Ensuring confidence and accuracy in COVID testing through effective instructions

Josefina Bravo and Sue Walker

Since December 2020, the approach to testing for COVID in the UK has shifted from self-administered home testing to mass testing in community sites. This means that going forward, an ever-expanding number of people will be training to deliver testing at their place of work. Although it has many advantages, the rapid tests being used for community testing are complex to operate, so ensuring that operators have clear and effective instructions is increasingly important to improve the accuracy of the tests.

The year 2020 was, without a doubt, a new experience for most. Testing technology became a mainstream topic in the media, and we saw an overwhelming requirement for COVD tests with variable types of sampling and new testing technologies emerging rapidly. The adoption of community mass testing in 2021 means that more and more people will need to train in order to operate point-of-care tests, that can be processed on site. A multidisciplinary team of experts in diagnostics and information design from University of Reading has been researching the ways in which better user instructions can improve the accuracy of COVID tests.

How design plays a part in the picture

By designing clear instructions, we can help operators to take COVID tests confidently and correctly. Instructions need to be user-friendly, and this means taking into account that people may be nervous or anxious when taking a test so clear explanation, reassurance and engaging verbal and visual messages are key. Evidence from past research has shown that effective instructions have plain words, a clear structure with steps, and combine images and text to clarify the actions of the user and positioning of the medical devices, among other features.

What we are doing

Our aim is to explore the information needs of untrained users for taking rapid tests and interpreting the results, and to design instructions to support them in taking tests confidently.

At the end of 2020, we designed prototype instructions for COVID antibody tests based on design best practice, a critical review of other current examples of home test instructions and the results from a survey of more than 120 people. Most importantly, we informed the design with research evidence about what works in instructional design.

We conducted a pilot study where we discussed the instructions with end users. Discussing early prototypes with end-users can reveal the initial impression caused by the instruction, and, for example, the perceived level of confidence in executing the test independently. It can tell you about perceived difficulty (the steps where there’s ‘room for messing up’), and expected use of the instructions.

Prototype of user instructions for antibody test using simplified instructions

What we have found so far

Preliminary results from our pilot reinforce that readers of instructions require clear language, diagrams and visual structure (through layout and typography) to understand and execute a self-administered test. Further, an instructional video that shows each step clearly was effective to explain how the test is done, and to demonstrate parts of the test that are complex or ambiguous. A combination of video and print/static instructions was deemed to be best for different activities (initial walk-though, executing step-by-step and monitoring progress) and provide the most access to multiple audiences. The combination of video and print was also picked out to be optimal for the different requirements of patients before and during the test.



The initial stage of the project was funded through the fantastic contribution of donors. Going forward in 2021, the work is funded by AHRC.