Assessment Report | LEAP

Assessment Information
eResource Title	Vendor	Overall Grade
ClinicalKey	Elsevier	A-

Key Findings

Strengths

All text and images meet contrast requirements
Information is not distorted when zoomed in at 200%
Information is preserved at different screen resolutions

Weaknesses

Some images contain a textual alternative

Images

Positioning of Images

Question	Answer	Notes	Images
Are the images positioned prominently and easy to find?	Always		No Images

Functional images embedded in the background

Question	Answer	Notes	Images
Are there functional images embedded in the background?	Never	Functional image adapts to size of box.	No Images

Presence of Icons

Question	Answer	Notes	Images
Are there icons where appropriate, such as icons to indicate PDF Full Text, Download, Folder, Citation, etc?	Always		No Images

Alt Text

Question	Answer	Notes	Images
Do informative images contain appropriate alt text or an appropriate textual alternative?	Sometimes	Sometimes there are detailed descriptions of informative images. Most of the books have detailed descriptions of images, however, most of the images found in the journals only contain basic alt text eg. "Figure 1" and no details of the actual image. Those images do have a text box next to them with a description, but it is not embedded in the ALT text.	No Images
Do functional images contain appropriate alt text or an appropriate textual alternative?	Always		No Images
Do images used as text contain appropriate alt text or an appropriate textual alternative?	Always		No Images

Content Scaling

Question	Answer	Notes	Images
When zoomed in at 200%, is text intact, readable, and not cut off?	Always		No Images
Are images clear and unpixelated at 200%?	Always		No Images
Is horizontal scrolling minimized at 200%?	Always		No Images

Colour and Contrast

Question	Answer	Notes	Images
Do text and images have a contrast ratio of at least 4.5:1?	Always		No Images

Colour

Question	Answer	Notes	Images
Do colour coded graphs have text equivalents?	Sometimes	Some colour coded graphs do not have text equivalents. Some colour coded graphs also use symbols (ie triangle and square) to denote different data instead of colour.	No Images
Are blocks of content separated from one another using visual separation (such as whitespace or borders)?	Always		No Images
Are text alternatives provided where colour is used to indicate an action?	Not Applicable	Unable to find a place where a colour indicates an action.	No Images

Text to speech

Question	Answer	Notes	Images
Is there a choice embedded within the database that offers text to speech or read aloud options?	Never	There are no embedded text to speech or read aloud options.	No Images

Clustered Links

Question	Answer	Notes	Images
Using your mouse, is the clickable area around links and buttons large enough for users to see and activate easily?	Always		No Images
Using your mouse to test links, are links and buttons far enough apart for users to accurately activate?	Sometimes	CME / Save / Email / PDF buttons are small and close together.	No Images
Using any method to test links, are all links and buttons functional (i.e., not dead)?	Always		No Images
Are links or buttons accessible via keyboard navigation?	Always		No Images

Dynamic content

Question	Answer	Notes	Images
Can users pause carousel movement?	Not Applicable	Carousels/scrolling images are not present.	No Images
Is all functionality, including navigating between carousel items, operable by keyboard?	Not Applicable	Carousels/scrolling images are not present.	No Images

Liquid layout

Question	Answer	Notes	Images
Is the order of the text preserved at all screen resolutions, without overlap?	Always		No Images
Do images avoid overlapping at all screen resolutions?	Always		No Images
Is the overall reading experience preserved at all screen resolutions?	Always		No Images

Key Findings

Strengths

The platform’s layout and navigation is consistent across all pages
User input fields contain labels and clear instructions to help users successfully complete the form
Page content has appropriate headers and is tagged appropriately

Labels and Instructions for Interactive Elements

Question	Answer	Notes	Images
Are user input fields accompanied by clear instructions on what the user needs to do to successfully complete the form?	Sometimes	Not every field has instructions associated with it. NVDA will alert the user to a menu being collapsed, and if a selection has been made.	No Images
Do user input fields contain labels in addition to overall instructions mentioned above?	Always		No Images
Are descriptions for fields and boxes easy to understand?	Always		No Images
Are labels placed above the user input fields and clearly associated with each field?	Always		No Images
Are text cues for coloured form control labels available?	Always	An asterisk * denotes a required field, not colour.	No Images
Are other visual indicators provided consistently, such as an asterisk for required form fields?	Always		No Images

Error Prevention

Question	Answer	Notes	Images
Are user input fields either reversible, checked, or confirmed? One of the three is acceptable.	Always		No Images

Error Reports

Question	Answer	Notes	Images
Are alert messages clearly visible to the user, either at the top of the form field, inline, or through a dialog box?	Always		No Images
Do alert messages clearly indicate the field in which the error has occurred and a description of the error and the fix?	Always		No Images
Is the user able to easily access the user input field to correct the error?	Always		No Images
Is the user able to resubmit the form and re-validate their submission?	Always		No Images
Do error reports follow a logical reading and navigation order?	Always		No Images

Search function spell-check

Question	Answer	Notes	Images
When a user spells a word incorrectly, does the search function offer spelling suggestions or synonyms?	Sometimes	A search for 'anatamy' or 'radilogy' or 'brest' gave no spelling suggestions in Firefox, but it did in Chrome and Edge. If we searched with the misspelled word, then ClinicalKey would offer results for correctly spelled word eg. "results for radiology" etc.	No Images

Functionality of Interactive Elements

Question	Answer	Notes	Images
Are icons such as to save, download, or print consistent across the site?	Always		No Images
Is alternative text clear and consistent for each icon type?	Always		No Images
Are actions consistently labelled across the site? For example, the “search” button is always labeled “search”.	Always		No Images
Are icons that have adjacent links consistent?	Always		No Images
Can the purpose of each link be determined from the link text alone?	Always		No Images

Consistent Navigation

Question	Answer	Notes	Images
Does the eresource have a consistent layout and navigation across all pages?	Always		No Images
Are search fields located in the same places throughout the website?	Always		No Images
Do other features occur in the same place throughout the website?	Always		No Images
Are links, buttons, images, and other components that are used repeatedly throughout a website labeled consistently?	Always		No Images

Pop-up windows/Interruptions

Question	Answer	Notes	Images
Does the electronic resource avoid the use of pop-up windows which open automatically in a new tab if a user clicks on a button?	Always		No Images
Does the database avoid launching pop-up windows automatically when the database is loaded?	Always		No Images
Where pop-ups occur, are users able to postpone or suppress any pop-ups?	Always	The user has the option to stay on the page, or open a new tab.	No Images
Does the database avoid launching pages in a new browser window with the usual browser controls missing?	Always		No Images

Headers

Question	Answer	Notes	Images
Is page content subdivided hierarchically into appropriate headings and tagged appropriately?	Sometimes	Sometimes a level is skipped (ie from H2 to H4), but never out of hierarchy order.	No Images
Are headings concise and clear, and accurately reflect the content under that heading?	Always		No Images

Menus

Question	Answer	Notes	Images
Do database page menus have a reasonable number of navigation items and drop-down options?	Always		No Images
Does the main navigation and drop-downs contain a reasonable number of menu items?	Always		No Images
Can all menus and submenus be accessed with screen readers and via keyboard navigation?	Always		No Images

Change of context

Question	Answer	Notes	Images
Does the “results” page or item record view avoid opening in a new tab without a warning?	Always		No Images
Is there an "update now" button that requests a refresh of content rather than automatically updating the content?	Always	You must select 'search' before a search is triggered.	No Images
Does the database avoid automatic redirection?	Always		No Images

Change of Context: Focus

Question	Answer	Notes	Images
Does the form refrain from submitting automatically when a component receives focus?	Sometimes	There is a new (in Beta) "Reading Assistant" option that opens a popup when the "Reading Assistant" search field receives focus using keyboard navigation.	No Images
Does the database avoid launching new windows when a component receives focus?	Always		No Images
Does the database avoid change of focus when a component receives focus?	Always		No Images
Are you able to tab through a page using keyboard navigation without the keyboard focus moving away from the control?	Always		No Images

Key Findings

Strengths

Screen readers accurately capture information presented in tables

Weaknesses

Some interactive functionality works consistently for users who are navigating a site via keyboard

Navigation Links

Question	Answer	Notes	Images
Can the purpose of each link be determined from the link text, or from the link text together with its surrounding context?	Always		No Images

Keyboard Navigation

Question	Answer	Notes	Images
Can keyboard focus be moved to all page elements?	Sometimes	Cannot get to 'Help and Feedback' section in right hand menu when accessing the menu from the Clinical References homepage. However, from other areas of the database, you can access the 'Help and Feedback' section in right hand menu.	No Images
If moving keyboard focus away from a component requires more than arrow or tab keys, is this clearly indicated on the page?	Never	Sometimes spacebar is used in a drop down menu instead of tab or enter. This is inconsistent with the rest of the database and it is not clearly indicated.	No Images
Is default keyboard navigation order logical and intuitive, following the visual flow of the page as described above?	Sometimes	Under main screen's search box, the keyboard then navigates right to left for 'Saved searches' and 'Saved history'. Navigation then resumes left to right.	No Images
When using a keyboard to navigate the interface, is the keyboard focus indicator visible?	Sometimes	Sometimes the visual indicator disappears.	No Images
Does all interactive functionality work via keyboard, and does it behave consistently and as expected?	Sometimes	The "Browse" and "Tools" menus in the Clinical References section, will not close automatically after being opened. They stay open and block other content after focus has moved away, unless the user returns to close them. "Saved searches" and "saved history" are right to left should be left to right (under the search bar) The keyboard navigation on a brand new page starts at 'Contents' section of the page, instead of the top left section of a page with skip links.	No Images
Does focus order move sequentially across form fields?	Always		No Images

Skip Links

Question	Answer	Notes	Images
Are there skip links (either visible or invisible)?	Always	Invisible	No Images
Are skip links visible or invisible?	Always	Invisible	No Images
Are skip links (visible or invisible) positioned prominently near the beginning of the page?	Always		No Images
Are skip links labelled properly?	Sometimes	"Skip to search" goes to the Question mark icon with "Help" and "Contact" options. It does not go to any search fields. This is not an intuitive label.	No Images
Are skip links accessible via keyboard?	Always	Yes, these are accessible via keyboard, but the user must navigate backwards to get to the skip links. A newly opened page does not have the keyboard focus start automatically from the skip links.	No Images
Do anchors (link destinations) appear at the beginning of the relevant content?	Always		No Images
Do skip navigation controls appear in the same place on every page?	Always		No Images

Tables

Question	Answer	Notes	Images
Does the reader capture accurate information as it appears in the table and the columns and rows?	Always		No Images

Frames

Question	Answer	Notes	Images
Does the screen reader successfully navigate from one frame to another?	Sometimes	There are frames ("Filter by" , "Featured books"), but the user cannot jump from frame to frame, you can only scroll through the entire frame, item by item, until you get to the next frame.	No Images
Does each frame have a meaningful title that tells the user the purpose of the frame?	Sometimes	"Filter by" and "Featured books" do have headings, but the other areas do not have titles.	No Images
When navigating the page using keyboard navigation, is the user able to navigate effectively from one frame to the next?	Never	There are frames ("Filter by" , "Featured books"), but the user cannot jump from frame to frame, you can only scroll through the entire frame, item by item, until you get to the next frame.	No Images

Key Findings

Weaknesses

PDFs are searchable but not tagged
Other

PDFs

Searchable PDFs

Question	Answer	Notes	Images
Are the sampled PDFs image-only?	Never	Can highlight and paste all text	No Images
Are the sampled PDFs locked (secured)?	Never	PDFs are not locked	No Images
Are the sampled PDFs fully searchable?	Always		No Images

Tagged PDFs

Question	Answer	Notes	Images
Are alternative descriptions provided?	Never	If images etc. are tagged, then they do not have appropriate alt descriptions (ie. "Image of Fig 3")	No Images
Is primary language specified?	Sometimes	Half of the PDFs that were checked (10) had the primary language specified.	No Images
Is reliable character encoding provided?	Sometimes	Very few PDFs passed the character encoding.	No Images
Are all page elements tagged?	Sometimes	Some PDFs are not tagged at all. When tags are included, the information (or alt text) is vague and provides no helpful information.	No Images
Are list and table structure correct?	Sometimes	When a PDF contains a table or list, the list and table structure is not always tagged properly.	No Images

Structure: Reading Order

Question	Answer	Notes	Images
Does the Read Out Loud function read the PDF in a logical way, preserving the order of the text and various sections?	Sometimes	The Read Out Loud function, reads normal text right to left as expected. Occasionally the columns within a journal article would read footer before it would jump to the second column. Occasionally would get "warning empty page" when the page was only filled with images (those were not tagged or labeled).	No Images
Does the Read out Loud function avoid problematic elements such as excessive blank spaces read as “blank”?	Sometimes	Sometimes entire document would get "warning empty page" and would not read the text out loud even though the text can be copy/pasted and is searchable.	No Images
Are the controls consistent and effective for navigating through the document?	Always	Used Read-Aloud built in navigation tool for best experience.	No Images

Magnification

Question	Answer	Notes	Images
When zooming in to 250%, does all text, images, tables, and other elements appear clear and easy to read?	Always		No Images

Images

Positioning of Images

Question	Answer	Notes	Images
Are the images positioned prominently and easy to find?	Always		No Images

Alternative Description

Question	Answer	Notes	Images
Do informative images contain appropriate alt text or an appropriate textual alternative?	Always	Informative Images did not contain alt text, but they would have an appropriate textual description written underneath.	No Images
Do images used as titles contain appropriate alt text or an appropriate textual alternative?	Not Applicable	Did not find any images used as titles.	No Images
Do rich images contain appropriate alt text or an appropriate textual alternative?	Sometimes	Some rich images had descriptions. No alt text	No Images

Tables

Question	Answer	Notes	Images
Are tables tagged and described with in-text summaries where appropriate?	Never	PDF tables are not tagged. There are no in text summaries available to describe the content of the tables.	No Images
Do table headers allow for easy navigation with screen readers?	Never	There are no table headers.	No Images

Additional Navigational Aids

Question	Answer	Notes	Images
Does the bookmarks panel display bookmarks?	Always		No Images
Do bookmarks link to the correct sections in the document?	Always		No Images

Video Captions

Question	Answer	Notes	Images
Are videos captioned?	Sometimes	Subtitles and Closed captions are not available within the Clinical References procedural videos. Closed captions are available within the Study Resource videos These sections both use a different players.	No Images
If captions are closed, and need to be turned on by the user, is that process straightforward and intuitive?	Always	When CC are available, they are already turned on. The process to turn them on and off is straightforward and intuitive.	No Images
Are captions typo-free and grammatically correct (unless slang and grammatical errors are intentionally used in the video)?	Always		No Images
Does caption placement avoid blocking any important visual components necessary to understand the video?	Always		No Images
Are the captions in sync with spoken words?	Always		No Images
For videos that contain captions, are transcripts provided?	Never	Transcripts are not provided.	No Images
For videos that do not contain captions, are transcripts provided?	Never	Transcripts are not provided.	No Images

Described Video

Question	Answer	Notes	Images
Do videos include described video, or if not, is there a text equivalent of the video provided on the same page or via a link?	Never	Described video and a textual equivalent are not available.	No Images
If the video includes described video or a text equivalent of the video, is it an accurate description of the video contents?	Not Applicable	Described video and a textual equivalent are not available.	No Images

Audio Accessibility

Question	Answer	Notes	Images
Is a link to a text transcript provided in reasonable proximity to the audio clip?	Not Applicable	Cannot find audio only clips	No Images
If a transcript is provided, does it accurately capture the content of the audio?	Not Applicable	Cannot find audio only clips	No Images

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