User centered design

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User-Centered Design (UCD) is a design methodology that considers the end user as the most important consumer of a product or service. This focus distinguishes UCD from other design methodologies which often focus on achieving a specific business goal or metric as their primary objective. In practice, UCD in clinical care involves the understanding and use of basic usability principles along with UCD tools to design, create, and implement clinical information systems. In a 2009 report on Electronic Health Record (EHR) Usability, the Agency for Healthcare Research and Quality (AHRQ) identified system usability as critical to the successful adoption of an EHR, as well as to meeting the requirements for Meaningful Use (MU).

Hoffman describes UCD as a process where the designer takes in information about the user, the task, and other tools involved before and during product creation. [1] The user’s role may be that of either a passive object (observed, for example, with ethnographic techniques) or an active participant (taking part in a focus group, for example, or being interviewed). [1]

Close analogs and complementary theories include:

  • Human factors engineering
  • Contextual Design
  • Co-Creation
  • Usability Engineering

Tools used in UCD


Takes prototyping to the extreme by reducing both the level of functionality and the number of features. By reducing the part of interface being considered to the minimum, a scenario can be very cheap to design and implement, but it is only able to simulate the user interface as long as a test user follows a previously planned path. [2]

Simplified Thinking Aloud

It is possible to run user tests without sophisticated labs, simply by bringing in some real users, giving them some typical test tasks, and asking them to think out loud while they perform the tasks. [2]

Heuristic Evaluation

Cuts down the complexity of UI standards used to define problems, an example of this would be Nielsen's Ten Basic Usability Principles. Typically employs usability experts to evaluate systems. [3] [4]

  1. Use simple and natural dialogue
  2. Speak the user's language
  3. Minimize memory load
  4. Be consistent
  5. Provide feedback
  6. Provide clearly marked exits
  7. Provide shortcuts
  8. Provide good error messages
  9. Prevent errors
  10. Provide help and documentation

Cognitive Walkthrough

Utilizes a usability expert to evaluate a user interface by analyzing the cognitive processes required for accomplishing tasks that users would take while supported by the computer. Evaluators will look at each step required to perform a task, detect potential mismatches between designers’ and users’ conceptualizations of a task, identify potential problems a user would have with interpreting certain verbal labels and menus, and potential problems with the system feedback about the consequences of a specific action. [3] [4]

Think Aloud Method

Method consists of two stages:

  1. Collecting think aloud protocols in a systematic way
  2. Analyzing these protocols to obtain a model of the cognitive processes that take place while a person tackles a problem. [3] [4]

Paper Prototyping

Utilizing code-free paper mockups of UIs to propose system designs or changes and utilizing them to solicit user feedback. [2]

Focus Groups

This technique involves small group discussions involving eight to 12 people and moderated by a trained facilitator. Usually everyone is in the same location. This technique is not usually good for actual behaviors but is a self-report technique. The discussion can be influenced by group dynamics. [2]

Card Sorting

This technique is used to form the information architecture of your site (i.e., grouping the content and information on your site). The technique can be done with cards or remotely with several Web-based applications. Each card represents a possible site topic or piece of content. [2]

Task Analysis

User and task analysis focus on understanding: [2] [4]

  • What are users' goals and what do they actually do to achieve the goals?
  • What personal, social, and cultural characteristics do users bring to the tasks?
  • How are users influenced by their physical environment?
  • How does users' previous knowledge and experience influence how they think about their work and the workflow they follow to perform their tasks?

Discount Usability Testing for Business

While research literature may require more rigorous standards to find statistical significance, utilizing usability testing to support UCD principles can be much more cost-effective in business. Discount usability testing allows for evaluation of system characteristics in a way that reduces the uncertainty around a decision. Nielsen argues that even though findings may not be significant, your tests have actually improved your chance of choosing the best interface, meaning that it would be foolish not to take the data into account when choosing. Furthermore, even though there remains a probability that that one option may be better than another, it becomes unlikely that the chosen interface is worse. Therefore, even tests that are not statistically significant are well worth doing since they will improve the quality of decisions substantially. [3]

Related papers


  1. 1.0 1.1 Stappers PJ, Hoffman RR. Once More, Into the Soup. Intelligent Systems, IEEE 2009;24(5):9-13.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Usability Methods. 2009; Accessed Mar. 11, 2012.
  3. 3.0 3.1 3.2 3.3 Monique W.M. J. A comparison of usability methods for testing interactive health technologies: Methodological aspects and empirical evidence. Int J Med Inf 2009 5;78(5):340-353.
  4. 4.0 4.1 4.2 4.3 Nielsen J. Guerrilla HCI: Using Discount Usability Engineering to Penetrate the Intimidation Barrier. 1994; Available at: Accessed Mar 11, 2012.