Goals of Refinement (Field) Testing
A summary of our broad goals for refinement (field) testing is to determine:
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What's really happening: understand the context on the ground in which the app will be
used
 Are questions in an order that doesn't match the users' current workflow?
 Are inputs required that will realistically not be available?
How the system will be used: observe app interaction during and app usage after training
to pinpoint potential barriers to app usage
 Is the app taking too long to use?
 Is a question better as open text than multiple choice?
What the users want: get end user feedback on what would work best and be most useful
for them
 Should we add something that the users want?
 Should we remove something that the users find irrelevant?
A note on duration: In order for us to gather meaningful feedback, refinement (field) testing
needs to run for a reasonable amount of time. Ideally, the duration would be around 2 months,
but timelines not permitting, 1 month is what we would aim for. Certainly anything less than 2-3
weeks will limit our takeaways and consequently how user-friendly and robust the next version of
the app would be. Anything less than 2 weeks will not give us the level of feedback we are
looking for, but may allow for some very basic testing.
The takeaways from a comprehensive process are related to workflow as well as app design.
Specifically, the following things are important for us to do.
1. Tablet: Observe how the tablet is handled by the users in order to:
 confirm the appropriateness of this device for the project,
 guage the level of comfort the users have with the tablet, and
 inform preparations and schedules for future trainings.
2. Printing: If the printing functionality is ready and printers have been procured by the
Karnataka launch, observe how the printing mechanism fits into the current workflow of the nurse
and doctor, including interaction with the patient, to determine:
 how the doctors feel about the printout, and
 whether the printout will be in the patient's possession at any point.
These would be to confirm, or iterate on changes to ensure, that:
 doctors do not have any issues with the introduction of the printout,
 the printout will not be lost or cause confusion,
 the printout will effectively convey information critical to the study between the nurse and
the doctor.
3. Workflow: Observe how the app fits into the daily workflow of the clinics, specifically of the
nurses and of the doctors. This would allow us to:
 confirm who should and would be using the tablets in a real setting,
 know where tablets will be stored, how they will be charged, etc.,
 iterate on app design so that it is least disruptive for the users, and not take too much time,
or even save time (ex: adding, removing and reordering of questions), and
 iterate on app design so that the system's required inputs are reasonable to expect at the
CHCs (ex: making questions required vs not required, adjusting algorithms as needed).
4. App: Observe how the nurses and doctors interact with the app to identify questions and/or
app structures that are pain points or not intuitive, in order to streamline the app accordingly. This
could include:
 updating the wording of questions,
 changing the format of certain inputs.
5. User feedback: Ask the nurses and doctors directly what the app could be doing better,
and if feasible, incorporate that to the app.
6. Content and algorithms: Look for insight into the content and algorithms in the app, but we
assume you [implementing/content partner] have your own processes to confirm the rigor
of those.
Please note that is not an exhaustive list, but highlights of things we will be looking for.
As such, refinement (field) testing is an important part of our design-test-iterate process, which is
best done at the ground level by putting an early version of the app in the hands of the end
users. We would like to understand the values, objectives and context of the users' reality to
create a tool that provides value at the frontline.
Please let me know if you have any questions.