## 4 Discussion  
The research results reveal that the hierarchy-based design process effectively increases user acceptance more than the traditional design process; however, some factors should be considered for future projects. Among them, the survey presented to users with the final designs should also be presented during the proposal stage, with the rendering and color level of all designs being the same in order to give uniformity to all of the designs so that the user can more objectively choose the best design based solely on the design itself.  
Stage B, the hierarchical design process, presented better results than traditional design; however, it is a longer process, but the increment of work/time represents an area of opportunity for the hierarchical design process.  
It is essential to mention that Stage B follows Stage A, which could be a risk in terms of the experiment because some might argue that the results of the first stage could help improve the results of Stage B. This could be discussed further in the future with more experiments.  
The experiment was developed with 40 Mexican students, of which the majority were women (88%). An information gap was detected with the male participants, showing an evident cultural issue when they were watching the birthing bed due to the graphic content of the videos since Mexican males are not familiar with this kind of content. For the majority, both women and men, it was their first time observing this type of procedure. This caused shock that could generate an area of opportunity for design, as it generated more empathy when designing their products.  
Research articles do not decide who the users of medical devices are. Different authors analyze products with engineering models and the design process but still do not agree on the users, making it difficult for the designer to conduct the design process; some studies divide users into primary, secondary, and subgroups [42]. Some authors only indicate two groups: those who are health professionals and those who are not [43]. Others only  
Figure 18: The results of the survey; factor percentages given by 453 respondents. The percentages of each design factor evaluated in the proposals from Stage A and Stage B (n = 453) are shown.  
identify two groups of users: women and men [31]. Others speak about the patient as the last consumer [4]. Once each medical product user has been detected, it is necessary to evaluate the hierarchy of those using the product--not only the hierarchy of use at the beginning but throughout the patient's health process, since depending on the health stage, the movement of users around the object may constantly fluctuate, changing the hierarchy of use and, at the same time, demanding different functions and characteristics from the product for each user at each stage.  
This indicates an information gap that requires further study. Suppose the designer of the medical device does not recognize all of the users. In that case, they would not be able to classify them, thus reducing the acceptability of the product, leading to a design process focused on the function alone, bringing t products with a high risk of poor usability to the market, which will undoubtedly result in the product being a commercial failure. More importantly, however, they could harm the patient or make incorrect diagnoses.