Controlled laboratory-based usability assessments of mobile information and communications technologies (ICT) for hospitals have been conducted. As part of these assessments, clinicians have acted out mobile work scenarios and used the systems to solve related tasks. The evaluations show that relevant usability issues go beyond those of graphical user interfaces. Many of these usability issues only show up when the real-world context of use is replicated in the laboratory to a high degree of fidelity. The complexity of the context of use for mobile ICT in hospitals has motivated us to explore training simulation fidelity theories. Based on a review of the training simulation literature, a set of fidelity dimensions through which training simulations are often adjusted to meet specific goals are identified. It is argued that the same mechanisms can be used in usability assessments of mobile ICT for hospitals. Our argument is substantiated by using the identified set of fidelity dimensions in a retrospective analysis of two usability assessments. The analysis explains how the configuration of fidelity dimensions, each reflecting various degrees of realism vis-à-vis the actual performance context, contributed to the identification of relevant usability issues.
Computer systems are first and foremost designed for primary users. The needs of the other types of users, such as secondary users, are often overlooked. These users are not interacting with the system directly but are yet affected by it. This study is based on empirical findings from two usability evaluations in a realistic hospital setting with physicians and patient actors. We have found that also secondary users, such as patients, have a kind of user experience during the primary user's interaction with the system. We conclude from this that designers and developers should also address the need of secondary users and include them in the design and evaluation process. This means designing devices or GUIs that (1) support non-verbal communication, (2) provide feedback to the secondary users, (3) use their language and representation, and (4) is tailored for the secondary user. Sometimes a focus on the secondary user implies that the designer must deal with conflicting needs between the primary and the secondary users.
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