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Implementation Science
Published in: Implementation Science 1/2015

Open Access 01-12-2015 | Research

Redesigning printed educational materials for primary care physicians: design improvements increase usability

Authors: Agnes Grudniewicz, Onil Bhattacharyya, K. Ann McKibbon, Sharon E. Straus

Published in: Implementation Science | Issue 1/2015

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Abstract

Background

Printed educational materials (PEMs) are a frequently used tool to disseminate clinical information and attempt to change behavior within primary care. However, their effect on clinician behavior is limited. In this study, we explored how PEMs can be redesigned to better meet the needs of primary care physicians (PCPs) and whether usability and selection can be increased when design principles and user preferences are used.

Methods

We redesigned a publicly available PEM using physician preferences, design principles, and graphic designer support. We invited PCPs to select their preferred document between the redesigned and original versions in a discrete choice experiment, followed by an assessment of usability with the System Usability Scale and a think aloud process. We conducted this study in both a controlled and opportunistic setting to determine whether usability testing results vary by study location. Think aloud data was thematically analyzed, and results were interpreted using the Technology Acceptance Model.

Results

One hundred and eighty four PCPs participated in the discrete choice experiment at the 2014 Family Medicine Forum, a large Canadian conference for family physicians. Of these, 87.7 % preferred the redesigned version. Follow-up interviews were held with a randomly selected group of seven participants. We repeated this in a controlled setting in Toronto, Canada, with a set of 14 participants. Using the System Usability Scale, we found that usability scores were significantly increased with the redesign (p < 0.001). We also found that when PCPs were given the choice between the two versions, they selected the redesigned version as their preferred PEM more often than the original (p < 0.001). Results did not appear to differ between the opportunistic and controlled setting. We used the results of the think aloud process to add to a list of end user preferences developed in a previous study.

Conclusions

We found that redesigning a PEM with user preferences and design principles can improve its usability and result in the PEM being selected more often than the original. We feel this finding supports the involvement of the user, application of design principles, and the assistance of a graphic designer in the development of PEMs.
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Literature
1.
Bero L, Grilli R, Grimshaw JM, Harvey E, Oxman A, Thomson MA. Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. BMJ. 1998;317:465–8.CrossRefPubMedPubMedCentral
2.
Giguère A, Légaré F, Grimshaw J, Turcotte S, Fiander M, Grudniewicz A, et al. Printed educational materials: effects on professional practice and healthcare outcomes (review). Cochrane Database Syst Rev. 2012. DOI:10.​1002/​14651858.​CD004398.​pub3.
3.
4.
Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362:1225–30.CrossRefPubMed
5.
Davis DA, Ciurea I, Flanagan TM, Perrier L, Cressey C, Faulds T, et al. Solving the information overload problem: a letter from Canada. Med J Aust. 2004;180:68–71.
6.
Versloot J, Grudniewicz A, Chatterjee A, Hayden L, Kastner M, Bhattacharyya O. Format guidelines to make them vivid, intuitive, and visual: use simple formatting rules to optimize usability and accessibility of clinical practice guidelines. Int J Evid Based Healthc. 2015;13(2):52-57.
7.
Davis F, Bagozzi R, Warshaw P. User acceptance of computer technology: a comparison of two theoretical models. Manage Sci. 1989;35:982–1003.CrossRef
8.
Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, et al. Lost in knowledge translation: time for a map? J Contin Educ Health Prof. 2006;26:13–24.
9.
Rogers E. Diffusion of innovations. 5th ed. New York: Free Press; 2003.
10.
11.
Witteman HO, Dansokho SC, Colquhoun H, Coulter A, Dugas M, Fagerlin A, et al. User-centred design and the development of patient decision aids: protocol for a systematic review. Syst Rev. 2015;4:11.
12.
13.
14.
15.
Kastner M, Estey E, Hayden L, Chatterjee A, Grudniewicz A, Graham ID, et al. The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives. BMC Fam Pract. 2014;15:19.
16.
Trevena L, Irwig L, Isaacs A, Barratt A. GPs want tailored, user friendly evidence summaries - a cross sectional study in New South Wales. Aust Fam Physician. 2007;36:1065–9.PubMed
17.
18.
Dormuth CR, Maclure M, Bassett K, Jauca C, Whiteside C, Wright JM. Effect of periodic letters on evidence-based drug therapy on prescribing behaviour: a randomized trial. CMAJ. 2004;171:1057–61.CrossRefPubMedPubMedCentral
19.
Wong B. Points of view: points of review (part 1). Nat Methods. 2011;8:101–1. Accessed 27 Oct 2015.CrossRefPubMed
20.
21.
22.
23.
Wong B. Points of view: visualizing biological data. Nat Methods. 2012;9:1131–1.CrossRef
24.
25.
26.
27.
Shoresh N, Wong B. Points of view: data exploration. Nat Methods. 2011;9:5–5.CrossRef
28.
29.
Wong B. Points of view: negative space. Nat Methods. 2011;8:1.
30.
31.
32.
Gehlenborg N, Wong B. Points of view: mapping quantitative data to color. Nat Methods. 2012;9:769–9.CrossRefPubMed
33.
34.
35.
Krzywinski M. Points of view: axes, ticks and grids. Nat Methods. 2013;10:183.CrossRef
36.
37.
38.
Wickens C, Lee J, Liu Y, Gordon S. An introduction to human factors engineering. 2nd ed. Upper Saddle River: Pearson Education; 2004.
39.
Adobe Systems. Adobe Illustrator CS5. 2010.
40.
Dabbs A, Myers B. User-centered design and interactive health technologies for patients. Comput Inform Nurs. 2009;27:175–83.CrossRef
41.
Van Waes L. Thinking aloud as a method for testing the usability of websites: the influence of task variation on the evaluation of hypertext. IEEE Trans Prof Commun. 2000;43:279–91.CrossRef
42.
43.
Nielsen J. Usability engineering. San Diego: Academic; 1993.
44.
Nielsen J. Estimating the number of subjects needed for a thinking aloud test. Int J Hum Comput Stud. 1994;41:385–97. Accessed 27 Oct 2015.CrossRef
45.
Kushniruk AW, Patel VL, Cimino JJ. Usability testing in medical informatics: cognitive approaches to evaluation of information systems and user interfaces. Proc AMIA Annu Fall Symp 1997:218–222.
46.
47.
Brooke J. SUS-A quick and dirty usability scale. Usability Eval Ind. 1996;189:194.
48.
Perrier L, Kealey RM, Straus SE. A usability study of two formats of a shortened review for clinicians. BMJ Open. 2014;4:e005919. Accessed 27 Oct 2015.CrossRefPubMedPubMedCentral
49.
50.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
51.
QSR International. NVivo for Windows. 2014.
52.
Zwolsman S, Te Pas E, Hooft L, Wieringa-De Waard M, Van Dijk N. Barriers to GPs’ use of evidence-based medicine: a systematic review. Br J Gen Pract. 2012;62(July):511–21.CrossRef
53.
U.S. Department of Health and Human Services Centres for DiseaseControl. Simply put: a guide for creating easy-to-understand materials. Atlanta; Office of the Associate Director for Communication Centers for Disease Control andPrevention. 2009.
Metadata
Title
Redesigning printed educational materials for primary care physicians: design improvements increase usability
Authors
Agnes Grudniewicz
Onil Bhattacharyya
K. Ann McKibbon
Sharon E. Straus
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2015
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-015-0339-5

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