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      Usability of a Patient Education and Motivation Tool Using Heuristic Evaluation

      research-article
      , MD, MPH 1 , , , MS 1 , , PhD 2 , , MS, RN 1 , , MS 1 , , PhD 1
      (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      Gunther Eysenbach
      Computers, health, education, usability, heuristic

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          Abstract

          Background

          Computer-mediated educational applications can provide a self-paced, interactive environment to deliver educational content to individuals about their health condition. These programs have been used to deliver health-related information about a variety of topics, including breast cancer screening, asthma management, and injury prevention. We have designed the Patient Education and Motivation Tool (PEMT), an interactive computer-based educational program based on behavioral, cognitive, and humanistic learning theories. The tool is designed to educate users and has three key components: screening, learning, and evaluation.

          Objective

          The objective of this tutorial is to illustrate a heuristic evaluation using a computer-based patient education program (PEMT) as a case study. The aims were to improve the usability of PEMT through heuristic evaluation of the interface; to report the results of these usability evaluations; to make changes based on the findings of the usability experts; and to describe the benefits and limitations of applying usability evaluations to PEMT.

          Methods

          PEMT was evaluated by three usability experts using Nielsen’s usability heuristics while reviewing the interface to produce a list of heuristic violations with severity ratings. The violations were sorted by heuristic and ordered from most to least severe within each heuristic.

          Results

          A total of 127 violations were identified with a median severity of 3 (range 0 to 4 with 0 = no problem to 4 = catastrophic problem). Results showed 13 violations for visibility (median severity = 2), 38 violations for match between system and real world (median severity = 2), 6 violations for user control and freedom (median severity = 3), 34 violations for consistency and standards (median severity = 2), 11 violations for error severity (median severity = 3), 1 violation for recognition and control (median severity = 3), 7 violations for flexibility and efficiency (median severity = 2), 9 violations for aesthetic and minimalist design (median severity = 2), 4 violations for help users recognize, diagnose, and recover from errors (median severity = 3), and 4 violations for help and documentation (median severity = 4).

          Conclusion

          We describe the heuristic evaluation method employed to assess the usability of PEMT, a method which uncovers heuristic violations in the interface design in a quick and efficient manner. Bringing together usability experts and health professionals to evaluate a computer-mediated patient education program can help to identify problems in a timely manner. This makes this method particularly well suited to the iterative design process when developing other computer-mediated health education programs. Heuristic evaluations provided a means to assess the user interface of PEMT.

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          Most cited references21

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          Using usability heuristics to evaluate patient safety of medical devices.

          To modify the traditional heuristic evaluation method of assessing software usability so that it can be applied to medical devices and used to evaluate the patient safety of those devices through the identification and assessment of usability problems. Heuristic evaluation, a usability inspection method commonly used for software usability evaluation, was modified and extended for medical devices. The modified method was used to evaluate and compare the patient safety of two 1-channel volumetric infusion pumps. The modified heuristic evaluation method was successfully applied to medical devices. One hundred and ninety-two heuristic violations were categorized for 89 usability problems identified for Pump 1, and 121 heuristic violations were categorized for the 52 usability problems identified for Pump 2. Pump 1 had more usability problems with high severity ratings than Pump 2. In general, Pump 1 was found to have more usability issues that are likely to induce more medical errors. Heuristic evaluation, when modified for medical devices, is a useful, efficient, and low cost method for evaluating patient safety features of medical devices through the identification of usability problems and their severities.
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            Designing the user interface Strategies for effective human-computer interaction

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              Heuristic evaluation

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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                Gunther Eysenbach (Centre for Global eHealth Innovation, Toronto, Canada )
                1438-8871
                Oct-Dec 2009
                6 November 2009
                : 11
                : 4
                : e47
                Affiliations
                [2] 2Usability Engineering GroupXerox CorporationBaltimoreMDUSA
                [1] 1simpleDepartment of Information Systems simpleUniversity of Maryland Baltimore CountyBaltimoreMDUSA
                Article
                v11i4e47
                10.2196/jmir.1244
                2802560
                19897458
                e69e19dd-3aed-4564-abe9-00de73745061
                © Ashish Joshi, Mohit Arora, Liwei Dai, Kathleen Price, Lisa Vizer, Andrew Sears. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.11.2009.  

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 06 April 2009
                : 28 April 2009
                : 17 September 2009
                : 09 October 2009
                Categories
                Tutorial

                Medicine
                computers,health,education,usability,heuristic
                Medicine
                computers, health, education, usability, heuristic

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