Currently submitted to: JMIR Human Factors
Date Submitted: Mar 22, 2026
Open Peer Review Period: Apr 7, 2026 - Jun 2, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Interactive In-App Guidance for Healthcare Software Onboarding: A Systematic Review and Mixed-Methods Survey
ABSTRACT
Background:
Healthcare organizations increasingly rely on complex digital systems, but software onboarding often depends on manuals and classroom-based training that do not fit well with fast-paced clinical workflows. Interactive in-app guidance may better support learning during real work, although healthcare-specific evidence is still limited.
Objective:
To synthesize evidence on effective onboarding mechanisms for healthcare software and to explore how interactive in-app guidance compares with traditional onboarding in terms of perceived learning support, cognitive burden, and adoption-related outcomes.
Methods:
The study used a sequential design with two components: (1) a systematic literature review following Kitchenham’s procedures; and (2) a mixed-methods survey administered via Qualtrics to healthcare professionals (n = 44), complemented by a small screened subsample of IT professionals with healthcare DAP implementation experience (n = 5). Quantitative data were analysed descriptively, and qualitative responses were examined through thematic analysis to explain and contextualize the observed patterns.
Results:
The findings from both the literature review and the survey showed a consistent pattern: workflow-embedded onboarding approaches, including hands-on practice, stepwise contextual guidance, and searchable in-app support, were perceived to reduce learning friction and cognitive effort while improving confidence. Among healthcare respondents, 61% reported greater willingness to use the software after onboarding. Continued use was mainly associated with remembering how to use features, interface usability, workflow efficiency, and perceived impact on patient care. IT respondents highlighted implementation constraints related to integration, analytics, and compliance, but also perceived reductions in support burden.
Conclusions:
Interactive, context-sensitive onboarding appears to be a practical strategy to support healthcare software adoption, especially because it aligns learning with real workflows. The findings support the use of workflow-embedded guidance to improve usability in context and user confidence during onboarding, while also indicating the need for stronger healthcare-specific, outcome-based evaluations of DAP-enabled approaches.
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