Usability is understood as a critical component to the success of electronic health records and other related healthcare technologies. Usability testing methods routinely employ scripts that help researchers understand how a particular tool works under real world conditions. This scoping review sought to better understand the guiding frameworks, principles, and methodologies employed when generating usability testing scripts to better understand how script generation occurs. Three main themes emerged through qualitative analysis: researchers sought to observe the baseline functionality being tested, the most representative tasks, or the most complex tasks. This scoping review highlights a lack of consistent processes in usability test script generation. There is a need to create standardized usability testing scripts for usability testing.