CUA of the Month – May, 2009

Speaking the Language of the User
Taking a cross-cultural approach makes e-learning usable for medical professionals

by Douglas Gorney

"Designing usable IT training interfaces for doctors and clinicians is critical," says Jamie Owen, Visual Information Specialist and Multimedia Project Manager at the U.S. Department of Veterans Affairs. "If our medical staff isn't conversant and comfortable with the technology-based training, they could make a mistake. When patient safety is at stake, that's not an option."

Jamie is one of the staff responsible for interface design and content strategy for e-learning products at the VA. Understanding the user is critical for any usability specialist, but particularly so for Jamie.

"Our training covers highly specialized medical systems and software. Now, if you're a user experience practitioner designing interfaces for that training," Jamie says, "you could guess at the precise function of each instruction, field and button, but you'd just trip over your shoelaces – you'll have to go through it again when you find out what their real significance is to the medical staff who are going to use them. On the other hand, if you know the meaning first, you can almost reverse-engineer the function... and the design falls into place."

Jamie's approach to user-centered design, practical yet deeply thoughtful, is reflected in his academic background. Looking for more effective ways for users to find value in their interactions, he pursued a master's degree integrating technology with learning and cognitive psychology. Now, Jamie is a Ph.D. candidate at Kent State University, a year or so away from receiving his doctorate in educational psychology with a focus on instructional technology.

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Speaking the Language of the User... (Continued)

"My dissertation will be focusing on cross-cultural variables regarding interaction designs in e-Learning," says Jamie. "And the cross-cultural perspective is actually fairly relevant to my work here at the VA. It has helped me notice little things that even experienced usability practitioners might take for granted – nuances that make or break it for people who use technology differently, as a lot of our hospital staff do."

Taking HFI training gave Jamie tools to make that "cross-cultural" approach work at the VA. "One of the things the HFI instructors covered was the concept of noun architecture. You need to use your users' language to build elements of interaction design, like buttons and labels, that must resonate with the audience. It's a proactive way of figuring out subtle nuances that might otherwise get missed. That's particularly important in speaking a specialized language like medicine! Our learning UI often needs to be in the medical vernacular."

It's certainly user-focused, but seen from the bottom line, it's also very practical. The noun-architecture technique lets Jamie and other development team members bypass unnecessary revisions in learning application designs. "The medical staff's language informs the design in just the right way. That's proactive design, not reactive – and it saves the VA time and money."

"Using noun architecture is just one example of how usability tools and techniques I learned from HFI fit into the projects I'm involved with," says Jamie. "The VA values systematic approaches to design, and there are any number of usability tactics in my kit that support systematic, user-centered design standards."

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When we talked with Jamie he had just completed the initial phase of work on a challenging project that drew on the full range of his HFI training and graduate education. Selected to join a leadership committee to establish e-learning standards for the VA's sizable training and education department, Jamie helped create consistent design and technical guidelines for e-learning products in the VA's Learning Management System (LMS). These guidelines make e-learning products more usable for everyone who accesses them.

"The goal was that busy people throughout the VA have to be able to find the e-learning they need, use it and understand it, and not have to familiarize themselves with a new GUI for every course."

In the end, Jamie's contributions in multimedia learning theory, interface design, and use context – for both learners and developers – played an important role in the success of the design guidelines. In fact, the committee was tasked with broadening the scope of the project to all VA departments who want to share their training in the LMS.

While facilitating a design effort intended to strengthen the existing informational website which supports VA LMS users, Jamie used techniques reinforced by the HFI toolkit and helped the team create personas so they could understand user requirements. "We had a persona of this amazingly busy nurse, for example. 'She' helped us see that VA staff are just not going to have the time to go deeply into the website. We'd have to make it easily accessible for a wide range of users who don't have time to chase after the information they need."

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Speaking the Language of the User.... (Continued)

After recognizing the value of the usability strategies Jamie practiced, the members of the design team understood usability in the context of the project's goals. They were able complete their activities using a shared usability perspective and vocabulary.

"You might almost consider it a cross-cultural understanding!" says Jamie. "The ideas were not foreign, they just needed to be expressed within a context meaningful to those unfamiliar with user-centered design."

This contextual meaning can also be expressed on another level: the monetary value of usability. When Jamie applied to the VA for funding for his HFI training, he had to write a business case, proposing a cohesive justification for return on investment. Leadership endorsed the initiative and encouraged others in his department to undertake usability training.

Whether it's spanning boundaries between team members, framing the ROI of usability, or helping to design training for those in the healthcare workplace, Jamie demonstrates that usability affects everyone, regardless of the context.

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