Script Voz - clinical case simulator of adults with behavioral dysphonia
usability and user acceptance testing
DOI:
https://doi.org/10.23925/2176-2724.2026v38i2e75433Keywords:
Clinical Reasoning, Clinical Decision-Making, Cognition, Learning, Simulation-Based Training, Speech-Language and Hearing SciencesAbstract
Purpose: To test the usability and user acceptance of an e-learning tool designed to train clinical reasoning for the management of behavioral dysphonias in speech-language pathology practice, developed through an expert consensus panel. Methods: This methodological study assessed the usability and acceptance of a digital simulation platform using the Net Promoter Score (NPS) questionnaire and questions targeting satisfaction, effectiveness, and efficiency dimensions. Thirty-five undergraduate students enrolled in the fifth and sixth semesters of the Speech-Language Pathology program participated in this study. The responses guided the platform refinement and the definition of its functionalities. Results: Named Script Voz, the tool was developed as a web-based platform comprising six real clinical cases of behavioral dysphonia. Regarding satisfaction, the NPS indicated 100% approval (excellent NPS). Regarding effectiveness, 94.3% of users reported developing clinical reasoning skills for managing behavioral dysphonia in adults. In terms of efficiency, most participants considered the language clarity, organization of images, videos, and information, question statements, and font size to be appropriate for the task. Based on these results, the platform was improved, and a user manual was created. Conclusion: Script Voz is a free e-learning tool for training clinical reasoning, whose usability test demonstrated high user acceptance and potential to support teaching and learning in speech-language pathology for behavioral dysphonia cases.
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1. Peixoto JM, Santos SME, Faria RMD. Clinical reasoning development in medical students. Rev Bras Educ Med. 2018; 42(1): 73-81. doi: 10.1590/1981-52712015v41n4RB20160079.
2. Hoben K, Varley R, Cox R. Clinical reasoning skills of speech and language therapy students. Int J Lang Commun Disord. 2007; 42(S1): 123-135. doi: 10.1080/13682820601171530.
3. Ginsberg SM, Friberg JC, Visconti CF. Diagnostic reasoning by experienced speech-language pathologists and student clinicians. Commun Sci Disord. 2016; 43: 87-97. doi: 10.1044/cicsd_43_S_87.
4. Schmidt HG, Rikers RJ. How expertise develops in medicine: knowledge encapsulation and illness script formation. Med Educ. 2007; 41: 1133-1139. doi: 10.1111/j.1365-2923.2007.02915. x.
5. Behlau M. The 2016 G. Paul Moore Lecture: lessons in voice rehabilitation. J Voice. 2019; 33(5): 669-681. doi: 10.1016/j.jvoice.2018.02.020.
6. Iliadou E, Fortune-Ely M, Melley LE, Garabet R, Sataloff RT, Rubin JS. Patients’ demographics and risk factors in voice disorders: an umbrella review of systematic reviews. J Voice. 2024; S0892-1997(24)00080-8. doi: 10.1016/j.jvoice.2024.03.006.
7. Tierney WS, Xiao R, Milstein CF. Characterization of functional dysphonia: pre- and post-treatment findings. Laryngoscope. 2021; 131(6). doi: 10.1002/lary.29358.
8. Roy N, Merrill RM, Gray SD, Smith EM. Voice disorders in the general population: prevalence, risk factors, and occupational impact. Laryngoscope. 2005;115(11):1988-1995. doi: 10.1002/lary.28853.
9. Martins LKG, Mendes ALF, Oliveira P, Almeida AA. Distúrbio de voz e fatores de risco em profissionais da voz falada: uma revisão integrativa. Audiol Commun Res. 2024; 29. doi: 10.1590/2317-6431-2023-2809pt.
10. Ricci G, Wolf AE, Barbosa AP, Moreti F, Gielow I, Behlau M. Sinais e sintomas de refluxo laringofaríngeo e sua relação com queixas e qualidade vocal. CoDAS. 2020; 32(5). doi: 10.1590/2317-1782/20202018052.
11. Huston MN, Puka I, Naunheim MR. Prevalence of voice disorders in the United States: a national survey. Laryngoscope. 2024; 134(1): 347-352. doi: 10.1002/lary.30929.
12. Biselli PJ, Atta JA. Diagnóstico sindrômico. Rev Med (São Paulo). 2005; 84(3-4): 95-101. doi: 10.11606/issn.1679-9836.v84i3-4p95-101.
13. Gama ACC. Planejamento terapêutico – ambulatório de voz. Belo Horizonte: UFMG; 2017.
14. Behlau M, Azevedo R, Pontes P. Conceito de voz normal e classificação das disfonias. In: Behlau M, editor. Voz: o livro do especialista. Vol. 1. Rio de Janeiro: Revinter; 2001.
15. Gartner-Schmidt J, Roth D, Zullo T, Rosen C. Quantifying component parts of indirect and direct voice therapy related to different voice disorders. J Voice. 2013; 27(2): 210-216. doi: 10.1016/j.jvoice.2012.11.007.
16. Behlau M. Voz: o livro do especialista. Vol. 2. Rio de Janeiro: Revinter; 2005.
17. Dijkers MP. Rehabilitation treatment taxonomy: establishing common ground. Arch Phys Med Rehabil. 2014;95(1 Suppl 1). doi: 10.1016/j.apmr.2013.09.023.
18. Van Stan JH, Whyte J, Duffy JR, Barkmeier-Kraemer J, Doyle P, Gherson S, et al. Voice therapy according to the rehabilitation treatment specification system: expert consensus ingredients and targets. Am J Speech Lang Pathol. 2021; 30(5): 2169-2201. doi: 10.1044/2021_AJSLP-21-00076.
19. Lopes L, Gama ACC, Madazio G. Plano terapêutico em voz a partir do modelo SETR. In: Tratado de Fonoaudiologia. 3ª ed. Barueri: Manole; 2025. p. 779-788.
20. Coulter I, Elfenbaum P, Jain S, Jonas W. SEaRCH™ expert panel process: streamlining the link between evidence and practice. BMC Res Notes. 2016; 9:16. doi: 10.1186/s13104-015-1802-8.
21. Jonas WB, Crawford C, Hilton L, Elfenbaum P. Scientific evaluation and review of claims in health care (SEaRCH): a streamlined, systematic, phased approach for determining “what works”. J Altern Complement Med. 2017; 23(1): 18-25. doi: 10.1089/acm.2016.0291.
22. Rodrigues R. Novas tecnologias da informação e da comunicação. Recife: Instituto Federal de Educação, Ciência e Tecnologia; 2016.
23. Organização das Nações Unidas para a Educação, a Ciência e a Cultura. Padrões de competência em TIC para professores: diretrizes de implementação. Paris: UNESCO; 2009. Disponível em: http://unesdoc.unesco.org/images/0015/001562/156209POR.pdf. Acesso em: 05 janeiro. 2026.
24. Perrenoud P. Dez novas competências para ensinar. Porto Alegre: Artes Médicas; 2000.
25. Al-Riyami AZ, Vanden Broeck J, Rahimi-Levene N, Das S, Saxon B, Lin Y, et al. E-learning in transfusion medicine: a scoping review. Transfusion. 2023; 63(12): 2362-2376. doi: 10.1111/trf.17564.
26. Kononowicz A, Woodham L, Edelbring S, Stathakarou N, Davies D, Saxena N, et al. Virtual patient simulations in health professions education: systematic review and meta-analysis. J Med Internet Res. 2019; 21(7). doi: 10.2196/14676.
27. Schiavoni FL, Gonçalves LL. Teste de usabilidade do sistema Mosaicode. In: IV Workshop de Iniciação Científica em Sistemas de Informação. Lavras: UFLA; 2017. p. 5-8.
28. Barboza HN, Lima MC, Ferreira RJS, Rosa MRD, Araújo ALLS, Acioly ASG. Teste de usabilidade do aplicativo Avazum. CoDAS. 2023; 35(5). doi: 10.1590/2317-1782/20232022103pt.
29. Nogueira LLCR, Dias SR, Almeida AAF, Azevedo RR, Gama ACC. Script Voz – clinical case simulator of adults with behavioral dysphonia: planning and content creation. CoDAS. 2025; 37(1). doi: 10.1590/2317-1782/e20240075pt.
30. Falkembach GAM. Concepção e desenvolvimento de material educativo digital. Novas Tecnol Educ. 2005; 3(1): 1-15. doi: 10.22456/1679-1916.13742.
31. Adams C, Walpola R, Schembri AM, Harrison R. The ultimate question? Evaluating the use of net promoter score in healthcare: a systematic review. Health Expect. 2022; 25(5): 2328-2339. doi: 10.1111/hex.13577.
32. Galvão MCB. Manual de software: facilitando a comunicação entre empresa produtora e sociedade. Transinformação. 2007; 19(1): 45-64.
33. Taylor DCM, Hamdy H. Adult learning theories: implications for learning and teaching in medical education. Med Teach. 2013; 35. doi: 10.3109/0142159X.2013.828153.
34. França T, Rabello ET, Magnago C. As mídias e as plataformas digitais no campo da educação permanente em saúde: debates e propostas. Saúde Debate. 2019; 43(spe1): 106-115. doi: 10.1590/0103-11042019S109.
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Copyright (c) 2026 Lorena Luiza Costa Rosa Nogueira, Sandro Renato Dias, Anna Alice de Figueirêdo Almeida, Renata Rangel Azevedo, Ana Cristina Côrtes Gama
This work is licensed under a Creative Commons Attribution 4.0 International License.
