Code Black: Desktop-Mediated Co-Design of AR-HMD Microinteractions for Emergency Department Teamwork

Abstract

Emergency Department (ED) teams coordinate shifting roles, medication decisions, and time-critical interventions under uncertainty. Augmented reality head-mounted displays (AR-HMDs) have shown potential to spatially anchor information during care, creating opportunities to examine how spatial interfaces might support teamwork. We conducted a speculative co-design study with 12 healthcare workers (HCWs) using an editable, desktop-mediated Unity-based 3D design probe to visualize and refine work-as-imagined AR-HMD interfaces for role-based notifications, task-specific timers, and dosage verification. Guided by microinteraction rules, participants identified future spatial user interfaces (SUI) requirements such as how they appear, update, or are dismissed in relation to clinical practice, safety concerns, and existing tools. Five returning participants and 26 additional HCWs subsequently provided follow-up feedback on derived visual interface alternatives. Findings show that desktop-mediated spatial co-design elicited formative specifications for role visibility, task-linked timing, and verification-oriented dosage assistance, while revealing tensions involving clutter, shared awareness, communication, privacy, and reliability. Rather than evaluating a functional AR-HMD system or team-based clinical performance, this study contributes the Speculative Co-Design Framework for AR-HMD Teamwork (SCF-HMD) and a visual design catalog for translating expert critique of work-as-imagined (WAI) concepts into situated goals for future AR-HMD systems.