Iterative Design of an Educational Telemedicine Simulation: Addressing Usability Issues to Enhance the Simulation.

Simulations offer safe environments for medical students to practice and develop skills (e.g., clinical, telemedicine). We previously usability tested a gestational hypertension telemedicine simulation to train obstetrics and family medicine residents (Round 1; n = 6). In this study, the next iteration, we revised the simulation and conducted another usability test. Our research questions were: (1) will faculty observers be able assess learner performance in the simulation using our evaluation rubric, and (2) are there remaining scenario, technology, or rubric issues that will complicate the simulation or measuring learner performance? First, we revised the simulation to address issues identified in Round 1. We then tested the revised simulation for Round 2 (n = 6) using the same methods as before. Round 2 results demonstrated improvements in the evaluation rubric; there were fewer instances where evaluators could not assess learner performance (i.e., decreased from 4 to 1). We identified new issues with the simulation which informed additional revisions (e.g., increased gestational age, added laboratory data). Usability testing educational simulations can be a rapid, low-resource method to improve simulation quality (e.g., clinical scenario, simulated patient materials, synthetic data). Usability testing educational simulations also increases the likelihood that faculty can evaluate learners' performance without unintended simulation confounders. High quality educational simulations may increase practitioner confidence in, and use of, telemedicine in specialties with historically low adoption rates (e.g., OBGYN).