Evaluating a Shared Decision Support Tool for Pediatric Cardiopulmonary Arrest: Mixed Methods Usability Study

Effective team communication is critical in pediatric cardiopulmonary arrest management, where delays or miscommunication can jeopardize survival. TeamScreen, a web-based interface displayed on a large screen, was developed to enhance cardiopulmonary resuscitation (CPR) by providing real-time visualization of clinical data and resuscitation steps aligned with the American Heart Association pediatric advanced life support algorithms.

This study evaluated the usability of the TeamScreen Figma prototype, evaluating how efficiently and accurately experienced emergency physicians and nurses retrieved critical information during a simulated pediatric in-hospital cardiac arrest scenario. Although no strict time constraints were imposed, participants were instructed to perform the tasks as spontaneously and as quickly as possible.

Usability testing involved 20 pediatric emergency physicians and nurses with varied CPR experience. Participants performed 21 information retrieval tasks within a simulated pediatric cardiac arrest scenario (shockable rhythm). The data collected included audio-video recordings via the think-aloud method and participant responses to the Post-Study System Usability Questionnaire (PSSUQ) version 3 and a posttest survey. Effectiveness, efficiency, and satisfaction were measured by task completion rates, time-on-task metrics, and PSSUQ scores, respectively. Think-aloud data were analyzed for usability issues using Nielsen Norman Group's rating scale and Bastien and Scapin's ergonomic criteria.

Five physicians and 15 nurses achieved a mean task success rate of 81.19% (SD 16.87%), with a mean completion time of 8.13 (SD 7.07) seconds, calculated across all 21 tasks and all participants. PSSUQ scores reflected high satisfaction (mean 2.40 [SD 1.24] of 7.00; the lower the better), notably for information clarity and system utility. Qualitative analyses identified 16 usability issues, of which 5 were deemed major, primarily involving information visibility, navigation, and density, highlighting areas for interface and workflow enhancement.

The usability evaluation confirmed TeamScreen's potential to improve real-time information access during pediatric CPR, with high task success and satisfaction scores supporting its role in aiding decision-making. Challenges with visibility, navigation, and information density require further refinement. These findings will guide improvements and inform the design of multicenter trials to assess TeamScreen's efficacy in simulation-based resuscitation settings.