HCI and Usability for Medicine and Health Care

The traditional approaches of HCI are essential, but they are unable to cope with the complexity of typical modern interactive devices in the safety critical context of medical devices. We outline some technical approaches, based on simple and “easy to use” formal methods, to improve usability and safety, and show how they scale to typical devices. Specifically: (

i

) it is easy to visualize behavioral properties; (

ii

) it is easy to formalize and check properties rigorously; (

iii

) the scale of typical devices means that conventional user-centered approaches, while still necessary, are insufficient to contribute reliably to safety related interaction issues.

In this paper we argue that the formal analysis of an interactive medical system can improve their usability evaluation such that potential erroneous interactions are identified and improvements can be recommended. Typically usability evaluations are carried out on the interface part of a system by human-computer interaction/ergonomic experts with or without end users. Here we suggest that formal specification of the behavior of the system supported by mathematical analysis and reasoning techniques can improve usability evaluations by proving usability properties. We present our approach highlighting that formal description techniques can support in a consistent way usability evaluation, contextual help and incident and accident analysis. This approach is presented on a wireless patient monitoring system for which adverse event (including fatalities) reports are publicly available from the US Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database.

Computer-based counseling systems in health care play an important role in the toolset available for doctors to inform, motivate and challenge their patients according to a well-defined therapeutic goal. In order to study value, use, usability and effectiveness of counseling systems for specific use cases and purposes, highly adaptable and extensible systems are required, which are – despite their flexibility and complexity – reliable, robust and provide exhaustive logging capabilities. We developed a computer-based counseling system, which has some unique features in that respect: The actual counseling system is generated out of a formal specification. Interaction behavior, logical conception of interaction dialogs and the concrete look & feel of the application are separately specified. In addition, we have begun to base the formalism on a mathematical process calculus enabling formal reasoning. As a consequence e.g. consistency and termination of a counseling session with a patient can be verified. We can precisely record and log all system and patient generated events; they are available for advanced analysis and evaluation.

As demonstrated by several studies, nurses are reluctant to use poorly designed computerised patient records (CPR). So far, little is known about the nurses’ interaction with paper-based patient records. However, these practices should guide the design of a CPR system. Hence, we investigated the nurses’ work with the patient records by means of observations and structured interviews on wards in internal medicine, geriatrics and surgery. Depending on the working context and the nursing tasks and activities to be performed, characteristic access preferences and patterns were identified when nurses interacted with patient records. In particular, we found typical interaction patterns when nurses performed tasks that included all assigned patients. Another important finding concerns worksheets. Nurses use them during their whole shift to manage all relevant information in a concise way. Based on our findings, we suggest a CPR design which reflects the identified practices and should improve the acceptance of CPR systems in the demanding hospital environment.

Currently, one of the main issues of Human Computer Interaction (HCI) in the area of e-Health is the design of telemedicine services based on the study of interactions established between people and new technologies. Nevertheless, the research in HCI has been mainly focused from a cognitive point of view, and most studies don’t consider other variables related to the social impact of technology. This gap is extremely important in e-Health, because Information Systems (IS) changes qualitatively work processes in health organizations. In this paper we present an interdisciplinary perspective that includes the cognitive and organizational aspects to the technical design of new e-Health services in the area of telecardiology. The results obtained permit to accurately define not only technical requirements and network resources management, but also user requirements, contextual particularities of the scenarios where these services could be implemented and the IS impact in organizational processes. Moreover, the ethnographical methodology proposed has been applied to specific emergencies scenarios, obtaining conclusions that allow new user-centered designs that can be directly integrated in medical practice in an efficient way.

Ergonomics and usability do not only pertain to computer work places. More and more they are becoming an important factor in the process of ensuring safety, efficacy, and a return on investment. Especially in the medical field, the increasing life expectancy requires among other things continually new methods of therapy and diagnosis. Triggered by competition and higher functionality of the devices medical products becomes more and more complex. The growing density of achievements in the public health care system such as DRG’s, as well as the larger number of various medical devices imply for physicians and nursing staff a heavy burden that can deteriorate therapy quality and safety. The rapidly changing user requirements have a high pressure also on products’ development. The critical questions refer equally to an efficient development combined with reduced expenses for development time and costs, as to an optimized use of the products by the customer with reduced process costs and an increased user satisfaction and safety for the welfare of patients and users. In order to guarantee the safe use of medical devices, a usability engineering process (UEP) should be integrated into a medical device development program. This article describes challenges and possible solutions for medical devices’ manufacturers seeking to do so.

This paper describes the usability evaluation conducted at the Experimental-OR of the University Hospital Tuebingen. Subjects of the study were three radio-frequency (RF) devices for surgery. The aim of this study was to detect the differences in the usability among devices which have the same mode of operation and to announce the usability problems occurring with their use. Standard usability test methods for interactive devices have been adapted and verified for the use in the medical field, especially for validating RF devices. With the aid of these methods several usability problems and their consequences to user satisfaction have been be identified. The findings of these tests provide data for the improvement in further development of RF devices.

This paper describes the use of a technique to improve design and to develop new uses and improve usability of user interfaces. As a case study, we focus on the design and usability of a research prototype of an actigraph - electronic activity and sleep study device - the Porcupine. The proposed BadIdeas technique was introduced to a team of students who work with this sensor and the existing design was analysed using this technique. The study found that the BadIdeas technique has promising characteristics that might make it an ideal tool in the prototyping and design of usability-critical appliances.

Data entry is still one of the most challenging bottlenecks of electronic patient record (EPR) use. Today’s systems obviously neglect the professionals’ practices due to the rigidity of the electronic forms. For example, adding annotations is not supported in a suitable way. The aim of our study was to understand the physicians’ and nurses’ practices when recording information in a patient record. Based on the findings, we outline use cases under which all identified practices can be subsumed. A system that implements these use cases should show a considerably improved acceptance among professionals.

The application of already widely available mobile phones would provide medical professionals with an additional possibility of outpatient care, which may reduce medical cost at the same time as providing support to elderly people suffering from chronic diseases, such as diabetes and hypertension. To facilitate this, it is essential to apply user centered development methodologies to counteract opposition due to the technological inexperience of the elderly. In this paper, we describe the design and development of a mobile medical application to help deal with chronic diseases in a home environment. The application is called

MyMobileDoc

and includes a graphical user interface for patients to enter medical data including blood pressure; blood glucose levels; etc. Although we are aware that sensor devices are being marketed to measure this data, subjective data, for example, pain intensity and contentment level must be manually input. We included 15 patients aged from 36 to 84 (mean age 65) and 4 nurses aged from 20 to 33 (mean age 26) in several of our user centered development cycles. We concentrated on three different possibilities for number input. We demonstrate the function of this interface, its applicability and the importance of patient education. Our aim is to stimulate incidental learning, enhance motivation, increase comprehension and thus acceptance.

The aim of this paper is to foster interdisciplinary research on technology use in old age by including psychological theories and dimensions such as cognitive, motivational and emotional factors which referring to recent research studies highly influence acceptability and usability of technical devices in old age. Therefore, this paper will focus on psychological theories in the context of ageing with regard to attitudes towards technology use, acceptability and the importance of user involvement at the very beginning of technological product development and design.

The present paper describes a scenario for examining mechanisms of movement coordination in humans and robots. It is assumed that coordination can best be achieved when behavioral rules that shape movement execution in humans are also considered for human-robot interaction. Investigating and describing human-human interaction in terms of goal-oriented movement coordination is considered an important and necessary step for designing and describing human-robot interaction. In the present scenario, trajectories of hand and finger movements were recorded while two human participants performed a simple construction task either alone or with a partner. Different parameters of reaching and grasping were measured and compared in situations with and without workspace overlap. Results showed a strong impact of task demands on coordination behavior; especially the temporal parameters of movement coordination were affected. Implications for human-robot interaction are discussed.

This article describes a service architecture for ambient assisted living and in particular an orientation navigation service in open places for persons with memory problems such as those patients suffering from Alzheimer’s in its early stages. The service has the following characteristics: one-day system autonomy; self-adjusting interfaces for simple interaction with patients, based on behavioural patterns to predict routes and destinations and to detect lost situations; easy browsing through simple spoken commands and use of photographs for reorientation, and independence of GISs (Geographic Information Systems) to reduce costs and increase accessibility. Initial testing results of the destination prediction algorithm are very positive. This system is integrated in a global e-health/e-care home service architecture platform (OSGi) that enables remote management of services and devices and seamless integration with other home service domains.

The authors describe a new approach towards assessing skills of medical trainees. Based on experiences from previous projects with (i) applying virtual environments for medical training and (ii) competence assessment and personalisation in technology enhanced learning environments, a system for personalised medical training with virtual environments is built. Thus, the practical training of motor skills is connected with the user-oriented view of personalised computer-based testing and training. The results of this integration will be tested using a haptic device for training spinal anaesthesia.

Information Visualization (InfoVis) techniques can offer a valuable contribution for the examination of medical data. We successfully developed an InfoVis application – Gravi – for the analysis of questionnaire data stemming from the therapy of anorectic young women. During the development process, we carefully evaluated Gravi in several stages. In this paper, we describe selected results from the usability evaluation, especially results from qualitative studies. The results indicate that Gravi is easy to use and intuitive. The subjects of the two studies described here especially liked the presentation of time-oriented data and the interactivity of the system. In the second study, we also found indication that Gravi can be used in other areas than the one it was developed for.

This paper details a usability study on a bioinformatics visualization tool. The tool was redesigned based on a usability engineering framework called UX-P (User Experiences to Patterns) that leverages personas and patterns as primary design directives, and encourages on-going usability testing throughout the design lifecycle. The goals were to carry out a design project using the UX-P framework, to assess the usability of the resulting prototype, and to mitigate the test results into useful recommendations.

Molecular interfaces between proteins are of high importance for understanding their interactions and functions. In this paper protein complexes in the PDB database are used as input to calculate an interface contact matrix between two proteins, based on the distance between individual residues and atoms of each protein

.

The interface contact matrix is linked to a 3D visualization of the macromolecular structures in that way, that mouse clicking on the appropriate part of the interface contact matrix highlights the corresponding residues in the 3D structure. Additionally, the identified residues in the interface contact matrix are used to define the molecular surface at the interface. The interface contact matrix allows the end user to overview the distribution of the involved residues and an evaluation of interfacial binding

hot spots.

Theinteractive visualization of the selected residues in a 3D view via interacting windows allows realistic analysis of the macromolecular interface.

The Lattice Bhatnagar Gross and Krook (LBGK) method is widely used to solve fluid mechanical problems in engineering applications. In this work a brief introduction of the LBGK method is given and a new boundary condition is proposed for the cardiovascular domain. This enables the method to support elastic walls in two and three spatial dimensions for simulating blood flow in elastic vessels. The method is designed to be used on geometric data obtained from magnetic resonance angiography without the need of generating parameterized surfaces. The flow field is calculated in an arbitrary geometry revealing characteristic flow patterns and geometrical changes of the arterial walls for different time dependent input contours of pressure and flow. For steady flow the results are compared to the predictions of the model proposed by Y. C. Fung which is an extension of Poiseuille’s theory. The results are very promising for relevant Reynolds and Womersley numbers, consequently very useful in medical simulation applications.

Medical researchers are constantly looking for new methods for early detection and treatment of incurable diseases. Cancer can severely hinder the lives of patients if they are not constantly attended to. Cancer patients can be assisted with the aid of constant monitoring by a support group and a continual sense of self-awareness through monitoring, which can be enabled through pervasive technologies. As human life expectancy rises, incidents of cancer also increase, which most often affects the elderly. Cancer patients need continuous follow-up because of the state of their disease and the intensity of treatment. Patients have often restricted mobility, thus it is helpful to provide them access to their health status without the need to travel. There has been much effort towards wireless and internet based health care services, but they are not widely accepted due to the lack of reliability and usability. In this paper, we present a software called Wellness Monitor (WM). The purpose of WM is to utilize the portability and ubiquity of small handheld devices such as PDAs, cell phones, and wrist watches to ensure secured data availability, customized representation, and privacy of the data collected through small wearable sensors. WM explores how the social and psychological contexts that encompass the patients could be enhanced by utilizing the same technology, an aspect which is mostly unexplored. A further goal was to provide continuous psychological assistance.

Mobile information systems show high potential in supporting emergency physicians in their work at an emergency scene. Particularly, information received by the hospital’s emergency room well before the patients’ arrival allows the emergency room staff to optimally prepare for adequate treatment and may thus help in saving lives. However, utmost care must be taken with respect to the usability of mobile data recording and transmission systems since the context of use of such devices is extremely delicate: Physicians must by no means be impeded by data processing tasks in their primary mission to care for the victims. Otherwise, the employment of such high tech systems may turn out to be counter productive and to even risk the patients’ lives. Thus, we present the usability engineering measures taken within an Austrian project aiming to replace paper-based Emergency Patient Care Report Forms by mobile electronic devices. We try to identify some lessons learned, with respect to both, the engineering process and the product itself.

Augmented and Mixed Reality technology provides to the medical field the possibility for seamless visualization of text-based physiological data and various graphical 3D data onto the patient’s body. This allows improvements in diagnosis and treatment of patients. For the patient, this technology offers benefits and further potential in therapy, rehabilitation and diagnosis, and explanation. Applications across the whole range of functions that affect the health sector from the physician, the medical student, to the patients are possible. However, the quality of the work of medical professionals is considerably influenced by both usefulness and usability of technology. Consequently, key issues in developing such applications are the tracking methodology, the display technology and most of all ensuring good usability. There have been several research groups who extended the state of the art in employing these technologies in the medical domain. However, only a few are addressing issues of Human-Computer Interaction, Interaction Design, and Usability Engineering. This paper provides a brief overview over the history and the most recent developments in this domain with a special focus on issues of user-centered development.

The following paper reports on a prototype Brain-computer Interface designed for pervasive control by paralyzed users. Our study indicates that current control and communication devices for users with severe physical disabilities restrict control and independence, offer little articulation and communication capabilities. Integrating multiple devices and services, our application is based on the functional Near-Infrared Imaging technology. Based on the overarching Value-sensitive design framework, our solution is informed by the usage patterns of technology, living habits and daily activities of the disabled users. By designing the context-aware pervasive control solution, we create a venue for communication, environmental control, recreation, assistance and expression among physically disabled patients. The evaluations results of the prototype are also discussed.

This study examined whether interfaces in computer-based decision aids can be designed to reduce the mental effort required by people to make difficult decisions about their healthcare and allow them to make decisions that correspond with their personal values. Participants (N=180) considered a treatment scenario for a heart condition and were asked to advise a hypothetical patient whether to have an operation or not. Attributes for decision alternatives were presented via computer in one of two formats; alternative-tree or attribute-tree. Participants engaged in significantly more compensatory decision strategies (i.e., comparing attributes of each option) using an interface congruent with their natural tendency to process such information (i.e., alternative-tree condition). There was also greater correlation (p<.05) between participants’ decision and personal values in the alternative-tree. Patients who are ill and making decisions about treatment often find such choices stressful. Being able to reduce some of the mental burden in such circumstances adds to the importance of interface designers taking account of the benefits derived from structuring information for the patient.

MEDIC is a dynamic decision making simulation incorporating time constraints, multiple and delayed feedback and repeated decisions. This tool was developed to study cognition and dynamic decision making in medical diagnosis. MEDIC allows one to study several crucial facets of complex medical decision making while also being well controlled for experimental purposes. Using MEDIC, there is a correct diagnosis for the patient, which provides both outcome and process measures of good performance. MEDIC also allows us to calculate cue diagnosticity and probability functions over the set of hypotheses that participants are explicitly considering, based on assumptions of local (bounded) rationality. MEDIC has served in a series of studies aimed at understanding learning in dynamic and real-time medical diagnotic situations. In this paper, we outline the tool and highlight results from these preliminary studies which set out to measure learning.

Public health care has to make use of the potentials of IT to meet the enormous demands on patient management in the future. Embedding artificial intelligence in medicine may lead to an increase in quality and safety. One possibility in this respect is an expert system. Conditions for an expert system are structured data sources to extract relevant data for the proposed decision. Therefore the demonstrator ‘allo-tool’ was designed. The concept of introducing a ‘Medical decision support system based on the model of Stem Cell Transplantation’ was developed afterwards. The objectives of the system are (1) to improve patient safety (2) to support patient autonomy and (3) to optimize the workflow of medical personnel.

The effects of patient characteristics, information, and framing on decision-making were explored using scenarios involving patients with AIDS and lung cancer. Participants were physicians affiliated with a large university medical center and undergraduate psychology students. For the physicians, the roles of experience, workload, fatigue, continuing education, and supervision were examined. In scenario one, physicians showed that the way outcomes were framed affected treatment selection for patients with hemophilia (

p

< .0005), but not for patients who were intravenous drug users (

p

= .107). In scenario two, similar to a previous study, the students showed a significant framing effect (

p

= .001), but the physicians did not (

p

= .085). Patient characteristics and the fram ing of treatment options can alter decision-making. Experience and additional outcome information also play a role in treatment selection. Computer applica tions may be a means to eliminate these treatment differences.

The potential of health information technology to effectively support the work of health care providers and reduce the likelihood of errors and incidents has not been realized; however, the manner of investigating incidents can provide information to aid in its realization. Implications of negligible findings from extensive research on provider accountability for errors point to the importance of addressing the nature of error incidents. Consideration of the nature of incidents together with lessons learned from industry error research expands the focus of incident investigations to include how and why the event happened. A model to guide incident investigations and examples of the viability of that model to address issues in using health information technology are described. The wisdom of Sherlock Holmes accompanies this sleuthing for methods to enhance information technology to better support care providers in their daily work.

Combining Virtual Reality (VR) and functional magnetic resonance imaging (fMRI) offers great possibilities to researchers. Brain activation in VR can be studied and more realistic stimuli can be used in fMRI studies. Unfortunately, no standard solution exists for the combination of both methods. As part of an interdisciplinary project addressing the diagnostics and treatment of neglect, we created a neuroscientific VR-fMRI experiment. Our experiences are reported in this paper. The description of problems and our solution are intended as substantial facilitation and help for other researchers interested in creating VR-fMRI experiments.

Within the framework of the INNORISK (Innovative Risk Analysis Methods for Medical Devices) project, a twofold strategy is pursued for prospective usability assessment of Computer-Assisted Surgery (CAS) systems in the context of a risk management process. In one approach ConcurTaskTrees are applied to accomplish a hierarchical task analysis including temporal relations. In the other approach, based on the Cognitive Task Analysis method CPM-GOMS (

C

ognitive

P

erceptual

M

otor –

G

oals

O

perators

M

ethods

S

election Rules), a new technique for detecting potential contradictions and conflicts in the use of concurrent cognitive resources is generated. Within this model-based approach, extrinsic and intrinsic performance shaping factors are comprised, taking into account the specific context of modern surgical work systems. Additionally, a computer assisted usability analysis tool including the above-mentioned methods is developed to provide support for small and medium-sized enterprises in early stages of the design development process of risk sensitive Human-Machine-Interfaces in medical systems.

Computers and video games are a normal part of life for millions of children. However, due to the association between intensive gaming and aggressive behavior, school failure, and overweight, video games have gained negative publicity. While most reports centre upon their potential negative consequences, little research has been carried out with regard to the innovative potentials of video games. ‘Treasure Hunt’, the first psychotherapeutic computer game based on principles of behavior modification, makes use of children’s fascination for video games in order to support psychotherapy. This interactive adventure game for eight to twelve year old children is not meant to substitute the therapist, but to offer attractive electronic homework assignments and rehearse basic psycho-educational concepts that have been learnt during therapy sessions. While psychotherapeutic computer games may prove to be a useful tool in the treatment of children and adolescents, unrealistic expectations with regard to such games should be discussed.

The human’s facial expression plays an important role as media that visually transmit feelings and the intention. In this study, the purpose is to support the effective process for facial expression training to achieve the target expression using computer. And, an interface for users to select a target facial expression and a whole development of an effective expression training system is proposed, as a first step toward an effective facial expression training system.

Evidence-based practice (EBP) is an established method for improving clinical practice and has been shown to improve cost-effectiveness of patient care. Despite the evidence that EBP promotes positive outcomes, nurses have been slow to incorporate this process into practice. One major barrier to nurses implementing evidence in their daily work is the lack of time to search the literature. The objective of this study is to design, implement, and evaluate an inpatient unit-specific website which allows nurses and other direct care providers to easily access literature on specific nursing and pediatric neuroscience care issues. The goal is to minimize time dedicated to the literature search as a barrier to implementing EBP.

In knowledge-work, there are increasing amounts of complex information rendered by information technology, which has led to the common term,

information overload

. Information visualization is one area where empirically tested semantic theory has not yet caught up with that of the underlying information storage and retrieval theory, contributing to information overload. In spite of a vast body of cognitive theory, much of the human factors research on information visualization has overlooked it. Specifically, information displays have facilitated the data gathering (ontological) aspects of human problem-solving and decision-making, but have exacerbated the meaning-making (epistemological) aspects of those activities by presenting information in linear rather than in graphical (holistic) forms. Drawing from extant empirical research, we present a thesis suggesting that cognitive load may be reduced when holistic information is imbued with transformational grammar to help alleviate the information overload problem, along with a methodological approach for investigation.

Multiple Sclerosis (MS) is an inflammatory autoimmune disease of the Central Nervous System, characterized by development of lesions that cause interference in the communication between brain and the rest of the body. Some techniques using numeric algorithms based on mathematical and probabilistic theories are generally used in order to obtain lesions detection. In this paper we describe an innovative approach for lesions recognition to be applied after segmentation of brain tissues from quantitive evaluation of MR studies. Knowledge about MS lesions is formalized through an ontology and a set of rules: integrating them, automatic inferences can be realized to point out lesions, starting from data about potentially brain abnormal white matter.

Over the past few years the extraction of medical information from German medical reports by means of semantic approaches and algorithms has been an increasing area of research. Currently, several tools are available that aim to support the physician in different ways. We developed a method to evaluate these tools in their ability to extract information from large amounts of data. We tested two off-the-shelf tools that worked in a background mode. We found that the field of quality management made it necessary that these large amounts of data could be background or batch processed. Additionally, we developed a metric, based on the semantic distance of the ICD codes, in order to improve the comparison of the accuracy of the codes suggested by the tools. The results of our evaluation showed that, at present, the tools are capable of supporting inexperienced physicians, however are still not sophisticated enough to work without human interaction.

One purpose of our research works is a contribution to a semantic indexing of structured reports in accordance with the DICOM SR standard and we propose to guide this process with an ontology. In this paper, we describe our motivations for building this ontology according to a modularization approach assisted by the reuse of existing ontologies. Moreover, a prototype of a bilingual visualization tool is suggested. It allows specialists during their semantic indexing to load and visualize ontologies or modules from an ontology in a multi-axial way. Currently, six axes are planned: patient context, anatomy, pathology, visual descriptor, technique and recommendation.

Psychology and Computer Science are growing in a interdisciplinary relationship mainly because human and social factors are very important in developing software and hardware. The development of new software/hardware products requires the generation of novel and useful ideas. In this paper, the Agile method called eXtreme Programming (XP) is analyzed and evaluated from the perspective of the creativity, in particular the creative performance and structure required at the teamwork level. The conclusion is that XP has characteristics that ensure the creative performance of the team members, but we believe that it can be fostered from a creativity perspective.

In health care, the use of technical equipment plays a central part. To achieve high patient safety and efficient use, it is important to avoid use errors and usability problems when handling the medical equipment. This can be achieved by performing different types of usability evaluations on prototypes during the product development process of medical equipment. This paper describes an analytical approach for predicting and identifying use error and usability problems. The approach consists of four phases; (1) Definition of Evaluation, (2) System Description, (3) Interaction Analysis, and (4) Result Compilation and Reflection. The approach is based on the methods Hierarchical Task Analysis (HTA), Enhanced Cognitive Walkthrough (ECW) and Predictive Use Error Analysis (PUEA).

In order to provide helpful proposals for future redesign of insulin pump interfaces, a study was carried out to investigate the expertise difference between novice users and expert users when interacting with a simple user interface of insulin pumps. In this study, two user groups with 13 participants in each, evaluated an insulin pump interface on a computer demo in usability tests. The results showed there was no significant difference between the novice users and expert users regarding the task completion time and the number of failures in performance. As for the cause of failures, the novice users showed weakness in domain knowledge, while the expert users showed weakness in task knowledge. No significant difference was shown on users’ satisfaction between the two user groups. The results also implied that the novice users elaborated their redesign suggestions in a deductive and summaric way, while the expert users proposed suggestions in an inductive and thorough way.

For two years, the University of Colorado Health Sciences Center nursing informatics program has joined with McKesson, a leading vendor of health care provider software, to simultaneously teach distance education students about user-centered design and to improve the usability of McKesson’s products. This paper describes lessons learned in this industry-education partnership. We have found that usability testing with nursing informatics students who are also experienced nurses compares well to testing with nonstudent nurses in terms of data collected, although there can be differences in how the data are interpreted organizationally and in the constraints on the data collection process. The students find participation in a remote usability test of health care software to be an engaging and helpful part of their coursework.

Visual Analytics is an emerging area of research and practice that aims for supporting analytical reasoning by interactive visual interfaces. The basic idea is the integration of the outstanding capabilities of humans in terms of visual information exploration and the enormous processing power of computers to form a powerful knowledge discovery environment. In the course of our half-day tutorial we will introduce this multi-disciplinary field by discussing its key issues of analytical reasoning, perception & cognition, visualization interaction, computation mining, the visual analysis process, and show potential application areas.