Usability of a Patient Education and Motivation Tool Using Heuristic Evaluation

Abstract

BackgroundComputer-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.ObjectiveThe 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.MethodsPEMT 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.ResultsA 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).ConclusionWe 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.

Evaluating the Usability of a Nationwide Pharmacy Information System in Iran: Application of Nielson’s Heuristics

“…Our results indicated that the heuristics "consistency and standard" and "recognition rather than recall" have the largest number of violations, with the lowest number of violations related to "error prevention" and "Help users recognize, diagnose, and recover from errors" heuristics. These results are similar to the results of other studies, such as the those conducted by Khajouei et al, Atashi et al, and Nabovati et al in Iran (25)(26)(27), and also the studies conducted by Choi and Bakken, Georgsson et al, Joshi et al, and Mirkovic et al in countries other than Iran, which reported a high number of violations concerning these heuristics (28)(29)(30)(31). On the other hand, the unexpected results of this study indicated that the severity of 60.8% of all violations is major and catastrophic, which accounts for more than half of the identified violations and, in this case, and efficiency of the systems, satisfaction of their users, and hospital's financial issues.…”

Evaluating the usability of an interactive, bi-lingual, touchscreen-enabled breastfeeding educational programme: application of Nielson’s heuristics

“…This would help the user to make a clear distinction between the correct and the incorrect response. This is consistent with literature, where raters using Nielson’s heuristics are able to identify instructions and functionality problems, simplified representation and improved labeling 43. Majority of the violations due to consistency and standards were reported in the self-efficacy assessment module (8%, n = 8), followed by the knowledge module (4%, n = 4) and socio-demographics (1%, n = 1).…”

“…Among Hispanic mothers, perceptions of infant rejection to breastfeeding and milk insufficiency are often reported,14 and formula supplementation is practised among one in three mothers 15. Previous research suggests that initiation of breastfeeding may be more frequent among urban women (59%) compared to that among rural women (49%) 16. In urban settings, several longitudinal studies have prospectively examined breastfeeding initiation and discontinuation 17–22.…”

“…Nielson’s heuristics are a set of usability engineering principles developed to identify issues in user interface design and involves analysis of the interface. 42,43 Ten essential criteria constitute the Nielson’s heuristics and they include visibility of system status, match between system and the real world, user control and freedom, consistency and standards, error prevention, recognition rather than recall, flexibility and efficiency of use, aesthetic and minimalist design, recovery from errors and help and documentation. 42 Severity indexes ranging from negligible usability issues represented by zero (I don’t agree that this is a usability problem at all) to one (Cosmetic problem only: need not be fixed unless extra time is available on project), two (Minor usability problem: fixing this should be given low priority), three (Major usability problem: important to fix, so should be given high priority) and four (Usability catastrophe: imperative to fix this before product can be released) are utilised in assessing the extent to which such errors can hamper utilisation of the system 42.…”

“…42 Severity indexes ranging from negligible usability issues represented by zero (I don’t agree that this is a usability problem at all) to one (Cosmetic problem only: need not be fixed unless extra time is available on project), two (Minor usability problem: fixing this should be given low priority), three (Major usability problem: important to fix, so should be given high priority) and four (Usability catastrophe: imperative to fix this before product can be released) are utilised in assessing the extent to which such errors can hamper utilisation of the system 42. The majority of the errors can be identified in a systematic process, such as instructions and functionality problems, simplified representation and improved labeling 43. Heuristic evaluations require fewer resources than other methods to predict major usability problems 44,45.…”