title: Usability of a patient education and motivation tool using heuristic evaluation.
abstract: BACKGROUND
  Computer-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.
  
  
  OBJECTIVE
  The 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.
  
  
  METHODS
  PEMT 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.
  
  
  RESULTS
  A 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).
  
  
  CONCLUSIONS
  We 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.
authors.affiliation: Department of Information Systems, University of Maryland, Baltimore County, Baltimore, MD 21250, USA. asjoshi@umbc.edu
authors.forename: Ashish
authors.initials: A
authors.lastname: Joshi
authors.forename: Mohit
authors.initials: M
authors.lastname: Arora
authors.forename: Liwei
authors.initials: L
authors.lastname: Dai
authors.forename: Kathleen
authors.initials: K
authors.lastname: Price
authors.forename: Lisa
authors.initials: L
authors.lastname: Vizer
authors.forename: Andrew
authors.initials: A
authors.lastname: Sears
mesh_terms: D000328:Adult; D001249:Asthma / Q000534:rehabilitation; D002648:Child; D005246:Feedback; D006801:Humans; D007252:Influenza Vaccines; D007858:Learning; D009042:Motivation; D010290:Parents; D010353:Patient Education as Topic / Q000379:methods*; D010380:Peer Review / Q000379:methods; D012984:Software; D014584:User-Computer Interface
chemical_list: D007252:Influenza Vaccines