Designing for Knowledge Generalization in Medical Device Instructions Among Health Care Professionals: Qualitative Interview and Observation Study.

Background: Instructional documents are crucial for safely operating medical devices. However, few studies have explicitly considered designing instructions for health care professionals (HCPs). Psychological research suggests that advanced learners with prior expertise in a domain are better able to generalize their existing knowledge to new areas compared to those with little prior expertise, resulting in different informational needs. Objective: We aimed to understand how HCPs learn from and use their existing expertise when interacting with instructions for use to familiarize themselves with a novel medical device. This would allow us to explore how instructional documents could be designed to better accommodate HCPs' needs as experienced learners with prior knowledge in the domain. Methods: We conducted our studies centered around a novel liver support system, the HepatiCan and its current instructions for use. We conducted 3 user studies, first using semistructured interviews and think-aloud protocols to understand HCPs' expectations for the process of setting up the HepatiCan and how training for the use of medical devices typically takes place. We followed this up with an observational study to understand HCPs' actual experience in practice and corresponding instructional design needs. Results: Our results showed that HCPs' prior expertise allowed them to prioritize key areas for attention, but also led them to make assumptions and potentially skim and miss important information. Visual representations and communication were preferred, as well as designs that supported memorization, as this was an essential function of using instruction manuals. Conclusions: Developers must be aware of what is considered "common" and potentially ignored knowledge within a specific domain in order to clearly emphasize important, safety-relevant information. We also recommend developers focus on using images with attached appendices where possible. This allows advanced users to process information more efficiently without compromising the needs of less familiar users for greater instructional details.