Aloud Sessions Research Articles

Accentuating patient values in shared decision-making: A mixed methods development of an online value clarification tool and communication training in the context of early phase clinical cancer trials

ObjectiveIn the shared decision-making (SDM) process for potential early phase clinical cancer trial participation, value clarification is highly recommended. However, exploration and discussion of patient values between patients and oncologists remains limited. This study aims to develop an SDM-supportive intervention, consisting of a preparatory online value clarification tool (OnVaCT) and a communication training. MethodsThe OnVaCT intervention was developed and pilot-tested by combining theoretical notions on value clarification, with interview studies with patients and oncologists, focus groups with patient representatives and oncologists, and think aloud sessions with patients, following the Medical Research Council (MRC) framework for complex interventions. These human-centered methodologies enabled a user-centered approach at every step of the development process of the intervention. ResultsThis study shows relevant patient values and oncologists’ perspectives on value exploration and discussion in daily practice. This has been combined with theoretical considerations into the creation of characters based on real-life experiences of patients in the OnVaCT, and how the tool is combined with a communication training for oncologists to improve SDM.

Capturing the patient’s voice to inform advanced clinical decision support for guideline-based cancer symptom management.

510 Background: Electronic patient reported outcomes (ePROs) have become routine in cancer care; however, ePROs alone do not provide sufficient information to enable informed symptom management. Informed symptom management requires an awareness of patient context to reduce inappropriate or erroneous advice. In this project we asked: how can information be collected directly from patients to provide clinicians with detailed, contextually-informed, patient-specific, evidence-based recommendations to manage distressing symptoms, especially among patients with complex comorbidities. Methods: The literature states that text messages are the most effective way to engage patients in clinical data collection. We texted patients a link that led them to a Web-based questionnaire that asked them about their common cancer symptoms. Prototypes were tested with 9 cancer patients through structured interviews and think aloud sessions from which themes were identified. Feedback from these interviews was used to develop a patient data collection questionnaire that we iteratively refined through think aloud sessions with 9 cancer patients to achieve universal patient acceptance. We also engaged 28 oncology clinicians in semi-structured interviews to assess the clinical impact of the additional contextual information on the symptom recommendations they received. Results: Formative evaluation identified four themes: 1) make instructions brief, 2) use intuitive navigation buttons with labels, 3) focus on multiple-choice style questions, and 4) extract data from the medical record for patient verification instead of free text entry by patients (e.g., medications). Developers incorporated “more detailed” questions into the patient data collection questionnaire; additional questions were presented if the patient indicated moderate or greater severity of a given symptom. These detailed questions focused on characteristics of the symptoms (e.g. neuropathic or somatic pain), remedies a patient had already initiated for self treatment (e.g., laxatives for constipation), and comorbid conditions that could impact the safety of recommendations (e.g., fall risk). Clinicians indicated that the additional data collected from patients increased the value of the tailored recommendations for enhanced symptom management. Conclusions: Additional data collection from patients using standard text messaging enables clinical decision support algorithms to provide more individually tailored cancer symptom management recommendations. This study is limited in that the design enhancements have been tested with a small number of end-users in a laboratory setting. Acknowledgements: This project was 100% funded using Cancer Moonshot funding through Phase I and II SBIR contracts from the National Cancer Institute, Contract #75N91018C00022 and #75N91020C00019, respectively.

Social Stories for Promoting Social Communication with Children with Autism Spectrum Disorder Using a Humanoid Robot: Step-by-Step Study

AbstractTechnological tools are being used in support sessions with children with autism spectrum disorder (ASD), producing a high level of encouragement and engagement in these individuals. A four-step study comprising a focus group session, thinking aloud sessions, an online questionnaire, and a pilot study was conducted. First, a focus group session was conducted with professionals (n = 10) with different backgrounds that support children with ASD on a daily basis. Considering the outputs from the focus group, thinking aloud sessions with two specialists and an online questionnaire with 138 participants were conducted. Finally, a pilot study with four children with ASD was performed in order to test the constraints of the system. The goal of this article is to present findings concerning the design of social stories in a storytelling game that uses a new object with playware technology (OPT) as tangible interface with children with ASD. The storytelling game allows promoting the recognition of emotions in a triadic setup involving a robot, a child, and a professional or researcher. The key issue in this activity is to find the adequacy of the scenarios. The participants pointed out the main aspects to take into account in the development of the storytelling scenarios. New designs of the story scenarios were developed and the final design of the OPT was elaborated. The pilot study allowed to conclude that the children understood the mechanics of the games and successfully interacted with the new OPT.

Factors clinicians consider when providing pediatric wheelchair skills training: a modified think aloud study

Purpose Children who use a manual wheelchair (WC) or a power WC may not receive adequate WC skills training. Clinicians report knowledge as a barrier to the provision of paediatric WC skills training. The purpose of this study was to explore the breadth and depth of specific factors clinicians consider when providing WC skills training for children. Methods Data in this modified Think Aloud study were gathered via one-on-one, Zoom-based, audio-recorded Think Aloud Sessions. Sessions consisted of participants viewing four videos, each of different children performing a different WC skill while thinking aloud (verbally expressing) about the factors they recognized, observed, and considered while watching the video. After each video, participants also responded to questions regarding the specific WC skill and the provision of WC skills training for the child in the video. Factors participants reported were independently identified by three researchers through a deductive process of directed content analysis and categorized using the International Classification of Functioning, Disability and Health (ICF) coding system. Results Twenty-eight English-speaking clinicians participated in the study. A total of 1246 distinct factors were mapped to 352 unique ICF codes spanning all four ICF Domains. The largest number of identified factors mapped to codes within the Activities and participation Domain (42.25%). Conclusion Participants reported considering multiple factors across the ICF in the provision of WC skills training for children. Providing paediatric WC skills training is a complex activity requiring clinicians to consider a wide range of factors that go beyond a child’s motor abilities.

Examining Patterns of Vocabulary Learning Strategy Use for Idioms and Single-Word Items

Vocabulary learning strategies are consciously activated actions that learners take to comprehend and then incorporate new vocabulary into their developing interlanguage. Much research to date has focused on observation and cataloging of strategies, surveying learners on the strategies they employ or find helpful, or examining the effectiveness of strategy use and explicit strategy training. Only a handful of studies have tried to compare vocabulary learning strategy use on single word vocabulary and idioms or other multi-word vocabulary items. This qualitative study reports on think-aloud protocols given to six Korean undergraduate English majors to examine what meaning discovery strategies they appear to be using in practice, combined with their own perceptions taken from interviews immediately after the think aloud sessions. The data shows four categories of vocabulary learning strategy in use, plus four additional coping strategies that allow learners to manage the task of meaning discovery. The data suggests that differences in English proficiency may affect how strategies are employed, that there are only superficial differences in approach between single word items and idioms, and that learners rely on methodical patterns of strategy use. The data leads to several questions open to future research, which are discussed.

A Pilot Study Conducting Online Think Aloud Qualitative Method during Social Distancing: Benefits and Challenges.

COVID-19 social distancing restrictions provided unprecedented insights into online research methodologies and approaches for both participants and researchers. Field research traditionally conducted face-to-face had to be transferred online, highlighting the great strides made in communication technologies (particularly live video streaming) over the last two decades for online qualitative research. However, dedicated research on these phenomena is tentative, including with regard to specific methods such as Think Aloud. This paper contributes to literature on online Think Aloud in qualitative research, evaluating new insights on its adoption online. It draws on findings from an online piloting study of Think Aloud tasks to explore the implications of using real-time internet video calls via SoIP applications by MS Teams. To assess the online Think Aloud process, this review called upon some of the comments made by participants during the semi-structured interview or comments made during the Think Aloud process, when they were relevant to the online process itself. It focuses on different dimensions of benefits, rapport in the session’s encounter, challenges, and ethical concerns. Overall, the findings indicate that online Think Aloud sessions cannot completely replace in-person sessions for some particular and highly in-depth research areas, but they can greatly facilitate qualitative data collection in most conventional contexts. It is necessary to carry out further studies exploring the use of this and other online approaches and instructions.

User-Centered Design of A Novel Risk Prediction Behavior Change Tool Augmented With an Artificial Intelligence Engine (MyDiabetesIQ): A Sociotechnical Systems Approach

BackgroundDiabetes and its complications account for 10% of annual health care spending in the United Kingdom. Digital health care interventions (DHIs) can provide scalable care, fostering diabetes self-management and reducing the risk of complications. Tailorability (providing personalized interventions) and usability are key to DHI engagement/effectiveness. User-centered design of DHIs (aligning features to end users’ needs) can generate more usable interventions, avoiding unintended consequences and improving user engagement.ObjectiveMyDiabetesIQ (MDIQ) is an artificial intelligence engine intended to predict users’ diabetes complications risk. It will underpin a user interface in which users will alter lifestyle parameters to see the impact on their future risks. MDIQ will link to an existing DHI, My Diabetes My Way (MDMW). We describe the user-centered design of the user interface of MDIQ as informed by human factors engineering.MethodsCurrent users of MDMW were invited to take part in focus groups to gather their insights about users being shown their likelihood of developing diabetes-related complications and any risks they perceived from using MDIQ. Findings from focus groups informed the development of a prototype MDIQ interface, which was then user-tested through the “think aloud” method, in which users speak aloud about their thoughts/impressions while performing prescribed tasks. Focus group and think aloud transcripts were analyzed thematically, using a combination of inductive and deductive analysis. For think aloud data, a sociotechnical model was used as a framework for thematic analysis.ResultsFocus group participants (n=8) felt that some users could become anxious when shown their future complications risks. They highlighted the importance of easy navigation, jargon avoidance, and the use of positive/encouraging language. User testing of the prototype site through think aloud sessions (n=7) highlighted several usability issues. Issues included confusing visual cues and confusion over whether user-updated information fed back to health care teams. Some issues could be compounded for users with limited digital skills. Results from the focus groups and think aloud workshops were used in the development of a live MDIQ platform.ConclusionsActing on the input of end users at each iterative stage of a digital tool’s development can help to prioritize users throughout the design process, ensuring the alignment of DHI features with user needs. The use of the sociotechnical framework encouraged the consideration of interactions between different sociotechnical dimensions in finding solutions to issues, for example, avoiding the exclusion of users with limited digital skills. Based on user feedback, the tool could scaffold good goal setting, allowing users to balance their palatable future complications risk against acceptable lifestyle changes. Optimal control of diabetes relies heavily on self-management. Tools such as MDMW/ MDIQ can offer personalized support for self-management alongside access to users’ electronic health records, potentially helping to delay or reduce long-term complications, thereby providing significant reductions in health care costs.

A Mobile Health App for Premarital Related Word Advice (AmeeSehat): Usability and Usefulness Evaluation Study

Background:Premarital counseling demonstrates promising approach for enhancing interaction between couples and to prevent deterioration in the well-being of relationships. Mobile health (mHealth) apps may provide an appropriate solution to this issue, as many potential brides and grooms are frequent users of internet or web-based health info.
 Aim:This research aimed to measure the usability and usefulness of the AmeeSehat App as interpreted by potential end users.
 Method: This study employed a mixed method carried out in one of the public-health centers in East Jakarta, Indonesia with the future bride and groom. Think Aloud (TA) sessions with participants (n=10 final users and 3 experts) and quantitative assessment with 60 participants were held.A think aloud meetings have been captured, transcripts, and analyzed. The usability issues were evaluated using Nielsen severity scale and the Device Usability Scale (SUS). The usefulness of the AmeeSehat App was assessed using a tool to evaluate an improvement in healthy family knowledge, attitude, and intention, and readiness to marry.
 Results: The SUS score obtained (mean=78.4, SD=6.83), and none of the participants experienced (severe) problems with usability. Only 1 usability problems have been reported with a severity of 3 (major), namely terminology issues. The change after using AmeeSehat was statistically significant different as McNemar test revealed p <0.05.
 Conclusion:This researcher revealed that, in terms of its usability and usefulness, the AmeeSehat app is feasible to future brides and grooms. Participants considered AmeeSehat beneficial because they had the opportunity to learn more about a stable home life in preparation for marriage. Further assessment should be carried out in the form of a randomized controlled trial to test AmeeSehat's effectiveness in enhancing awareness, attitude, intention and readiness.

Demystifying the Two Different Design Approaches of Architect Paul Stallan, Descriptive and Comparative Analysis of His Conventional and Iconic Design Approaches

The design process is a mysterious problem solving activity which is full of hidden cognitive processes. Investigating the design behaviour of expert architects may demystify the hidden aspects in the design cognition. Accordingly, the paper emphasizes that more thinking aloud sessions with expert architects can give the opportunity to investigate the design behaviour towards the design briefs and constraints. Therefore, the protocol analysis is used as the research method to investigate the two architectural design approaches of the pioneering Scottish Architect Paul Stallan. The analysis of the two design processes presents significant differences in the design methodology of the two different design approaches.

Investigation of classroom management skills by using eye-tracking technology

The purpose of this research is to show how wearable eye-tracking technology can be employed to assess and enhance classroom management skills by analyzing the instructors’ eye movements in a university. The research also aimed to evaluate the instructors’ gestures by recording with a video camera synchronized with the eye-tracking data. The findings showed that the wearable eye tracker gives informative feedback about the visual attention of the instructors. It provided meaningful data by video recordings and Retrospective Think Aloud sessions. Also, it demonstrated how the instructors interacted with classroom technology. Consequently, the wearable eye tracker and video-camera together could be used by Teaching/Learning Centers to improve instructors’ classroom management skills and to observe their interaction with instructional technologies.

The Potentials of Tangible Technologies for Learning Linear Equations

Tangible technologies provide interactive links between the physical and digital worlds, thereby merging the benefits of physical and virtual manipulatives. To explore the potentials of tangible technologies for learning linear equations, a tangible manipulative (TM) was designed and developed. A prototype of the initial TM was implemented and evaluated using mixed methods (i.e., classroom interventions, paper-based tests, thinking aloud sessions, questionnaires, and interviews) in real classroom settings. Six teachers, 24 primary school students, and 65 lower secondary school students participated in the exploratory study. The quantitative and qualitative analysis revealed that the initial TM supported student learning at various levels and had a positive impact on their learning achievement. Moreover, its overall usability was also accepted. Some minor improvements with regard to its pedagogy and usability could be implemented. These findings indicate that the initial TM is likely to be beneficial for linear equation learning in pre-primary to lower secondary schools and be usable in mathematics classrooms. Theoretical and practical implications are discussed.

Risk communication in a patient decision aid for radiotherapy in breast cancer: How to deal with uncertainty?

Background and aimPatient decision aids for oncological treatment options, provide information on the effect on recurrence rates and/or survival benefit, and on side-effects and/or burden of different treatment options. However, often uncertainty exists around the probability estimates for recurrence/survival and side-effects which is too relevant to be ignored. Evidence is lacking on the best way to communicate these uncertainties. The aim of this study is to develop a method to incorporate uncertainties in a patient decision aid for breast cancer patients to support their decision on radiotherapy. MethodsFirstly, qualitative interviews were held with patients and health care professionals. Secondly, in the development phase, thinking aloud sessions were organized with four patients and 12 health care professionals, individual and group-wise. ResultsConsensus was reached on a pictograph illustrating the whole range of uncertainty for local recurrence risks, in combination with textual explanation that a more exact personalized risk would be given by their own physician. The pictograph consisted of 100 female icons in a 10 x 10 array. Icons with a stepwise gradient color indicated the uncertainty margin. The prevalence and severity of possible side-effects were explained using verbal labels. ConclusionsWe developed a novel way of visualizing uncertainties in recurrence rates in a patient decision aid. The effect of this way of communicating risk uncertainty is currently being tested in the BRASA study (NCT03375801).

Bonding through books behind bars: Reconnecting incarcerated mothers/grandmothers with children

Bonding through books is a piloted project that sought to engage incarcerated mothers/grandmothers through furthering their literacy skills to promote prosocial relationships with their children/grandchildren. Literacy measurements often consider fourth-grade literacy as the measure for future achievement. Approximately 68% of children in the U.S. do not meet this standard with most youth coming from rural, low-income or at-risk homes—an almost exact match for incarcerated mothers and children in Kansas. We sought to help reduce prison disciplinary issues, ease the reintegration process, and increase success upon release. This was accomplished through both live (on-site) and recorded read aloud sessions and measured through pre/post-test data analysis and the review of disciplinary reports. Pre and post-test surveys included the Rhody Secondary Reading Attitude Assessment, Parenting Sense of Competency Scale, and National Assessment of Adult Literacy. At the culmination of the project, the mothers/grandmothers would be assisted with recording themselves reading a children’s book to be sent home to their children/grandchildren. Due to unforeseen travel restrictions, post-test data is not available and all reported data is based on pre-test data. Most participants were already interested in reading and felt competent parenting behind bars.

Realizing better doctor-patient dialogue about choices in palliative care and early phase clinical trial participation: towards an online value clarification tool (OnVaCT)

BackgroundPatients with advanced cancer for whom standard systemic treatment is no longer available may be offered participation in early phase clinical trials. In the decision making process, both medical-technical information and patient values and preferences are important. Since patients report decisional conflict after deciding on participation in these trials, improving the decision making process is essential. We aim to develop and evaluate an Online Value Clarification Tool (OnVaCT) to assist patients in clarifying their values around this end-of-life decision. This improved sharing of values is hypothesized to support medical oncologists in tailoring their information to individual patients’ needs and, consequently, to support patients in taking decisions in line with their values and reduce decisional conflict.MethodsIn the first part, patients’ values and preferences and medical oncologists’ views hereupon will be explored in interviews and focus groups to build a first prototype OnVaCT using digital communication (serious gaming). Next, we will test feasibility during think aloud sessions, to deliver a ready-to-implement OnVaCT. In the second part, the OnVaCT, with accompanied training module, will be evaluated in a pre-test (12–18 months before implementation) post-test (12–18 months after implementation) study in three major Dutch cancer centres. We will include 276 patients (> 18 years) with advanced cancer for whom standard systemic therapy is no longer available, and who are referred for participation in early phase clinical trials. The first consultation will be recorded to analyse patient-physician communication regarding the discussion of patients’ values and the decision making process. Three weeks afterwards, decisional conflict will be measured.DiscussionThis project aims to support the discussion of patient values when considering participation in early phase clinical trials. By including patients before their first appointment with the medical oncologist and recording that consultation, we are able to link decisional conflict to the decision making process, e.g. the communication during consultation. The study faces challenges such as timely including patients within the short period between referral and first consultation. Furthermore, with new treatments being developed rapidly, molecular stratification may affect the patient populations included in the pre-test and post-test periods.Trial registrationNetherlands Trial Registry number: NTR7551 (prospective; July 17, 2018).

Children\u2019s Encounters with Natural Selection During an Interactive Read Aloud

Previous studies have shown that children as young as 5 years of age are able to form a basic understanding of evolution after listening to a storybook about natural selection. This study offers a semiotic exploration of children’s meaning making during an interactive read aloud of the same storybook by investigating what children focus on and negotiate during the read aloud. Video data from eight interactive read aloud sessions (N = 24 children) were analysed using a multimodal approach and contrasted with seven biological concepts intentionally described in the storybook. During the interactive reading, the children focused on all biological concepts at some point. However, apart from the biological concepts, the children also paid attention to other topics during the read aloud. These topics comprised Death, Change in behaviour, Realism, Babies, Milli bugs, and Aesthetics. Throughout the read aloud, a child-centric view of life influenced how the children made meaning about evolution. The findings highlight that through interactive reading, instructional storybooks also become a tool for discussing other aspects that children find important. Overall, the findings contribute with knowledge about the role of interactive read aloud as a pedagogical tool for introducing evolution in early childhood education.

Understanding citizen perspectives on open urban energy data through the development and testing of a community energy feedback system

With the rise of advanced and affordable sensors offering continuous monitoring of city infrastructure, cities are increasingly seeking to become more ‘smart’ and are adopting data-driven approaches to help meet sustainability goals. In the area of building energy efficiency, closely coupled with this effort is the prevalence of building energy benchmarking policies, which require public disclosure of vast new quantities of building-level energy data at urban scales (i.e., open urban energy data). While existing research efforts have focused on the potential of this data to transform energy efficiency markets and investments in the real estate sector, little research has been dedicated to assessing this information’s value to the general public. Given that achieving energy reductions in the built environment will require not only energy efficiency investments, but also greater awareness, engagement, and action from ordinary citizens, we study the potential of open urban energy data in providing citizen benefits. Energy-cyber-physical systems offer a pertinent framework to link data from the virtual world to citizens’ physical reality in order to improve their understanding and decision making. Adopting an energy-cyber-physical system perspective, we aim to connect open urban energy data to citizens through the development and evaluation of a novel community-scale energy feedback system. This mobile cyber-physical system transforms building-level electricity consumption and production data across Georgia Tech’s campus into a mobile application consisting of three features: spatial feedback, energy supply feedback, and energy consumption feedback. Augmented-reality visualization elements are integrated into the system, providing Georgia Tech community members a direct link between their experienced physical environment and data stored in the virtual world. Applying a user-centered design approach, prospective users evaluate the system via thinking aloud sessions and user surveys to assess understandings and perceptions of open urban energy data for the Georgia Tech campus. The results contribute to literature seeking to create energy feedback systems at the community-scale and expand research investigating citizen reactions to and opinions of open urban energy data. This research is an integral step to further engagement and participation from the public to help achieve a sustainable and citizen-valued energy future.

The influence of multimedia development knowledge and workplace pressures on the design decisions of the instructional designer

This study explored the interaction of multimedia production competencies of expert and novice instructional designers on the design decisions made during the instructional design process/workflow. This multiple measures study used qualitative survey instruments to access and measure the production competencies of participants, then a design aloud protocol to capture and measure the instructional design decision-making process for those same participants. A follow-on interview after the initial design aloud session was conducted in order to triangulate and confirm any trends or findings uncovered during the earlier design aloud session. Ultimately, the objective of this study was to provide some evidence that suggests whether certain production skills are influencing instructional design decision-making. Employer influence on the instructional designer’s decision-making was also explored. Results indicated that a substantial number of instructional designers (n = 30) who participated in this study were selecting media as a preliminary step in their workflow process, and were often then using analysis as a measure to confirm the early media selection. Expert instructional designers appeared to be less susceptible to the early media selection behavior, though not immune. Results indicate that one reason the expert instructional designers were less likely to adopt media as a preliminary instructional design step was that the experts conducted a more diverse set of analysis activities. Additionally, results indicated that instructional designers were often experiencing pressure to adopt media based on employer demands, and project constraints such as budget and time.

Usability and Usefulness of a Mobile Health App for Pregnancy-Related Work Advice: Mixed-Methods Approach.

BackgroundPregnant women are often unaware of the potential risks that working conditions can cause to them and their unborn child. A mobile health (mHealth) app, the Pregnancy and Work (P and W) app, developed by a multidisciplinary team and based on an evidence-based guideline for occupational physicians, aims to provide advice on work adjustment during pregnancy.ObjectiveThis study evaluates the usability of the mHealth P and W app and the perceived usefulness of the work advice, the main goal of the app, by potential end users.MethodsA total of 12 working pregnant women participated in think aloud usability sessions and performed 9 tasks. All think aloud sessions were recorded, transcribed, and coanalyzed. The usability problems were rated for their severity in accordance with Nielsen severity scale. The completion rates and time taken for completion of tasks were registered. In addition, participants were questioned on demographics and user characteristics and were asked to evaluate the value of the app by filling in the Intrinsic Motivation Inventory (IMI) score and the System Usability Scale (SUS) questionnaire.ResultsIn total, 82 usability problems with a severity ≥1 were identified, of which 40 had severity ≥3. The main usability problems concerned the interpretation of terminology used in the app’s questionnaires and difficulties in finding and understanding the work advice. Furthermore, 10 out of 12 participants were able to open the work advice page in the app. Only 7 out of these 10 participants understood and intended to follow the work advice. The overall mean IMI score was relatively high (5 out of 7), indicating that the participants did indeed value the use of the app. This IMI score corresponded to the overall mean SUS score (68 out of 100) and the mean grade given to the P and W app (7 out of 10).ConclusionsThis think aloud usability study showed that the information provided in the P and W app was considered valuable by the end users, working pregnant women, and it meets their needs; however, usability issues severely impacted the perceived usefulness of the work advice given in the app.

Impact of usability on process lead-time in information systems: A case study

Technological advancements have started to demand the need for information systems to survive in the business world. There is an inherent need to be fast and efficient to conquer the market. In order to reduce time to market there is a need to shorten the lead-time in design and development process of products. Hence, lead-time is a significant performance metric for a product development organizations having information systems. It is important to explore the factors which affect the process lead-time in information systems. The objective of this study is to explore the impact that usability (one of the factors that may affect the process lead-time) has on process lead-time. This paper presents a case study involving qualitative and quantitate data from Volvo Group, which uses an information system called KOLA for their design and development process. Data was collected through 29 interviews, 17 think aloud sessions, 5 document studies, and 73 responses from a survey. This study identifies which usability factors and heuristics that have an impact on process lead-time. Moreover, the results show that the users level of experience determines the effective utilization of accelerators and thereby affecting the process lead-time. Finally, usability plays an important role in shortening the process lead-time in information systems.

The moderating influence of idea sequence: A re-analysis of the relationship between category switch and latency

Divergent thinking (DT) tests are often used to estimate the potential for creative thinking. They are usually scored for fluency, originality, and flexibility. The last of these is especially important because it allows the person to avoid rigidity and conceptual ruts. Usually, flexibility is operationalized in terms of the absolute number of conceptual categories used by the individual, but occasionally it has been scored in terms of the number of switches rather than the absolute number of categories used. The present study investigated if idea sequence moderates the relationship between category switch and the latency between consecutive ideas. Data were collected through think aloud sessions with four DT tests. These elicited 1408 ideas. A three-level hierarchical linear modeling (HLM) structure indicated that idea sequence moderated the relationship between category switch and latency. Latency tended to be shorter in early ideas than those coming later and it was the highest when a category switch took place in later sections than those occurring earlier. Findings are discussed in terms of creativity assessment and the process of DT.