Tremoulet Patrice D
Department of Psychology, Rowan University, Glassboro, NJ, USA.
Digit Health. 2022 Aug 7;8:20552076221113696. doi: 10.1177/20552076221113696. eCollection 2022 Jan-Dec.
This study investigated how effectively simplified cognitive walkthroughs, performed independently by four nonclinical researchers, can be used to assess the usability of clinical decision support software. It also helped illuminate the types of usability issues in clinical decision support software tools that cognitive walkthroughs can identify.
A human factors professor and three research assistants each conducted an independent cognitive walkthrough of a web-based demonstration version of T3, a physiologic monitoring system featuring a new clinical decision support software tool called MAnagement Application (MAP). They accessed the demo on personal computers in their homes and used it to walk through several pre-specified tasks, answering three standard questions at each step. Then they met to review and prioritize the findings.
Evaluators acknowledged several positive features including concise, helpful tooltips and an informative column in the patient overview which allows users direct (one-click) access to protocol eligibility and compliance criteria. Recommendations to improve usability include: modify the language to clarify what user actions are possible; visually indicate when eligibility flags are snoozed; and specify which protocol's data is currently being shown.
Independent, simplified cognitive walkthroughs can help ensure that clinical decision support software tools will appropriately support clinicians. Four researchers used this technique to quickly, inexpensively, and effectively assess T3's new MAP tool, which suggests positive actions, such as removing a patient from a ventilator. Results indicate that, while there is room for usability improvements, the MAP tool may help reduce clinician's cognitive load, facilitating improved care. The study also confirmed that cognitive walkthroughs identify issues that make clinical decision support software hard to learn or remember to use.
本研究调查了由四名非临床研究人员独立进行的简化认知走查，在评估临床决策支持软件可用性方面的有效性。同时，本研究也有助于阐明认知走查能够识别的临床决策支持软件工具中的可用性问题类型。
一位人体因素学教授和三名研究助理各自对T3的基于网络的演示版本进行了独立的认知走查。T3是一个生理监测系统，具有名为管理应用程序（MAP）的新型临床决策支持软件工具。他们在家中通过个人电脑访问该演示，并使用它完成几个预先指定的任务，在每一步回答三个标准问题。然后他们会面，对调查结果进行审查并确定优先级。
评估人员认可了几个积极的特性，包括简洁、有用的工具提示以及患者概述中的信息栏，该信息栏允许用户直接（一键）访问方案资格和合规标准。关于提高可用性的建议包括：修改语言以明确可能的用户操作；在资格标志被暂停时进行视觉指示；指定当前显示的是哪个方案的数据。
独立的简化认知走查有助于确保临床决策支持软件工具能够适当地支持临床医生。四名研究人员使用这种技术快速、廉价且有效地评估了T3的新MAP工具，该工具能给出诸如让患者脱离呼吸机等积极的操作建议。结果表明，虽然在可用性方面仍有改进空间，但MAP工具可能有助于减轻临床医生的认知负担，促进护理质量的提高。该研究还证实，认知走查能够识别那些使临床决策支持软件难以学习或容易忘记使用的问题。
