Proposed protocol · not yet run
Usability study kit
Everything a team needs to test the conversation workspace in one session: seven tasks, a think-aloud script, teach-back checks and the System Usability Scale. Adapt it and take it through your own IRB. No results are reported here.
Run it with a demo persona
Fictional people, so participants never enter anything real. Each opens the workspace filled in.
- Interpreter-supported family meetingArabic-speaking family, interpreter presentThe person prefers Arabic and wants their son involved. A qualified interpreter, not family, interprets. No religion is assumed from language.
- Hospice chaplain visitHospice chaplain, spiritual care declinedThe person declines a spiritual conversation. The chaplain records that and supports the spouse, who is worn out.
- Primary care planning visitPrimary care, preparing to plan aheadA well person prepares for an advance care planning visit. Who decides is named but not yet made official.
Seven tasks
- 1
Record who decides if the person cannot.
Done when: Enters a role or relationship in “Who decides”, not in another field.
Workspace, step 4 - 2
Record a spiritual or existential concern in the person's own words.
Done when: Uses “In their words” and records who asked, without adding a faith label.
Workspace, step 4 - 3
Choose what to share.
Done when: Sets each section to Share or Keep private, leaving none undecided by mistake.
Workspace, sharing choices - 4
Say who will see the summary.
Done when: Opens a role view and names what that reader will and will not see.
Workspace, handoff preview - 5
Stop sharing a section already marked to share.
Done when: Switches it to Keep private and confirms it is gone from the preview.
Workspace, sharing choices - 6
- 7
Export a summary for one reader.
Done when: Downloads or copies the family, chaplain or clinician summary.
Workspace, handoff
Think-aloud script
- Please say what you are looking at and what you expect to happen, as you go.
- There are no wrong answers. We are testing Values in Care, not you.
- If you get stuck, tell me what you would do next. I may not answer right away.
- Use the fictional example only. Do not enter anything about a real person.
Who to recruit
Proposed design, not a validated sample size
| Patients or family members, per language | 6 to 8 per round, 2 rounds |
|---|---|
| Clinicians | 4 to 6 |
| Chaplains | 4 to 6 |
| Social workers | 4 to 6 |
Teach-back checks
- In your own words, who can see what you saved?
- Correct if it matches: Only people the person chooses to show it to. Nothing leaves the device unless they copy, print or download it.
- Does reading this summary let someone make decisions?
- Correct if it matches: No. Reading it gives no decision-making authority.
- How would you take something back out?
- Correct if it matches: Switch that section to Keep private.
System Usability Scale
Ten items, 1 (strongly disagree) to 5 (strongly agree). Hand the participant the printed kit, or enter their answers here for a score.
Answered 0 of 10. The score appears when all ten are answered.
Scored on this device only and cleared when you leave. Record it in your study file. Brooke J. SUS: a “quick and dirty” usability scale. In: Jordan PW, Thomas B, Weerdmeester BA, McClelland IL, eds. Usability Evaluation in Industry. Taylor & Francis; 1996:189-194.
Consent outline
Template only. Use the version your IRB approves.
- Purpose: test whether the workspace is clear and easy to use.
- What happens: about 45 minutes of tasks with a fictional example, then a short questionnaire.
- Recording: screen and voice only if the participant agrees, and they can stop at any time.
- Privacy: no real patient information is entered. Values in Care stores nothing on a server.
- Voluntary: taking part or stopping has no effect on care or employment.
- Contact: the study team and the IRB, named on the approved form.
Licensed measures
For outcome studies. Licensed by their owners, so they are named here, not reproduced.
- ACP Engagement Survey · PREPARE for Your Care, UCSF
- FACIT-Sp · FACIT.org
Proposed feasibility pilot
Proposed design, not yet run
Primary outcome: The brief is in the medical record before the visit (yes or no, checked by chart review).
Usual care
The clinic's current advance care planning process.
Brief plus a person
The person makes a brief, then a navigator, nurse, social worker or chaplain contacts them once to go over it and help put it in the record.
How the brief reaches the record
- Invitation sent through the patient portal before a scheduled visit.
- The brief reaches the record by portal upload, a portal questionnaire the health system builds, or a scanned paper copy.
- The clinic names the document type and who files it before recruitment starts.
Secondary measures
- Preparation for Decision Making scale, after the visit (free to use under the Ottawa terms).
- SDM-Q-9, after the visit, which has a validated Arabic version.
- ACP Engagement Survey, short form, before and after, only if a license from the University of California is in place.
- System Usability Scale.
- Staff minutes per participant.
- Whether the clinician reports reading the brief before or during the visit.
About 30 per arm, plus allowance for dropout, following published guidance for feasibility pilots (Whitehead et al., 2016).
Why the record, and why a person
- A standalone website whose results patients had to bring to the visit was rarely used; a questionnaire inside the patient portal reached more patients. Naimark et al., JMIR Form Res 2024 (Patient Priorities Care pilot)
- Adding a website link to a portal message did not raise advance directive documentation; navigator outreach did. Walling et al., Ann Intern Med 2026 (cluster randomized trial, 50 University of California clinics)
Precedent
PREPARE was pilot-tested before its clinical trial. Participants rated ease of use 9 of 10.
Sudore RL, Knight SJ, McMahan RD, et al. A novel website to prepare diverse older adults for decision making and advance care planning: a pilot study. J Pain Symptom Manage. 2014;47(4):674-686. doi:10.1016/j.jpainsymman.2013.05.023