Ann L. Fruhling

Field Experiences with eXtreme Programming: Developing an Emergency Response System

eXtreme Programming (XP) is a well-known agile software development method. While a number of reports have been published on explaining the XP methodology and the perceived benefits when using XP for system development in recent years, less is known about the actual operationalization of the XP principles. This paper presents an action research study reporting on the experiences of implementing the XP methodology in a development project for a Web-based, distributed information system. The goal of this research was to increase the understanding of how to effectively operationalize XP techniques so that the system being developed catered to todays fast-paced technological environment by allowing the developers to respond quickly to innovative and changing requirements. Overall, the research indicates that most of the XP principles could be effectively implemented; however, three of the principles required modification (i.e., testing, pair programming, customer collocation). Several benefits resulted from the usage of XP. The rapid prototyping enabled information technology developers and users to clarify system requirements, communicate openly, quickly build rapport, and create an interface that was easy to use and learn. Further, the research found that where the technology was new or foreign to the development team and the user, the XP process was flexible enough to support several iterations of technology and produce prototypes in a timely manner. Pair programming appeared to work effectively and offer value; however, it is not always practically feasible.

Evaluating the success of an emergency response medical information system

OBJECTIVE STATPack™ is an information system used to aid in the diagnosis of pathogens in hospitals and state public health laboratories. STATPack™ is used as a communication and telemedicine diagnosis tool during emergencies. This paper explores the success of this emergency response medical information system (ERMIS) using a well-known framework of information systems success developed by DeLone and McLean. METHOD Using an online survey, the entire population of STATPack™ users evaluated the success of the information system by considering system quality, information quality, system use, intention to use, user satisfaction, individual impact, and organizational impact. RESULTS The results indicate that the overall quality of this ERMIS (i.e., system quality, information quality, and service quality) has a positive impact on both user satisfaction and intention to use the system. However, given the nature of ERMIS, overall quality does not necessarily predict use of the system. Moreover, the users satisfaction with the information system positively affected the intention to use the system. User satisfaction, intention to use, and system use had a positive influence on the systems impact on the individual. Finally, the organizational impacts of the system were positively influenced by use of the system and the systems individual impact on the user. CONCLUSIONS The results of the study demonstrate how to evaluate the success of an ERMIS as well as introduce potential changes in how one applies the DeLone and McLean success model in an emergency response medical information system context.

Assessing organizational innovation capability and its effect on E-Commerce initiatives

This research uses a qualitative approach to study the innovative capability of two organizations and the effect of innovation on their E-Commerce initiatives, strategies, and outcomes. The Innovation Strategy Model is used in this research to analyze the innovative capability of two organizations. The case study research methodology was selected and two case studies are presented. The research results show that one organization is more innovative than the other in terms of its innovative capability. A post-study follow-up shows that the organization that was high on innovative capability was very successful in their E-Commerce initiative whereas the other organization was not.

An evaluation of the usability of a computerized decision support system for nursing homes

BACKGROUND Computerized decision support systems (CDSSs) have the potential to significantly improve the quality of nursing care of older people by enhancing the decision making of nursing personnel. Despite this potential, health care organizations have been slow to incorporate CDSSs into nursing home practices. OBJECTIVE This study describes facilitators and barriers that impact the ability of nursing personnel to effectively use a clinical CDSS for planning and treating pressure ulcers (PUs) and malnutrition and for following the suggested risk assessment guidelines for the care of nursing home residents. METHODS We employed a qualitative descriptive design using varied methods, including structured group interviews, cognitive walkthrough observations and a graphical user interface (GUI) usability evaluation. Group interviews were conducted with 25 nursing personnel from four nursing homes in southern Norway. Five nursing personnel participated in cognitive walkthrough observations and the GUI usability evaluation. Text transcripts were analyzed using qualitative content analysis. RESULTS Group interview participants reported that ease of use, usefulness and a supportive work environment were key facilitators of CDSS use. The barriers identified were lack of training, resistance to using computers and limited integration of the CDSS with the facilitys electronic health record (EHR) system. Key findings from the usability evaluation also identified the difficulty of using the CDSS within the EHR and the poorly designed GUI integration as barriers. CONCLUSION Overall, we found disconnect between two types of nursing personnel. Those who were comfortable with computer technology reported positive feedback about the CDSS, while others expressed resistance to using the CDSS for various reasons. This study revealed that organizations must invest more resources in educating nursing personnel on the seriousness of PUs and poor nutrition in the elderly, providing specialized CDSS training and ensuring that nursing personnel have time in the workday to use the CDSS.

A Collaborative Software Code Inspection: The Design and Evaluation of a Repeatable Collaboration Process in the Field

The use of software products in todays world has increased dramatically making quality an important aspect of software development. There is a continuous need to develop processes to control and increase software quality. Software code inspection is one way to pursue this goal. This paper presents a collaborative code inspection process that was designed during an action research study using Collaboration Engineering principles and techniques. Our inspection process was implemented as a sequence of thinkLets, chunks of facilitation skill, that were subsequently field tested in a traditional paper-based and Group Support System (GSS)-based environment. Four inspections were performed on four different pieces of software code in two different organizations. Results show that regardless of the implementation, the process was found to be successful in uncovering many major, minor, and false-positive defects in inspected pieces of code. Overall observations and feedback suggest that the collaborative inspection process was considered to be productive and satisfactory. GSS inspections were more effective, especially in terms of major defects. GSS inspections were also found to be more efficient. Finally, the GSS inspections outperformed the paper inspections from a practical perspective: logging and managing defects in a GSS was far superior.

Collaborative usability testing to facilitate stakeholder involvement

Stakeholder involvement is an essential part of Value-Based Software Engineering. A critical part of the software engineering life cycle concerns usability testing. System usability refers to the effectiveness, efficiency, and satisfaction with which users can use the system for their relevant tasks. Unfortunately stakeholder involvement in usability testing is costly and challenging to organize. This chapter presents a repeatable collaborative usability testing process supported by a Group Support System that was developed and evaluated in a series of workshops involving a real system. The results show that the collaborative usability testing process facilitates stakeholder involvement through stakeholder expectation management, visualization and tradeoff analysis, prioritization of usability action items, the use of advanced groupware tools, and a simple business case analysis. Furthermore, the process can be considered productive and stakeholders reported substantial levels of satisfaction with it.

A Case Study: Introducing eXtreme Programming in a US Government System Development Project

The US Militarys ability to meet its mission critical requirements calls for increased agility in its information technology development process. The purpose of this case study is to better understand how agile principles, specifically eXtreme Programming (XP) practices, can be effectively introduced and implemented into government organizations that have historically embraced the plan-driven traditional software development environment. In particular, we studied the eXtreme Programming process to develop a new capability for USSTRATCOMs premier knowledge management system, SKIWeb. There were several lessons learned that will assist practitioners in future implementations of XP and new research questions emerged that suggest further study.

Teaching clinical reasoning and decision-making skills to nursing students: Design, development, and usability evaluation of a serious game

BACKGROUND Serious games (SGs) are a type of simulation technology that may provide nursing students with the opportunity to practice their clinical reasoning and decision-making skills in a safe and authentic environment. Despite the growing number of SGs developed for healthcare professionals, few SGs are video based or address the domain of home health care. AIMS This paper aims to describe the design, development, and usability evaluation of a video based SG for teaching clinical reasoning and decision-making skills to nursing students who care for patients with chronic obstructive pulmonary disease (COPD) in home healthcare settings. METHODS A prototype SG was developed. A unified framework of usability called TURF (Task, User, Representation, and Function) and SG theory were employed to ensure a user-centered design. The educational content was based on the clinical decision-making model, Blooms taxonomy, and a Bachelor of Nursing curriculum. A purposeful sample of six participants evaluated the SG prototype in a usability laboratory. Cognitive walkthrough evaluations, a questionnaire, and individual interviews were used for the usability evaluation. The data were analyzed using qualitative deductive content analysis based on the TURF framework elements and related usability heuristics. RESULTS The SG was perceived as being realistic, clinically relevant, and at an adequate level of complexity for the intended users. Usability issues regarding functionality and the user-computer interface design were identified. However, the SG was perceived as being easy to learn, and participants suggested that the SG could serve as a supplement to traditional training in laboratory and clinical settings. CONCLUSIONS Using video based scenarios with an authentic COPD patient and a home healthcare registered nurse as actors contributed to increased realism. Using different theoretical approaches in the SG design was considered an advantage of the design process. The SG was perceived as being useful, usable, and satisfying. The achievement of the desired functionality and the minimization of user-computer interface issues emphasize the importance of conducting a usability evaluation during the SG development process.

Experiences with Extreme Programming in Telehealth: Developing and Implementing a Biosecurity Health Care Application

There has been limited research on how non-conventional system development methodologies such as, Agile modeling methods could improve the successful development and implementation of telehealth services. The goal of this research was to increase the understanding of the impact of using the Extreme Programming process, an Agile modeling approach, to the development effort of a biosecurity telehealth project. Overall, the research indicates that Extreme Programming is an effective methodology to develop health care applications. The rapid prototyping enabled IT developers and health care users to clarify system requirements, communicate openly, and quickly build rapport. Further, the research found that that where the technology was new or foreign, the Extreme Programming process was flexible enough to support several iterations of technology and produce prototypes in a timely manner.

Exploring User Preference for the Dashboard Menu Design

User interfaces generally rely on a main menu for navigation and orientation. Therefore, the main (navigational) menu layout design is a determinant of user performance and satisfaction levels. Effective menu designs also help users avoid feeling lost and disoriented when seeking information or finding functionality. Research on menu design finds that an understanding of users’ ability to recognize a menu layout through positional and semantic grouping of menu items helps explain design effectiveness and user preference. Our research compares an expandable index menu layout design to a framebased (dashboard) design, and finds that the positional and semantic groupings of the framebased (dashboard) design were preferred. Real clients using a live system participated in this study using the Think Aloud usability evaluation method. This research is significant in that it contributes to ongoing work in development of effective user interfaces, and in that it strengthens the findings of earlier researchers.