Anyone who works with technology development knows that there will be a time when someone will say, “That is a training issue”. This statement often comes after someone asks, “how will the user know how to do <insert workflow step>?”

Sometimes the technical steps are not necessarily intuitive to the user’s anticipation of what to do next. This is a mismatch in the user experience. When this occurs, the user has (at best) confusion in trying to identify the next step. The confusion can lead to extreme frustration that halts progress toward completing the next step in the process (and lost time). 

Example: Pop Up Window Advertisements

Consider when you see a pop-up window to save you 10% on your first order for any given advertisement. You may or may not be interested in the welcome discount. If not, it can be quite difficult to find the “X” on the screen to exit the offer. You look around all four corners and sometimes need to locate the very faint area where you can exit out. If not found, you could exit the screen or put in your email to just get to what you wanted to see. (Of note, this is likely by design to obtain your email address  ). 

The lack of visibility of the “X” is a user experience or more specifically, a usability design issue. Sure, one could say it is a training issue and tell each person they need to look VERY CAREFULLY each time they accidentally find themselves with a discount offer. However, this becomes the user’s issue rather than the system design issue that removes this extra step. This usability design issue turns into a training issue. The usability shifts from the responsibility of the system designers to that of the individual to “learn” how to “workaround” the intended design.

Healthcare Training Issues

Now, let us look at healthcare. Healthcare is dependent upon clinical and administrative information systems to manage the individual and population level care. However, most clinicians are not formally educated on the foundations of informatics and/or information system design. Therefore, there is an inherent concern and perhaps intimidation faced where there is concern about whether they are charting the right way. 

Some clinicians will over chart while others will struggle to know what exactly needs to be charted and may unintentionally miss something. The extremes here are a result of a culture, especially in nursing, of “if it is not documented, it is not done”. However, when it becomes hard to know where to go next or how to enter some data correctly, you see the (largely unintentional) risk of error.  Add to this baseline, a handful of “training issues” and we have just added more stress to an already  stressed and fatigued workforce. 

Of course there are some aspects that do require training. However, for a moment think about how many times you have turned to watch a video or training session to use your new smart phone. Much of what you need to be able to do with your smart phone or device can be figured out without a training session.

We should be striving for this type of user experience with healthcare technology.  The need for formal training sessions should be minimal or very brief. Instead, the design of the systems should be such that the user is able to follow what the next step is through an intuitive human computer interaction experience. 

There is an abundance of qualitative and quantitative data to show that nurses, doctors, and healthcare professionals in general are working against the clock each day. There are never enough minutes to go around for everything that needs to get done in that shift. To add more things to what is expected of them will only increase the burden felt rather than create relief.

Healthcare cannot be delivered without the use of technology. However, we must consider that we have a workforce already spread thin. Instead of putting more responsibility through “training issues”, why not create a sense of ease and/or intuitive flow for them to experience each day? 

~ Dr. Kelley

“Lunch?” I heard my co-worker say to me one Friday around noon. A few of my coworkers were headed to get lunch at a nearby sandwich shop, and I was being invited to join. I was sitting at my desk, deep in focus on one of many design document spreadsheets.

“What?” I said as I turned my head toward him with a bit of confusion. I was relatively new to the role and working in IT. I had come from working on the inpatient floor as a nurse. I did not understand the question. I said, “We can do that? We can leave and get lunch?”

Here I am over 20 years later, and for some reason I find myself reliving that moment in my mind. My question and response may seem bazaar to someone who has not worked in clinical care. Some may even think ‘why would you not be able to leave and go get lunch?’ However, I know that any nurse (and/or other healthcare professional), understands this all too well.

To have the opportunity to eat lunch is not a given across the profession. In fact, taking 30 uninterrupted minutes to sit and renourish one’s body over the course of a 12.5-hour workday, can feel like a luxury to a nurse. Nurses learn this incredibly early in their careers. Yet, this is a cultural experience of our profession that does not need to occur.  

We, nurses and healthcare professionals, create the systems (e.g., processes) that are necessary to deliver care for patients. Those systems should be designed to support delivering quality care for patients AND the responsible nurses and healthcare professionals. To effectively deliver care for patients, we need our nurses and healthcare professionals at their own optimal operating capacity and capability. Being able to eat lunch over the course of 12.5 hours is part of that optimal operating capacity and capability.

Unfortunately, there is often an underlying or unspoken belief that the need for a break to eat, or even use the bathroom, is a sign of weakness. You are not strong enough if you cannot power through the day without eating or taking a bathroom break. Yet, we will teach our patients how they need to do the exact opposite to care for themselves. Now, looking back 20 years later, I can see how that is a belief and/or cultural expectation that needs to shift.

Time to Shift that Mindset.

Nurses are humans too. I mention the topic of lunch because it reflects a persistent blind spot (at best) within the profession. Over the last few years, I have seen an increase in attention and promotion of encouraging self-care and burnout reduction strategies. However, we continue to see that one of the more basic needs that could be met (lunch) is often left up to an individual to manage (e.g., find a way to make it happen), rather than an organizational system or process set up to support any and all nurses on a given day.  

The need for organizational systems to support nurses extends beyond far beyond lunch. There are many other areas where nurses work around challenges. Finding equipment, finding answers, finding resources, and finding linen are just four areas where nurses are continuously searching for something to work through the next step in the process of care. Yet often each one of these ‘finding’ steps takes up valuable time. So, the nurse is challenged to take that time or create a workaround, to cut that lost time down.

What if nurses did not have to look in every room and closet for a piece of equipment?

What if the linen cart was always stocked enough?

What if the meds were always in the med room when you were due to give them?

What if the ID band always scanned and lessened the risk for an override or late administration? (Better yet, what if it was not an ID band, but rather a biometric)?

What if you did not need to rush through discharge patient education?

These are just a few examples that I believe many, if not most, nurses who work in direct care can relate to, in terms of areas where you either lose time or do not have enough of it in a day.

I believe these “what if” statements are possible. However, these require more than the bedside nurse. These need system support to create processes that ensure they work well for all involved. (This also includes lunch).

In the age of the growing uncertainty of AI’s place in our lives, there are some areas where technology can assist in these ‘What If’ statements. None of those ‘What If’ statements posed would eliminate the need for a nurse. Instead, such tools would be what we hope technology can be: a tool that meets a specific unmet need.

I’d challenge you to consider your own What If. What would it take to make that thought a reality in the day to day?

Have you ever been in a store that just had too much to look at or look through? Perhaps you went to dinner at a restaurant where the menu could be a book with dozens of options. In both examples, there is just too much to process and find what you are looking for at that moment in time.

We are entering an age where you will hear, “it is all available online”. “Just ask <insert the name of the preferred LLM (large language model)>.

However, having something available via a short prompt does not necessarily make it meaningful nor address all information needs. Instead, you must create the meaning behind the data, information, knowledge and wisdom.

Lawrence Weed wrote “Medical Records that Guide and Teach” in 1968, published in the New England Journal of Medicine. Here we are in 2026, nearly 60 years later, and reading that historical referent holds true still today.

What does this mean? We still have more work to do in order to ensure people have the right information needed for their healthcare experiences.

I was asked this question, “Where is the roadmap?” a few years ago from someone who is not a healthcare professional. We were in a conversation about nursing and healthcare in general. I was explaining a bit about the culture in nursing and healthcare from a nursing experience. I have had far more nursing experiences than patient experiences. However, these are very different experiences.

To be a patient requires that someone has found a healthcare provider (e.g., doctor, nurse practitioner, nurse, phlebotomist, etc.) to receive some form of care. Before this happens, one is a person in need of care. However, how do you find it? How do you find the care that you need from the best person and/or organization that can deliver it?

While there are multiple pathways, the short answer today is ‘it depends’.

A logical first step is to search providers in network with one’s health insurance company, (if one has health insurance and/or a directory to search).

From there, one will receive a list of names that may say, “Accepting New Patients” or “Not Accepting New Patients”. One can then filter out the “Not Accepting New Patients” and work from the “Accepting New Patients” list. However, then one is making choices based on information that may or may not be available. This entire process could be enough to delay or stop some from getting to the initial appointment.

Another option is to take to a search engine or what now many are likely using, generative AI models, to provide responses. Yet, one cannot truly know if that healthcare professional is the best person for them without an initial appointment or consultation. The bedside manner, practice and/or organizational standards, wait times, responsiveness, supportive technology, trust, success rates, and more can all impact this experience. Sometimes, whether a person selects a provider or not has nothing to do with the condition or reason for visit that makes or breaks the next step on the healthcare roadmap journey.

If one is lucky, they may know someone who can provide the best name and/or be referred by someone else. However, this is not something available to everyone.

Yes, there are a few emerging companies working to provide these matches. However, this is just the beginning of the healthcare experience. What does one do when they have passed the entry point? What is one to expect? What questions should be asked? What should they know? What could be learned on the side of the patient? What is expected of the patient but not clearly communicated to the patient?

Now, the healthcare experience is not one that can be prescriptive as each person has different clinical and personal needs for care. However, we do not have a consistent onramp for anyone to know how to navigate what could be the most important decision that one could make around who to see (or not see) for a specific healthcare concern.

Patient-centeredness is one of the six parts of quality care. To be patient-centered is to provide care that addresses the individual needs of the patient to make decisions for optimal care outcomes. Being both a nurse and a patient at times, there is great opportunity to increase the voice and experience of the patient within the care experience.

~ Tiffany Kelley PhD MBA RN NI-BC FNAP FAAN