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PubMed · 8563326

Contextual inquiry: discovering physicians' true needs.

J M Coble·J S Maffitt·M J Orland·M G Kahn
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Abstract

Gathering user requirements that represent the true needs of the users is a challenge. There are many elicitation methods in use today, but they generally are not successful in identifying a comprehensive set of requirements that reflect the users' true needs. This paper describes the requirements gathering method, Contextual Inquiry, that we used to generate physician requirements for a comprehensive Clinical Information System. We feel that this method has advantages over traditional techniques such as surveys, questionnaires, traditional interviews, and focus groups, in obtaining a more comprehensive analysis of the true needs of the users.

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Attitude to ComputersHospital Information SystemsHumansPhysiciansPoint-of-Care SystemsJournal Article

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J M Coble, J S Maffitt, M J Orland, M G Kahn. 1995. Contextual inquiry: discovering physicians' true needs.. https://pubmed.ncbi.nlm.nih.gov/8563326/

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Evaluation of an intelligent tutoring system in pathology: effects of external representation on performance gains, metacognition, and acceptance.

OBJECTIVE: Determine effects of computer-based tutoring on diagnostic performance gains, meta-cognition, and acceptance using two different problem representations. Describe impact of tutoring on spectrum of diagnostic skills required for task performance. Identify key features of student-tutor interaction contributing to learning gains. DESIGN: Prospective, between-subjects study, controlled for participant level of training. Resident physicians in two academic pathology programs spent four hours using one of two interfaces which differed mainly in external problem representation. The case-focused representation provided an open-learning environment in which students were free to explore evidence-hypothesis relationships within a case, but could not visualize the entire diagnostic space. The knowledge-focused representation provided an interactive representation of the entire diagnostic space, which more tightly constrained student actions. MEASUREMENTS: Metrics included results of pretest, post-test and retention-test for multiple choice and case diagnosis tests, ratios of performance to student reported certainty, results of participant survey, learning curves, and interaction behaviors during tutoring. RESULTS: Students had highly significant learning gains after one tutoring session. Learning was retained at one week. There were no differences between the two interfaces in learning gains on post-test or retention test. Only students in the knowledge-focused interface exhibited significant metacognitive gains from pretest to post-test and pretest to retention test. Students rated the knowledge-focused interface significantly higher than the case-focused interface. CONCLUSIONS: Cognitive tutoring is associated with improved diagnostic performance in a complex medical domain. The effect is retained at one-week post-training. Knowledge-focused external problem representation shows an advantage over case-focused representation for metacognitive effects and user acceptance.

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