Research problem: Tutorials and user manuals are important forms of impersonal support for using software applications, including electronic medical records (EMRs). Differences between user- and vendor-generated documentation may indicate support needs, which are not sufficiently addressed by the official documentation, and reveal new elements that may inform the design of tutorials and user manuals. Research question: What are the differences between user-generated tutorials and manuals for an EMR and the official user manual from the software vendor? Literature review: Effective design of tutorials and user manuals requires careful packaging of information, balance between declarative and procedural texts, an action and task-oriented approach, support for error recognition and recovery, and effective use of visual elements. No previous research compared these elements between formal and informal documents. Methodology: We conducted a mixed-methods study. Seven tutorials and two manuals for an EMR were collected from three family health teams and compared with the official user manual from the software vendor. Documents were qualitatively analyzed using a framework analysis approach in relation to the principles of technical documentation described before. Subsets of the data were quantitatively analyzed using cross-tabulation to compare the types of error information and visual cues in screen captures between user- and vendor-generated manuals. Results and discussion: The user-developed tutorials and manuals differed from the vendor-developed manual in that they contained mostly procedural and not declarative information; were customized to the specific workflow, user roles, and patient characteristics; contained more error information related to work processes than software usage; and used explicit visual cues on screen captures to help users identify window elements. These findings imply that to support EMR implementation, tutorials and manuals need to be customized and adapted to specific organizational contexts and workflows. The main limitation of the study is its generalizability. Future research should address this limitation and may explore alternative approaches to software documentation, such as modular manuals or participatory design.

中文翻译：

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初级保健电子病历系统用户手册：用户和供应商生成文档的混合方法研究

研究问题：教程和用户手册是对使用软件应用程序（包括电子病历 (EMR)）的非个人支持的重要形式。用户和供应商生成的文档之间的差异可能表明支持需求，官方文档没有充分解决这些需求，并揭示了可能为教程和用户手册的设计提供信息的新元素。研究问题：用户生成的 EMR 教程和手册与软件供应商的官方用户手册有什么区别？文献回顾：教程和用户手册的有效设计需要仔细包装信息，平衡声明性和程序性文本，以行动和任务为导向的方法，支持错误识别和恢复，以及有效使用视觉元素。以前没有研究比较正式和非正式文件之间的这些元素。方法：我们进行了混合方法研究。从三个家庭健康团队收集了七个 EMR 教程和两个手册，并与软件供应商的官方用户手册进行了比较。使用与前面描述的技术文档原则相关的框架分析方法对文档进行了定性分析。使用交叉制表对数据的子集进行定量分析，以比较用户和供应商生成的手册之间的屏幕截图中的错误信息和视觉提示的类型。结果和讨论：用户开发的教程和手册与供应商开发的手册不同，它们主要包含程序性信息而不是声明性信息；根据特定的工作流程进行定制，用户角色和患者特征；包含更多与工作流程相关的错误信息，而不是软件使用；并在屏幕截图上使用明确的视觉提示来帮助用户识别窗口元素。这些发现表明，为了支持 EMR 实施，需要定制教程和手册并使其适应特定的组织环境和工作流程。该研究的主要局限性在于其普遍性。未来的研究应该解决这一限制，并可能探索软件文档的替代方法，例如模块化手册或参与式设计。教程和手册需要根据具体的组织环境和工作流程进行定制和调整。该研究的主要局限性在于其普遍性。未来的研究应该解决这一限制，并可能探索软件文档的替代方法，例如模块化手册或参与式设计。教程和手册需要根据具体的组织环境和工作流程进行定制和调整。该研究的主要局限性在于其普遍性。未来的研究应该解决这一限制，并可能探索软件文档的替代方法，例如模块化手册或参与式设计。