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Usability testing ensures clear info
Make sure instructions can be understood
Consider evaluating educational materials, such as an educational sheet, self-care instructions, or an informational website, with a usability test instead of a focus group, says Dana Botka, manager of customer communications with the Washington Department of Labor and Industries in Olympia.
According to Botka, usability testing is a tool for determining if an instructional piece follows the rules of clear communication. A focus group will give you reactions to the materials, explains Botka.
The communication problems Botka helps solve within a state agency are similar to those that occur within the health care industry. These problems might include a form on which customers tend to make repeated mistakes that have to be corrected, or a letter providing instructions that people find confusing and thus inundate staff with telephone calls. Her job entails training and mentoring groups of state employees who have business problems, because their customers misunderstand what they are trying to communicate.
Patient education managers know that health care costs rise when patients are readmitted to the hospital, because they did not follow the discharge instructions, or a patient's surgery is postponed, because he or she did not prepare adequately.
Usability testing can uncover the following:
terms patients and family members don't understand;
words that can mean something else;
basic information or context that is missing;
information that is unimportant and distracting;
a patient or family member's emotional reaction to what was developed;
the unexpected, or something the developer had no idea would happen.
When designing a piece, make sure the process is centered on the people who will use it, says Botka. To correct a document that is not working, gather a team of subject-matter experts together. As a group, gather around a projected laptop screen and work together to develop a clearer, more usable document, she adds.
"The most important step is the one that follows. The second step is to test the product, which may be a form or letter, with a representative sample of the real people who would use the document in real life," says Botka.
Taking a medical example, Botka explains that by creating user-centered design, post-operation instructions for cardiac patients would begin by considering the demographics of the patients who undergo the surgery. It is important to have the typical users clearly in mind when creating the document, says Botka. To make sure the piece is on target, it would then be tested with a representative sample of the typical audience.
Conducting the testing
To test the product, recruit four to six people who fit the description of your typical user, but who are not familiar with the material that is to be tested, advises Botka.
These people would be asked to come to a particular location for the usability test, and they would be scheduled at different times. Botka says offering money, or a gift card, provides incentive to follow through on the commitment.
Create a scenario that will allow the test participant to understand the situation. For example, for the post-op instructions for cardiac surgery, tell the participant that he is John Smith, a 56-year-old man who had a heart attack and underwent surgery three days ago. He is being discharged from the hospital with a set of instructions to follow.
Once the participant understands the scenario, he or she is given the instructions to read. Then, a series of questions prepared in advance are asked. These questions should be designed to get the person to do the tasks in the instructions, such as track daily sodium intake.
"If you want post-op cardiac patients to understand their diet, ask questions about that. You record the answers to see if they answer accurately, or see if they are missing something," says Botka.
Don't ask easy questions, she advises. For example, to determine if the medication instructions are easy to follow, ask what the patient's daily medication routine would be.
The test participants may use different words from those in the instructions, paraphrasing the information in their own words. This can give you clues as to phrasing the message, says Botka.
Also, in usability testing, you can use the "talk out loud protocol," which is to read a sentence or paragraph that you are concerned about and then ask the test participant to say it back in his or her own words. This helps you know how people would actually say something, says Botka.
The solution to misunderstood instructions may not be plainer language, but a chart instead of a paragraph, or information may need to be explained so there is context.
"The easier you can make it for people to understand the steps required in the task, the more likely it is they will do it," says Botka.
Usability testing is particularly popular with Web design, adds Botka. It helps site developers determine if users can find information, and once they find it, if they can understand it. Also, if they can act on whatever task they need to do.
A survey or focus group does not test whether a person can do a task, says Botka. People will often say they "like" a document or website and yet not know how to use it. That's because they don't want to admit they had trouble or hurt the designer's feelings, explains Botka.
In addition, people may say they understand instructions, because they think they do; yet if asked to perform a given task, they are unable to do so, she adds.
"That is the advantage of a usability test; you get a better understanding of what people understand," says Botka.
For more information about usability testing contact:
Dana Botka, Manager of Customer Communications, Washington Department of Labor and Industries, P.O. Box 44050, MS 4050, Olympia, WA 98504. Telephone: (360) 902-5408. E-mail: BOTD235@LNI.WA.GOV.
Usability Professionals' Association, 140 N. Bloomingdale Road, Bloomingdale, IL 60108-1017. Telephone: (630) 980-4997. Web site: www.upassoc.org.