Publication Date


Document Type


Committee Members

Helen Altman Klein (Committee Member), Kevin Bennett (Committee Member), Nancy Elder (Committee Co-chair), John Flach (Advisor)

Degree Name

Doctor of Philosophy (PhD)


Ecological interface design (EID; Vicente & Rasmussen, 1992) is a discipline that emphasizes the necessity of understanding the laws and constraints of a domain in order to make meaningful design decisions. We applied EID principles to create an ecological interface aimed at helping physicians with the detection, evaluation, and treatment of cardiovascular disease risk (specifically for hypertension and hyperlipidemia) and then evaluated it in two exploratory studies. In the first study, twenty-three internal medical residents participated viewed data from twelve patients (in six blocks) in a repeated measures study that measured which risk factors participant felt required follow-up and if their treatment decisions agreed with medically established guidelines (e.g., ATP-III for hyperlipidemia and JNC-7 for hypertension). The results indicate that residents were significantly more likely to follow up on metabolic syndrome when using the ecological display (p <. 0004) and that in 3 of the 6 trial blocks, they were more likely to choose treatment decisions that agreed with medical guidelines when using the ecological display for LDL cholesterol. Two faculty and two residents participated in our follow-up study, which included a simplified version of the first study but utilized an interactive version of the display and where performance and interactions were recorded and analyzed. It also included interviews regarding usability issues. The results demonstrated a preference for greater guideline agreement when using the ecological display in only one block of trials, even though almost all participants reported high levels of confidence that their decisions were in agreement with medical guidelines. The usability interviews suggested many ways in which the ecological display could be changed in future re-designs in order to better serve various user groups and purposes. The many positive reactions from our participants, in conjunction with our results, suggest that that further design and evaluation of the ecological display would likely be beneficial in medical decision making.

Page Count


Department or Program

Department of Psychology

Year Degree Awarded