Decision support for acute problems: The role of the standardized patient in usability testing

For applications that require clinician use while interacting with patients, usability testing with standardized patients has the potential to approximate actual patient care in a controlled setting. We used hypothetical scenarios and a standardized patient to collect quantitative and qualitative results in testing an early prototype of a new application, the Acute Respiratory Infection (ARI) Smart Form. The standardized patient fit well into the usability testing sessions. Clinicians had a positive response to the standardized patients and behaved as they normally would during a clinical encounter. Positive findings of the ARI Smart Form included that users thought it had impressive functionality and the potential to save time. Criticism focused on the visual design, which could be streamlined, and navigation, which was difficult in some areas. Based on these results, we are modifying the ARI Smart Form in preparation for use in actual patient care. Standardized patients should be considered for usability testing, especially if an application is to be used during the patient interview.

[1]  D. Cherry,et al.  National Ambulatory Medical Care Survey: 2002 summary. , 2004, Advance data.

[2]  M. Patton.  Qualitative research and evaluation methods , 1980 .

[3]  R. Tamblyn,et al.  Use of standardized patients in the assessment of medical practice. , 1998, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[4]  Jeffrey A Linder.  Health information technology as a tool to improve care for acute respiratory infections. , 2004, The American journal of managed care.

[5]  James R. Lewis,et al.  IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use , 1995, Int. J. Hum. Comput. Interact..

[6]  Qi Li,et al.  Using qualitative studies to improve the usability of an EMR , 2005, J. Biomed. Informatics.

[7]  Reed G. Williams,et al.  Have Standardized Patient Examinations Stood the Test of Time and Experience? , 2004, Teaching and learning in medicine.

[8]  Monique W. M. Jaspers,et al.  The think aloud method: a guide to user interface design , 2004, Int. J. Medical Informatics.

[9]  J. Bartlett,et al.  Principles of Appropriate Antibiotic Use for Treatment of Acute Respiratory Tract Infections in Adults: Background, Specific Aims, and Methods , 2001, Annals of Internal Medicine.

[10]  R. Tamblyn,et al.  Factors associated with the accuracy of standardized patient presentation , 1990, Academic medicine : journal of the Association of American Medical Colleges.

[11]  Christopher D. Wickens,et al.  An introduction to human factors engineering , 1997 .

[12]  Marie-Dominique Beaulieu,et al.  Using standardized patients to measure professional performance of physicians. , 2003, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[13]  Mitchell L. Cohen.  Epidemiology of Drug Resistance: Implications for a Post—Antimicrobial Era , 1992, Science.

[14]  S. Jain,et al.  Assessing the Accuracy of Administrative Data in Health Information Systems , 2004, Medical care.

[15]  Vimla L. Patel,et al.  Usability in the real world: assessing medical information technologies in patients' homes , 2003, J. Biomed. Informatics.

[16]  R. Tamblyn,et al.  The accuracy of standardized patient presentation , 1991, Medical education.

[17]  Roger C. Duvoisin.  Simulated Patients (Programmed Patients): The Development and Use of a New Technique in Medical Education. , 1972 .

[18]  P C Tang,et al.  Major issues in user interface design for health professional workstations: summary and recommendations. , 1994, International journal of bio-medical computing.

[19]  D. Bates,et al.  Incidence and preventability of adverse drug events among older persons in the ambulatory setting. , 2003, JAMA.

[20]  Ralph Gonzales,et al.  Changing Use of Antibiotics in Community-Based Outpatient Practice, 19911999 , 2003, Annals of Internal Medicine.

[21]  J. Hernández,et al.  Adverse drug events in ambulatory care. , 2003, The New England journal of medicine.

[22]  Vimla L. Patel,et al.  Cognitive and usability engineering methods for the evaluation of clinical information systems , 2004, J. Biomed. Informatics.

[23]  V. Patel,et al.  Assessment of a computerized patient record system: a cognitive approach to evaluating medical technology. , 1996, M.D. computing : computers in medical practice.

[24]  Colin Sharp.  Qualitative Research and Evaluation Methods (3rd ed.) , 2003 .

[25]  Jie Huang,et al.  Research Paper: Health Information Technology and Physician-Patient Interactions: Impact of Computers on Communication during Outpatient Primary Care Visits , 2005, J. Am. Medical Informatics Assoc..