automobiling were found and it was decided that the attitude of obtaining status by ‘being a paragon of sustainable automobiling’ would be the segment in which we would aim to position Mercedes EQ to subsequently pull the Mercedes-Benz brand as a whole into this direction. Furthermore, to make the concept Mercedes-fitting, an extensive analysis of the brand was executed to integrate a clear and expected link to specific elements of Mercedes’ heritage in the design.

Vision
Following the newly formulated strategy, a design vision was created. This vision covers a mission statement that aims to have Mercedes EQ users be a ‘paragon of sustainable luxury automobiling’ and to provide a ‘car interior in which the user can optimally be, considering everyday and real situations’. Multiple moods to cover these everyday and real situations were summed up, and it was found that a cosy old train coupe lounge served as a fitting interaction analogy for the desired interactions. In this analogy and through extensive brainstorming and sketching, a table and/or desk surface was found to be a key element in the interior around which the rest of the architecture could follow.

Design
Extensive research and ergonomic reviews lead to a tangible design basis.

Evaluation
The design tells an honest story in which the need to rush for users is decreased. The integrated elements are, also with the help of industry experts, well-argued and in a research based future context. They can be further detailed following the classic design for sustainability principles. The ideas were valued so much by Mercedes that, during this thesis, their research and development team put effort in helping with developing the proposition.

Success doesn’t come by following the beaten track, by following in the footsteps of the great visionaries of the past. No, success comes to those who dare to think differently, who dare to challenge and to do the unexpected. Starting a new brand requires this mindset, because only those who dare to think differently succeed. Back in 2018, Automobili Pininfarina was founded as a new luxury car manufacturer bearing one of the most celebrated and revered names in the industry: Pininfarina. A design house known for their iconic masterpieces. Starting a new brand with such a famous and recognizable name is a beautiful opportunity, but also a risky operation. Paving the way for Automobili Pininfarina brand success, that was the goal of this thesis done in collaboration with the new Italian luxury car manufacturer. A new brand strategy and vision needed to be developed, hence the brief for this project was as follows: “Create a design driven brand strategy, delivering a brand vision for the year 2025.” This graduation project focused on analyzing the company’s existing brand strategy and compares that with external influences that create opportunities for the brand to grow. The synthesis of this is a brand vision for the year 2025. Based on this vision, a proposal for the visual identity of the new brand strategy is made, including a roll-out plan for implementation and further development. The steps provided are forming the roadmap that paves the way for Automobili Pininfarina brand success.

This thesis, done in collaboration with Guerrilla, a subsidiary of Sony Interactive Entertainment, will explore new merchandise possibilities for Guerrilla’s hit game Horizon Zero Dawn, which is an open world action/adventure videogame set in a post-post-apocalyptic world, where nature has reclaimed the Earth and terraforming machines have turned violent against humans.

Guerrilla releases a new videogame every few years, meaning there is a period of silence of multiple years between every game release. To keep the Horizon Zero Dawn title still alive and relevant, the experience of the game will be translated into a physical product. Horizon Zero Dawn’s current merchandise is quite safe and standard and does not translate the experience of the game well, and therefore a product expansion is advised.

Based on the strengths of Horizon Zero Dawn and the opportunities derived from a trend analysis, multiple search areas were explored, of which eventually a combination of two was chosen. One of the chosen search areas focusses on interactive objects, such as radio-controlled vehicles and modelling kits, while the other one focusses on creating environmental or cultural awareness.

Within the two chosen search areas many ideas were explored. This eventually led to the direction of self-sufficient enclosed ecosystems. Over time, the plants inside the ecosystem will grow bigger, and “Mother Earth will slowly reclaim what has always been hers”. This perfectly fitting direction for Horizon Zero Dawn led to three different concepts.

One of the concepts, the main focus of this project, is a limited art “toy” aimed at the “hardcore” fans of Horizon Zero Dawn, while the other two concepts are subtilized versions of the same idea.
The subtilized concepts are both jarred ecosystems with a collectible figure inside of it. The two concepts vary in size and price, while only the more expensive ecosystem also includes an internal light.
The concept for the “hardcore” fanbase also includes a self-sufficient ecosystem, but this one is placed inside a massive (250x250x225 mm) scale model of a Shell Walker. Furthermore, the concept works interactive with Horizon Zero Dawn by reflecting the in-game’s events with (coloured) light effects. When not playing the game, the product can still be used as a wakeup light.
All concepts keep the user interacting with the product once in a while, as they need to water or trim the plants. The concepts also add a touch of real nature inside a gamer’s house, and thereby adding environmental awareness.

It is a given that the world changes. A changing world means that the problems society faces change too. Solving these problems has become more complex, and will so even more in the future. Increasingly, designers are the ones expected to be the ones to solve them. To that end, new design methods need to be devised to support designers in approaching these new challenges. This project focuses on improving one aspect of design behavior: reducing designers’ reliance on exhaustive search strategies.

Exhaustive search strategies are characterized by designers trying to exhaust an imaginary source of ideas and methods as a way to attain certainty in the design process. These are resource intensive and low in effectiveness. As problem complexity and consequently uncertainty in the design process rise, resources become more scarce and the risk these strategies bring increases.

A literature study was executed to investigate the origin of these strategies, as well as search for opportunities for improvement. The aforementioned problematic situation is a trait of non-expert designers. Expert designers employ completely different strategies. In order to deepen the understanding of the problem and create a better understanding of the expert approach, two sets of structured interviews were performed. One set with graduating industrial design students and one set with expert industrial designers. It was confirmed that the expert approach is characterized by a high tolerance for complexity and uncertainty.

As a way to instill this quality in non-expert designers, the design of the method thus focuses on supporting designers in embracing complexity and uncertainty. From findings in the literature study and the interviews, a promising direction was identified in the use of narratives and reflection. By means of rapid prototyping tests of the method with graduating students, a methodological structure for a narrative-based reflection method was designed: Design Interlude. A Design Interlude is a break in the design process to reflect on the complexity of the project and look ahead to the uncertainties that are to come. Additionally, a template for performing the method was designed.

The results of several validation tests suggest that this method is effective at supporting designers in embracing uncertainty and complexity. More research is needed to measure if using the method consequently affects reliance on exhaustive search strategies. Additional effects of using the method that were observed are: increased likelihood of new insights, clearer project direction and easier communication of problem complexity.

From here, a larger study of the effectiveness of this method should be conducted. As well as an investigation into the possibility of implementing it into the industrial design curriculum.