User Testing for Healthcare

Kelly McCann

User testing a great way to supply your team with qualitative data that can prove/disprove assumptions and breathe context into your team’s quantitative data. The process involves one or two people on your team getting real-time feedback as a user or potential user explores your product. There’s a ton of content and resources out there to help you get started with user testing at your company.

Some interviews involve sensitive topics and need special consideration before jumping in. This is particularly true for healthcare projects, like the ones we did for Ieso Health and Healthify. I was recently on a website redesign project for Seniorlink, a company that empowers caregivers with the tools and resources they need to give exceptional in-home care. My team conducted user testing to learn more about caregivers’ experiences. Before kicking off, we recognized that our conversations would likely touch on sensitive topics, like the health of loved ones, choosing in-home or out-of-home care, or quitting a job to give care full-time. The below tips helped our team navigate topics like these.

What qualifies as a sensitive topic?

Sometimes as teams regularly talk about their product, sensitive topics can become day-to-day business conversations. Try to consider the user testing conversations you’ll be instigating outside the context of your work. Raymond Lee’s Doing Research on Sensitive Topics defines three types of sensitive topics that come up during research:

  • An inquisition into areas that are private, stressful, or sacred. These could include topics like marriage, death, sex, or illness.
  • The study of deviance and/or social control. This could involve individuals revealing information that could be stigmatizing or incriminating.
  • Exploring “political alignments, if ‘political’ is taken to its widest sense. This is inquiring about a person’s vested interests in the actions and impact of powerful persons/institutions, or how they view the use of coercion or domination.

Before your next user testing session, consider if you could be discussing topics that match one or more of the above types.

Writing your script/interview questions

Preparing a script or interview questions is always helpful in planning your conversation. Use this time to consider your question phrasing: open-ended questions empower participants to choose the amount of information they disclose, and to dictate a vocabulary that feels comfortable to them.

Have extra questions planned should you need them, but expect most of your questions to take more time than questions around non-sensitive topics. Diligently prioritize which questions will be of the highest value to your research, and plan to ask those first.

That said, plan your conversational arc to start with a lower-pressure introduction. I usually open with “Can you tell me a little bit about you, where you’re calling from, and what your day-to-day is like?” Often, participants’ responses to this question offer an ‘in’ to ask more specific questions:

  • “What does caring for your child entail?”
  • “What did that process look like?”
  • “How many hours a day do you spend doing (activity)?”

On the Seniorlink project, my team initiated user testing by requesting a participant explain what the word “caregiver” meant to them. In response, most people self-identified as a caregiver; but some, who spent hours daily giving care, revealed that they did not identify as a caregiver. Participants’ answers to this question steered our language and phrasing as we progressed through each session. Asking this open-ended question prevented us from assigning identities to people that they didn’t agree with.

Preparing for the user interview

Gather your materials and study up

Study the subject matter you’ll be discussing in the days preceding the interview. This way, you’ll avoid needlessly asking participants to explain sensitive topics. I like to print my script before interviews so that participants can see me reference it, even if I’m conducting the interview in a video call. If a participant looks distressed, I can make a point to look at my script, say something like, “Thank you for sharing that. I was wondering about…” This way, I can change the subject without a user feeling like they’re ‘failing’ the user test.

Find a spot and an (optional) partner

To avoid overwhelming the participant, no more than two people on your team should participate in the interview. If you are co-facilitating the interview with someone, make a game plan: assign one person to ask questions and one to take notes. This way the participant can focus on a single person during the interview. If you are recording the interviews and/or conducting the interview via video call, ensure your equipment is powered and working.

Reserve a quiet spot for your interview. If the interview will be conducted in person, place waters and tissues in the room. Plan for the participant to sit in a position with a clear view of the door, and for you to sit in a place that is not blocking the exit. For remote or in-person interviews, if you are in an office, explain to those in the surrounding space that you’ll be conducting interviews about a sensitive topic, and ask that noise be kept to a minimum. Place a note on the door stating that an interview is underway so that no one accidentally interrupts your session.

Send confirmation details

Send an email to participants confirming the time, date, and duration of their interview, and who will be present. In this message, also state your reason for speaking to them, and what your intention is for the conversation. Something like, “to learn more about your experience and to see how (product) could help others with similar experiences.” This allows the participant time to consider what they are willing to share before the interview. When deciding on an interview duration, allocate more time per session than you normally would. This allows time for a slower-paced conversation or someone who has a lot to share.

Start the interview

Take at least a few minutes before the interview to center yourself. Make yourself some tea, meditate for a few minutes, journal - whatever will help you channel receptivity and compassion.

If the test is being conducted via a video call, ensure that it is still a good time for the participant to speak. If the interview is being conducted in person, situate the participant in the room and check that they have everything they need. Then, start the interview by thanking the participant for their time and reintroducing yourself and (if applicable) your teammate. Explain who will be taking notes and who will be asking questions.

If you are recording the interview, ask the participant if it will be alright to record the test for note-taking purposes. Specify if you are recording audio, video, and/or screen interactions, and make sure you’re only recording what you have permission to record. Then, restate your intentions for the user interview. On the Seniorlink project, we said something along the lines of: “We’d love to get an idea of what your experience has been caring for a loved one and how Seniorlink might be able to help others with similar experiences.”

Finally, address the fact that due to the utility of the product that you’re testing, topics that surface could be of a sensitive nature. Assure the participant that they are under no obligation to answer any questions you ask and that they may skip any questions they wish. Also offer them the option to end the interview at their discretion.

During the interview

Practicing active listening is 85% of an effective user interview. If you haven’t, definitely look into exploring and building this skill!

Go off-script

As with any user interview, some of the most valuable user feedback comes from unscripted questions. Pay attention to the language participants use, and topics they continue to bring up. I like to repeat those topics and words back to the participant, then ask them to speak about them a bit more. Again, open-ended questions empower participants to dictate both a vocabulary that feels comfortable to them and the amount of information they are comfortable disclosing.

Allow for silence

Establishing a slower cadence in the conversation can diffuse loaded topics. It also allows participants space to explore their thoughts and responses. During longer silences, if you feel a participant has more to communicate, consider asking a question like “Is there anything else on your mind?” Be sure to allow yourself time for thoughtful responses, as well.

Keep the focus on the participant

Periodically check in with participants to ask how they are doing, especially if you sense any distress. Wrap up the interview if the participant becomes visibly upset. Some people have a tendency to talk a lot when they are nervous; try not to interject while they speak (you planned extra time for this!). If someone really derails, wait for a pause, then reference something they said before the derail to gently guide them back to the topic you’re hoping to learn about.

As you respond to the participants’ offerings, resist the temptation to share a similar experience you may have had. ‘Piggybacking’ can sometimes register as an effort to compete with an experience rather than to empathize.

Emotions are part of the human experience. If a participant appears upset in any way, allow them the space to feel that emotion. Statements like, “Please don’t cry. It will be okay,“ are better replaced with a simple acknowledgment of the person’s experience: “That sounds really difficult. Thank you for sharing.”

When things get tough

Take a deep breath. However things may have gone awry, remember that whomever you’re speaking to has plenty more going on in their life outside of this interview. Whatever is happening, there’s a strong possibility that it has little or nothing to do with you.

Keep in mind that you have no obligation to agree with a participant. If someone makes a statement or tells an anecdote that you find disturbing or that conflicts with your values, tactfully continue on. If the participant asks to know what you think, do your best to deflect: “Sorry, I’d really like to keep this conversation about your experience. Would you mind telling me a bit more about… ?” Likewise, avoid offering advice to a participant. If you are directly asked for advice, aim to present your ideas as possibilities rather than prescriptions.

Sometimes people don’t want to talk: your open-ended questions may be answered with three words, or a participant may become unexpectedly defensive or shut down. It’s okay. When this happens, you can always thank the person for their time and end the interview early. If it feels okay, you can also try switching gears: sometimes asking which products a person most often uses can surface valuable information about what is important to them. You can also ask what they like or don’t like about the products they use and when during their day they use them.

On the Seniorlink project, one participant seemed defensive at the beginning of our user testing session. She worked long days to care for both her parents and an elderly neighbor couple that her family had known for years. It was clear that she cared deeply for all 4 of the individuals in her care. Midway into the session, she revealed that her commitment to her parents and neighbors had been questioned on occasion: some caregivers receive government stipends per individual in their care, and the system was prone to abuse in her area. This is a great example of how sensitive topics can arise despite planning.

Wrapping up the interview

Be sure to allow some time for the participant to ask you questions, but don’t worry about ending the session early if the participant has nothing to ask. Graciously thank the participant for sharing their time and experiences, regardless of how you felt the session went.

As you’re synthesizing and presenting your findings, aim to anonymize personal details about the participants you interviewed, and be mindful of any public records that could betray participants’ identities.

Take care of yourself <3

Consider reserving some self-care time yourself between interviews: go pet an animal, grab coffee with a colleague, journal, take a walk outside - whatever helps. If needed, work with your manager to revise your approach so that it feels more sustainable. Other mechanisms of support like counseling are a great option if you are feeling emotionally impacted by this work.

Final thoughts

Though this work can be taxing, user testing can also be deeply and wonderfully rewarding. Through these types of interviews, I’ve had the privilege of hearing the stories of everyday heroes: folks who manage full-time work and caring for loved ones, survivors, devoted parents who make it work, and bleeding hearts who are dedicated to a mission. Most people are eager to assist in building tools that help others, and in my experience, that enthusiasm can be inspiringly contagious. So go forth, learn, be inspired, and build some amazing products that do the world some good <3

A huge thanks to Eric Bailey for his insights on this topic! 🙏