Usability testing of a computerized communication tool in a diverse urban pediatric population

Cancer Nurs. Nov-Dec 2014;37(6):E25-34. doi: 10.1097/NCC.0000000000000115.


Background: Developed in Norway, Sisom is an interactive, rigorously tested, computerized, communication tool designed to help children with cancer express their perceived symptoms/problems. Children travel virtually from island to island rating their symptoms/problems. While Sisom has been found to significantly improve communication in patient consultations in Norway, usability testing is warranted with US children prior to further use in research studies.

Objective: The objective of this study was to determine the usability of Sisom in a sample of English- and Spanish-speaking children in an urban US community.

Methods: A mixed-methods usability study was conducted with a purposive sample of healthy children and children with cancer. Semistructured interviews were used to assess healthy children's symptom recognition. Children with cancer completed 8 usability tasks captured with Morae 3.3 software. Data were downloaded, transcribed, and analyzed descriptively.

Results: Four healthy children and 8 children with cancer participated. Of the 44 symptoms assessed, healthy children recognized 15 (34%) pictorial symptoms immediately or indicated 13 (30%) pictures were good representations of the symptom. Six children with cancer completed all tasks. All children navigated successfully from one island to the next, ranking their symptom/problem severity, clicking the magnifying glass for help, or asking the researcher for assistance. All children were satisfied with the aesthetics and expressed an interest in using Sisom to communicate their symptoms/problems.

Conclusions: A few minor suggestions for improvement and adjustment may optimize the use of Sisom for US children.

Implications for practice: Sisom may help clinicians overcome challenges assessing children's complex symptoms/problems in a child-friendly manner.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Communication*
  • Female
  • Humans
  • Male
  • Neoplasms / complications
  • Neoplasms / diagnosis*
  • Pediatrics / methods*
  • Software / standards*
  • Software Validation
  • Surveys and Questionnaires
  • United States
  • Urban Population*