Red Cross Instruction Editing

Usability Report

By:
Jordan Dagenais
HU4628
Table of Contents
Executive Summary... 2

Methodology...... 3

Where and When the Test Occurred..... 3

Who Was Tested... 3

What Was Tested.. 3

What Participants Did... 3

What Data Was Collected. 4

Introductory Questions and Tasks. 5

Findings and Recommendations.... 8

Exit Questions and User Impressions... 8

Appendices.... 10

1
Executive Summary
In January of 2017, the Red Cross made many changes to the instructions for a passive victim
with a suspected spinal injury. These changes came about after the Red Cross decided that
instead of having some rescues that get the victim out of the water as quickly as possible and
some that get the victim out of the water as securely as possible, all rescues should focus on
getting the victim out of the water as quickly as possible. However, the new instructions
provided by the Red Cross were rather confusing. As a result, it was the goal of this usability test
to determine the viability of new instructions that were made to replace the ones created by the
Red Cross.

The usability test, which called for test subjects to test out the new instructions went well. The
test subjects were able to get through the instructions will relative ease. There were some parts of
the instructions that could still use some work, though, in order to make them more clear. At the
end of the usability test, the most common analysis was that pictures are needed in order to make
the instructions as clear as they can be.

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Methodology
The usability test was conducted by Jordan Dagenais as part of Dr. Karla Kitalongs class,
HU4628 Usability and Instruction Writing.

Where and When the Test Occurred

The testing occurred on Wednesday, March 8 at the Michigan Tech Student Development
Complex pool. The testing lasted for two hours.

Who Was Tested

The test subjects were three lifeguards employed at the Michigan Tech Student Development
Complex. They all have backgrounds in the previous ways in which the Red Cross has taught
lifeguard these skills. They all exemplified the persona used in the usability test plan. The rest of
the test plan can be found in Appendix B:

Meredith

Meredith is a 22-year-old college student that works as a lifeguard part time. She, like many
other lifeguards, does not work full time as a lifeguard and thus can struggle to remember all the
details of the complicated rescues provided by the Red Cross. She is confused by the Red
Crosss newest changes to spinal victim rescues because of their lack of detail. She wants
instructions that are easy to follow but dont leave any room for questions about what to do.

What Was Tested

The Concurrent Think Aloud Protocol was used for the method of testing. The reactions of the
lifeguards was tested as they went through the instructions. The goal was to find out what was
confusing and difficult about the instructions by watching how they reacted to them. Then, the
recall of each lifeguard was tested to see if the instructions were easy to remember. Ultimately
what was tested was whether or not these instructions are better or worse than the instructions
provided by the Red Cross, and how they can be improved.

What Participants Did

The test subjects completed three tasks during the usability test:
1. The test subjects were asked about their previous experiences with Red Cross instructions
in order to determine a baseline of knowledge.

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 2. The test subjects went through the instruction set three times, using the Concurrent Think
Aloud Protocol and rotating through three positions:
a. Primary rescuer
b. Secondary rescuer
c. Observer
3. The test subjects were asked about their overall impressions after they had each rotated
through the three positions.

A full list of the instructions that the test subjects completed can be found in the section
Introductory Questions and Tasks, as well as in Appendix A.

What Data was Collected

Subjective and quantitative metrics were used in order to collect data.

Subjective Metrics: Each test subject was asked about their experience with the new methods of
rescue. Their answers were collected as follows:
Test subject 1: I was at an inservice at the pool where we went through the new
instructions.
Test subject 2: I was at that inservice too. The instructions were weirdly written.
Test subject 3: I wasnt at that inservice so I havent used the new instructions yet.

Quantitative Metrics: The tests was judged success based on the time it took to complete each
task, how well the testers understood the instructions, and how many minor and critical errors
they made. During the first rotation, it took 7 minutes and 42 seconds for the primary and
secondary rescuer to complete all of the steps. During the second rotation, it took 7 minutes and
6 seconds for the primary and secondary rescuer to complete all of the steps. During the third
rotation, it took 6 minutes and 51 seconds for the primary and secondary rescuer to complete all
of the steps. The changes in time can most likely be attributed to having run through the steps
multiple times. Because there were no drastic changes in time and no observed critical errors, it
can be stated that the new instructions prevent critical errors from happening.

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Introductory Questions and Tasks
The following questions were asked of each test subject before the usability test was conducted:
1. Are you currently a lifeguard?
2. How long ago did you practice your rescuing skills, whether at an employee inservice or
during your own time?
3. What is your experience with the 2017 Red Cross updates to the passive victim rescues?

This is the full list of instructions performed by each test subject:

Note: The primary and secondary rescuers should be working concurrently.
Primary Rescuer Secondary Rescuer

Upon identifying an unconscious victim with The secondary rescuer calls 911.
a suspected spinal injury, the primary rescuer
blows their whistle three times to activate the
Emergency Action Plan.

The primary rescuer performs an off-the-wall The secondary rescuer directs other pool
entry into the pool, making as little patrons to quickly and calmly exit the pool.
disturbance to the water as possible.

The primary rescuer carefully wades to the The secondary rescuer checks to make sure all
unconscious victim. patrons have exited the pool.

Upon reaching the victim, the primary rescuer The secondary rescuer retrieves the nearest
moves the victims arms above their head, backboard and stands at the edge of the pool
securing them against the head by applying nearest to the victim.
pressure with both of their hands.

The primary rescuer rotates the victim onto The secondary rescuer removes the head
their back. immobilizers.

If the pool has a low wall: If the pool has a low wall:

The primary rescuer changes the positions of The secondary rescuer submerges the
the their hands so that neither arm reaches backboard in the water, setting the end on the
underneath the victim. low wall and keeping the board at a roughly
30 degree angle.

The primary rescuer begins walking with the The secondary rescuer grabs and holds the
victim in order to straighten the victims spine victim on the arms where the primary rescuer
and heads towards the nearest wall. has been holding them.

The primary rescuer walks the victim up onto The secondary rescuer grabs and holds the
the backboard. victim on the arms where the primary rescuer
has been holding them.

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The primary rescuer places and tightens one
strap over the victim, under the armpits.
The primary rescuer puts the victim in a
head-and-chin splint.
The primary rescuer positions themselves at
the other end of the backboard.
The primary rescuer pushes the backboard out The secondary rescuer pulls the backboard out
of the water while the secondary rescuer pulls. of the water while the primary rescuer pushes.
Both rescuers handle any other medical
ailments until more highly skilled individuals
arrive.
If the pool has a high wall:
The primary rescuer begins walking with the
victim to straighten their spine.
The primary rescuer approaches the
secondary rescuer with the victim.
The primary rescuer walks the victim on the
backboard to a pool wall.
The primary rescuer places and tightens one
strap over the victim, under the armpits.
The primary rescuer grabs the head
immobilizers and places them one at a time
against the sides of the victims head, the
secondary rescuer moving their hands to the
The secondary rescuer puts on and secures the
head immobilizers.
The secondary rescuer grabs the end of the
backboard on the low wall.
The secondary rescuer waits for the primary
rescuer to position themselves at the other end
of the backboard.
Both rescuers handle any other medical
ailments until more highly skilled individuals
arrive.
If the pool has a high wall:
The secondary rescuer performs an
off-the-wall entry into the pool, making as
little disturbance to the water as possible. The
secondary rescuer brings the backboard with
them.
When the primary rescuer comes near, the
secondary rescuer will submerge the
backboard and let it float back up so it is
underneath the victim.
Note: The secondary rescuer has to match the
speed of the primary rescuer. The primary
rescuer cannot slow down.
The secondary rescuer positions themselves
between the wall and the backboard, grabs
victims head in stabilization, and braces the
backboard with their collarbone.
The secondary rescuer continues to hold their
position, awaiting the primary rescuers
securing of the chest strap.
The secondary rescuer moves their hands to
the outsides of the head immobilizers as the
primary rescuer places them one at a time
against the sides of the victims head.
6
outsides of the head immobilizers in the Note: This switch should be done from a
process. Note: This switch should be done countdown called out by the primary rescuer.
from a countdown called out by the primary
rescuer.

The primary rescuer exits the water. The secondary rescuer holds their position
while the primary rescuer exits the water.

The primary rescuer grabs each side of the The secondary rescuer positions themselves at
end of the backboard that is propped up by the the other end of the backboard.
secondary rescuer.

The primary rescuer pulls the backboard out The secondary rescuer pushes the backboard
of the water while the secondary rescuer out of the water while the primary rescuer
pushes. pulls.

Both rescuers handle any other medical Both rescuers handle any other medical
ailments until more highly skilled individuals ailments until more highly skilled individuals
arrive. arrive.

7
Findings and Recommendations
The answers to each of the introductory question are as follows:
1. Are you currently a lifeguard?
a. Test subject 1: Yes
b. Test subject 2: Yes
c. Test subject 3: Yes
2. How long ago did you practice your rescuing skills, whether at an employee inservice or
during your own time?
a. Test subject 1: About a month ago.
b. Test subject 2: It was about a month ago for me too.
c. Test subject 3: It was sometime last semester, so Id say about three months
ago.
3. What is your experience with the 2017 Red Cross updates to the passive victim rescues?
a. Test subject 1: I was at an inservice at the pool where we went through the new
instructions.
b. Test subject 2: I was at that inservice too. The instructions were weirdly written.
c. Test subject 3: I wasnt at that inservice so I havent used the new instructions
yet.

The comments made during the usability test have been compiled here. The comments are
paraphrases:
I like the note at the beginning. Its good that it explains why the instructions were made.
I like that it says that the rescuers work on their steps at the same time.
It makes sense that the steps are divided into two columns. Thats less confusing than the
way the Red Cross wrote them.
How is the primary rescuer supposed to rotate the victim? Is there a specific way to do it?
I like that it indicates which parts are for the high wall and which parts are for the low
wall.
I would actually prefer two separate sets of instructions. This pool has a low wall so its
confusing that I have both sets of instructions here.
Im confused by the switching of the hands step for low wall pools. I think it needs a
picture to show what it means.
To go off of that, I think there should be pictures to show what the difference is between
low and high wall pools.
I like that the steps are specific. It doesnt assume much other than that the rescuers are
going to be lifeguards.
The pushing and pulling part of the low wall rescue is a little confusing. A picture would
be helpful here too.
Its good that the notes are underlined. It helps us see whats important.
The pushing and pulling is confusing for the high wall too.
I think this should be two separate sets of instructions too.

Exit Questions and User Impressions

These were the questions used to assess the instructions after the usability test was complete,
along with their subsequent answers.
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1. What was your overall impression of the instructions?
a. Test subject 1: Theyre relatively easy to get through. Most of the steps are really
clear, with only a few hiccups here and there.
b. Test subject 2: I like them. Theyre better than the old ones for sure.
c. Test subject 3: Since I havent seen the Red Crosss new instructions they were a
little confusing, but overall I didnt have a lot of problems.
2. Do you think these instructions are more useful, less useful, or as useful as the current
instructions being used by the Red Cross?
a. Test subject 1: Yes.
b. Test subject 2: I agree. Theyre way better.
c. Test subject 3: I cant answer that since I havent used the new Red Cross
instructions.
3. What did you like the most about these instructions as compared to the Red Cross ones?
a. Test subject 1: I like the separation of the steps into columns so you can see who
is supposed to do what.
b. Test subject 2: I like the column instructions too. The Red Crosss instructions
are too jumbled together. These are a lot clearer.
c. Test subject 3: Same answer as before. (referring to question 2)
4. What is the biggest change that needs to be done to these instructions? Why?
a. Test subject 1: I think it needs pictures. Some of the areas are just a little
confusing and a picture would help clear them up.
b. Test subject 2: I think this needs to be divided into two sets of instructions. Like
I said earlier, this pool has a low wall so if Im rescuing someone I dont care
about the high wall instructions.
c. Test subject 3: I think it needs some pictures too. It would make the complicated
parts easier to understand, especially if its a new lifeguard performing the
rescue.
5. Do you have any questions, comments, or concerns about the usability test?
a. Test subject 1: No
b. Test subject 2: No
c. Test subject 3: No

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Appendices

Appendix A
New Passive Victim with a Suspected Spinal Injury Rescue
Instructions
Note: In January of 2017, the Red Cross made many changes to the instructions for a passive
victim with a suspected spinal injury. These changes came about after the Red Cross decided that
instead of having some rescues that get the victim out of the water as quickly as possible and
some that get the victim out of the water as securely as possible, all rescues should focus on
getting the victim out of the water as quickly as possible. Now, there are two overarching types
of these rescues: low wall and high wall situations.

Note: The primary and secondary rescuers should be working concurrently.

Primary Rescuer Secondary Rescuer

Upon identifying an unconscious victim with The secondary rescuer calls 911.
a suspected spinal injury, the primary rescuer
blows their whistle three times to activate the
Emergency Action Plan.

The primary rescuer performs an off-the-wall The secondary rescuer directs other pool
entry into the pool, making as little patrons to quickly and calmly exit the pool.
disturbance to the water as possible.

The primary rescuer carefully wades to the The secondary rescuer checks to make sure all
unconscious victim. patrons have exited the pool.

Upon reaching the victim, the primary rescuer The secondary rescuer retrieves the nearest
moves the victims arms above their head, backboard and stands at the edge of the pool
securing them against the head by applying nearest to the victim.
pressure with both of their hands.

The primary rescuer rotates the victim onto The secondary rescuer removes the head
their back. immobilizers.

If the pool has a low wall: If the pool has a low wall:

The primary rescuer changes the positions of The secondary rescuer submerges the
the their hands so that neither arm reaches backboard in the water, setting the end on the
underneath the victim. low wall and keeping the board at a roughly
30 degree angle.

10
The primary rescuer begins walking with the
victim in order to straighten the victims spine victim on the arms where the primary rescuer
and heads towards the nearest wall.
The primary rescuer walks the victim up onto
the backboard.
The primary rescuer places and tightens one
strap over the victim, under the armpits.
The primary rescuer puts the victim in a
head-and-chin splint.
The primary rescuer positions themselves at
the other end of the backboard.
The primary rescuer pushes the backboard out The secondary rescuer pulls the backboard out
of the water while the secondary rescuer pulls. of the water while the primary rescuer pushes.
Both rescuers handle any other medical
ailments until more highly skilled individuals
arrive.
If the pool has a high wall:
The primary rescuer begins walking with the
victim to straighten their spine.
The primary rescuer approaches the
secondary rescuer with the victim.
The primary rescuer walks the victim on the
backboard to a pool wall.
The secondary rescuer grabs and holds the
has been holding them.
The secondary rescuer grabs and holds the
victim on the arms where the primary rescuer
has been holding them.
The secondary rescuer puts on and secures the
head immobilizers.
The secondary rescuer grabs the end of the
backboard on the low wall.
The secondary rescuer waits for the primary
rescuer to position themselves at the other end
of the backboard.
Both rescuers handle any other medical
ailments until more highly skilled individuals
arrive.
If the pool has a high wall:
The secondary rescuer performs an
off-the-wall entry into the pool, making as
little disturbance to the water as possible. The
secondary rescuer brings the backboard with
them.
When the primary rescuer comes near, the
secondary rescuer will submerge the
backboard and let it float back up so it is
underneath the victim.
Note: The secondary rescuer has to match the
speed of the primary rescuer. The primary
rescuer cannot slow down.
The secondary rescuer positions themselves
between the wall and the backboard, grabs
victims head in stabilization, and braces the
backboard with their collarbone.
11
 The primary rescuer places and tightens one The secondary rescuer continues to hold their
strap over the victim, under the armpits. position, awaiting the primary rescuers
securing of the chest strap.

The primary rescuer grabs the head
immobilizers and places them one at a time
against the sides of the victims head, the
secondary rescuer moving their hands to the
outsides of the head immobilizers in the
process. Note: This switch should be done
from a countdown called out by the primary
rescuer.
The secondary rescuer moves their hands to
the outsides of the head immobilizers as the
primary rescuer places them one at a time
against the sides of the victims head.
Note: This switch should be done from a
countdown called out by the primary rescuer.

The primary rescuer exits the water. The secondary rescuer holds their position
while the primary rescuer exits the water.

The primary rescuer grabs each side of the The secondary rescuer positions themselves at
end of the backboard that is propped up by the the other end of the backboard.
secondary rescuer.

The primary rescuer pulls the backboard out The secondary rescuer pushes the backboard
of the water while the secondary rescuer out of the water while the primary rescuer
pushes. pulls.

Both rescuers handle any other medical Both rescuers handle any other medical
ailments until more highly skilled individuals ailments until more highly skilled individuals
arrive. arrive.

Appendix B
Test Plan
Scope: My scope is taken from the special note that appears at the beginning of my instructions:
Note: In January of 2017, the Red Cross made many changes to the instructions for a passive
victim with a suspected spinal injury. These changes came about after the Red Cross decided that
instead of having some rescues that get the victim out of the water as quickly as possible and
some that get the victim out of the water as securely as possible, all rescues should focus on
getting the victim out of the water as quickly as possible. Now, there are two overarching types
of these rescues: low wall and high wall situations.

Purpose: The purpose of this instruction set is to test the them under stressful situations. The
current instructions are too vague and do not provide the proper means to save a victim through
these new means in a timely fashion. My goal is to create instructions that are detailed and clear
enough that a lifeguard can read through them quickly but still understand what to do.

Persona:
Meredith
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Meredith is a 22-year-old college student that works as a lifeguard part time. She, like many
other lifeguards, does not work full time as a lifeguard and thus can struggle to remember all the
details of the complicated rescues provided by the Red Cross. She is confused by the Red
Crosss newest changes to spinal victim rescues because of their lack of detail. She wants
instructions that are easy to follow but dont leave any room for questions about what to do.

Method of Testing: I will be using Concurrent Think Aloud Protocol for my method of testing.
Based on the complexity of the directions I think I will be best if the usability testers can voice
their thoughts and opinions as they are working. This will allow me to see and hear where
changes need to be made in my instructions.

Scenario: As seen in the instructions, there will be be two scenarios that will be run during the
testing. They are outlined thoroughly on pages one and two.

Sessions/Location: I plan to have two sessions will two separate sets of three lifeguards for
testing. Each session will last approximately 30 minutes (20 minutes to run through all the
instructions and 10 minutes to give feedback) and will take place at the SDC pool.

Subjective Metrics: I will ask each lifeguard to tell me about their experience with the new
methods of rescue. The assumed metrics will be that each person is a lifeguard and that they are
up to speed with the 2016 Red Cross updates but not necessarily the 2017 Red Cross updates.

Quantitative Metrics: I will judge the tests success based on the time it takes to complete each
task, how well the testers understand the instructions, and how many minor and critical errors
they make. I will judge a minor error as something like forgetting to only put one chest strap on
the victim. I will consider a critical error to be something like bending the victims spine too
much.

Staff/Roles: I will moderate while three lifeguards that I work with will act in the persona roles.
The three lifeguards will rotate between primary rescuer, secondary rescuer, and victim. Two of
the three lifeguards have practiced these news rescues once before, and one of them has never
been exposed to the changes.

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