Author
Charlie Exley Abstract
This paper presents valuable insights gained from technical experience in applying company Human Factors Engineering (HFE) specific standards to assess engineering designs within the oil and gas sector. The focus is on highlighting the value provided and limitations faced during technical HFE design reviews, offering a comprehensive showcase of findings that contribute to a deeper understanding of the challenges and successes encountered in the process. The lessons presented in this paper provide valuable guidance for professionals and organisations involved in similar endeavours.

Author
Graham Sabine & David J Thompson Abstract
The Interactive Measures of Performance and Assessment of Cognitive Tasks (IMPACT) tool; developed to provide defence with a reconfigurable, repeatable, and scalable battery of military orientated tasks. The design, development, validation, early exploitation, and future use are discussed briefly in this paper.

Author
Yuzhi Pan and Chris Baber Abstract
We presented probability problems to two Large Language Models (LLMs) and asked human judges to evaluate the correctness of the outputs. Neither LLM achieved 100% on the questions but participants did not always spot the errors these made. Two types of human error were identified: i. the LLM answer is correct, but the participant thought it was wrong (especially with the smaller LLM); ii. the LLM answer was wrong, but participants thought it was correct (especially with the larger LLM). Participants tended to trust the LLM when they were unsure how to answer a question and the LLM provided an answer that seemed reasonable and coherent (even if it is actually wrong)

Author
Mahnaz Sharafkhani, Mary Browne, Margaret Codd, Angela O’Dea, Dorothy Breen, Dara Byrne, Maria Chiara Leva, Siobhán Corrigan, Sam Cromie, Eva Doherty, John Fitzsimons, Una Geary, Samantha Hughes, Cora McCaughan, Nick McDonald, Gemma Moore, Maureen Nolan, Paul O’Connor, Leonard O’Sullivan, Lorraine Schwanberg, David Vaughan, Marie E. Ward Abstract
Healthcare Human Factors / Ergonomics (HF/E) involves the rigorous application of multiple academic disciplines (e.g. engineering, psychology) with the aim of improving patient safety, quality of care, efficiency, and staff wellbeing. This paper discusses the establishment of a research collaboration of interested HF/E researchers, academics, frontline staff, quality and patient safety (QPS) practitioners and patient and public partners (PPP) and reports on a snapshot of the HF/E different activities being undertaken in the Irish healthcare system over the past 5 years (2018-2023).

Author
T Hyat & A Monk Abstract
An accident investigation framework has been introduced into the GB rail industry's safety management intelligence system (SMIS) to understand the immediate and underlying causes of SPAD events. This paper will show the process of reporting detailed causes, the challenges of introducing this framework into operational environments and an analysis of the causes of SPAD events.

Author
Emily Thorne, Dr Stuart Smith Abstract
This paper explores how the client/consultancy partnership enabled effective Ergonomics/Human Factors (E/HF) integration for the concept design of the Washwood Heath (WWH) Depot rolling stock depot for High Speed 2 (HS2). Exploring lessons learnt from this case study intends to highlight examples of “best practice” for effective E/HFI and discuss practical tips and tools for implementation which may be transferrable to other projects, and sectors beyond the rail sector.

Author
Erinn Sturgess, Victoria Steane & Mark Chattington Abstract
This paper introduces the Interactive Measures of Performance and Assessment of Cognitive Tasks (IMPACT) tool, a new cognitive test battery for defence human sciences practitioners. The paper describes a comprehensive research study adopting a multi-method approach using a range of subjective and objective measures of human performance and cognitive states (including functional Near Infrared Spectroscopy; electrodermal activity; heart rate variability; gaze metrics; subjective workload; task performance and subjective situational awareness) to validate the assumptions made about IMPACT’s ability to elicit a number of cognitive properties. A brief overview of the findings is presented demonstrating the potential of the tool to elicit different behavioural outcomes based on task load manipulation – an important first step in understanding the construct validity of the IMPACT tool for human sciences practitioners moving forward.

Author
Susmitha Cherukuru Lakshmipathy Abstract
This paper explores the potential benefits and limitations of upright therapy compared to the traditional supine approach, focusing on the human factors perspective. The research is based on a combination of literature review, workshops with patients and clinicians, and ergonomic analysis. Upright therapy shows promise as a potential alternative to supine therapy, offering benefits for both patients and clinicians. Further research is crucial to fully understand the benefits of upright therapy for effective treatment approaches for various conditions and adaptability across various treatment conditions and requirements.

Author
Clare Y Crowley, Rosemary H Lim, Nick Woodier, Scott Hislop Abstract
There is inequity in the care of adults with a learning disability, urgently admitted from a community to an acute hospital setting. Functional Resonance Analysis Method (FRAM) was used to identify and describe how everyday care is usually provided (work as done), variability in performing core functions (tasks), understand the potential impact of output variability, and indicate where action to improve the system might best be focussed. The FRAM model developed consisted of 15 interdependent core functions, with differing types and sources of variability in the function output, showing a high level of complexity. Six key factors were identified that may contribute to variability in the care commonly provided to this cohort. Three common adaptations to the care processes were reported.

Author
Arielle Vriesekoop-Beswick, Charlotte Kaul & Marcus Carmichael Abstract
Train drivers must have extensive knowledge about the features on each route they drive, called ‘route knowledge’. The upgrade of signalling systems from lineside signals to in-cab signalling changes key driving tasks and the requirements for route knowledge. This project sought to understand the route knowledge requirements for drivers under the in-cab signalling system European Train Control System (ETCS) and to update the industry guidance.

Author
Haotian Yi, Gyuchan Thomas Jun, Diane Gyi & Samar Betmouni Abstract
The hexagonal socio-technical framework was employed to understand the complex system of digital pathology (DP) workflow and artificial intelligence (AI) application while identifying the complex human factors challenges within the DP and AI integration process.

Author
Katherine L. Plant, Richard Bye, Katie J. Parnell, Craig K. Allison, Jade Melendez, Neville A. Stanton Abstract
This work presents a collaboration between [an academic] and [industry partner] to help improve safety at level crossings by developing a deeper understanding of how people behave at them. Using the theoretical foundations of the Perceptual Cycle Model (Neisser, 1976) to generate behavioural insights from workshops, interviews and field observations, the work aims to create decision support tools for level crossing managers, engineers, safety teams and investigators. The resulting human factors toolkit will inform hazard analysis, system design and behavioural interventions that will put level crossing users—and their needs, goals and behaviours—at the centre of activities to improve system safety.

Author
Brook Howells Abstract
The Patient Safety Incident Response Framework (PSIRF) launched in 2022 aims to improve healthcare safety through improved learning from incidents. Effective investigations are a critical part of safety management and one area that requires further research is in how incident analysis can take a safety-II approach to understand how systems adapt to maintain safety and what enables operational staff to have positive adaptive capacity. This study utilised appreciative inquiry to assess the work as done of investigators, in particular relation to how they identify positive adaptive practices. Qualitative interviews with investigators and safety specialists from safety-critical industries were used to identify current methods and practice, plus perceptions of how safety-II might be enabled in investigations. The main findings were that investigators already identify positive adaptive practices by operational staff, although it is not a priority focus and minimally reported. There was less evidence that current practice facilitates greater understanding of factors that enable positive adaptations. The diversity of investigation methodologies used and the value of multi-disciplinary investigation teams was a common theme. The impact of safety-II on kindness – both within investigations and for wider cultural change – was also a key finding, although there was variation between industries that merits further analysis. This study has implications for how investigative practice and skills are taught and refined, and how safety-II might be integrated within wider safety campaigns.

Author
Victoria Villalobos-Molina, Paulina Hernandez & Eric Tapia Escobar Abstract
The present paper outlines the trend of exposure to psychosocial risks in companies from various industrial sectors affiliated with a mutual insurance company in Chile. This report is part of a longitudinal descriptive study conducted using secondary data from 1,568,340 records collected between 2014 and 2022. The findings show a general trend indicating a decreasing exposure to psychosocial risks, particularly significant in the dimensions of "Psychological Demands" and "Social Support". However, the results in the double presence dimension remain concerning. Although the psychosocial risks surveillance protocol implemented in Chile shows positive results, there is still a relevant group of workers that needs a more targeted intervention.

Author
David Golightly , David Ethell & James Lonergan Abstract
Previous research has identified that the complexity of freight yards – layout, capacity, access and local physical context – is one factor that impacts the safe performance of freight yard tasks. We present the rationale, method and contents of a tool that makes explicit the definition of site complexity, and elements that comprise site complexity. Applications of the tool include site risk assessment, impact assessment of operational change, and potential to underpin a design standard.

Author
Declan Saunders, Kyle Hu & Wen-Chin Li Abstract
This study investigates the feasibility of a generative-pre-trained transformer (GPT) to analyse aviation accident reports related to decision error, based on the Human Factors Analysis and Classification System (HFACS) framework. The application of artificial intelligence (AI) combined with machine learning (ML) is expected to expand significantly in aviation. It will have an impact on safety management and accident classification and prevention based on the development of the large language model (LLM) and prompt engineering. The results have demonstrated that there are challenges to using AI to classify accidents related to pilots’ cognitive processes, which might have an impact on pilots’ decision-making, violation, and operational behaviours. Currently, AI tends to misclassify causal factors implicated by human behaviours and cognitive processes of decisionmaking. This research reveals the potential of AI's utility in initial quick analysis with unexpected and unpredictable hallucinations, which may require a domain expert’s validation.

Author
Wu Xiaoli, Zhang Lan, Huang Xiaoli Abstract
SAP system, as a typical production management system, has great advantages in operation monitoring and production management, which has the characteristics of rapidly processing massive data and integrating information modules. However, in terms of human-computer interaction, the presentation of massive data is prone to an increase of cognitive load of users. The disorderly connection of information makes the user's misunderstanding of interface information, and it is also easy to add unnecessary operation steps. The SAP system information data of an enterprise was selected as the sample to optimize the information organization and presentation. It analyzed the production management task process for different types of users, and built an information association architecture for them based on the task domain model. The results show that the information association structure of purchasing engineer, planning engineer, quality engineer and manufacturing engineer established according to the task domain model can intuitively show the hierarchical relationship, importance and task flow of production data information under the real-time monitoring of SAP system, which is conducive to improving the work efficiency of users.

Author
Em Thorogood, Joy McKay & John Preston Abstract
Interest and investment in Mobility as a Service (MaaS) is expanding, and the technology is anticipated to play a key role in affecting behavioural change towards more sustainable personal transit choices on a societal level. As yet there is little published research on the prioritisation of various in-app features with respect to their impact on user experience (UX); an important consideration if stakeholders are to achieve the widespread uptake of MaaS needed to realise their broad environmental and social aims. We examine the impact of the absence of turn-by-turn navigation; analysing data from a set of user trials to identify the uptake implications of this deficit.

Author
Ousmane Diack, James Blundell & Wen-Chin Li Abstract
The safety net, made of a set of alarms, is considered the final Air Traffic Management (ATM) protection to prevent an accident. The prevalence and causes of false Short-term Conflict Alerts (STCA), an alarm intended to represent one of the final safety barriers, was investigated based on the occurrence of 315 STCA events generated by a Western African Upper Airspace ATM system over an 11-month time period. Based on subject matter expert review, 313 STCA events (99.9%) were classified as false alarms. False STCA were caused by a combination of technical (aircraft position sensor fusion misalignment) and human attributes within the system. Furthermore, a survey with 26 ATCOs on the cognitive and behaviour effects elicited by the experience of false STCAs revealed that 73.08% of ATCOs experienced increased workload. Whilst 38.46% reported a reduction in situation awareness. Results of the analysis of the retrieved data on the STCA suggest that implementing efficient system integration of different sensors and reducing human error will reduce workload, and improve ATCO’s situation awareness and overall ATM system efficiency.

Author
Katie J. Parnell Abstract
There is a historic ‘gender-data gap’ in transportation research, which has led to a male-bias in the design, experience and development of the transport industry. Electric micromobility is still a relatively new mode of transportation which offers an opportunity to study the mode from a gender balanced perspective, preventing a gender data gap and reducing biases. A literature review was conducted to review the sampling of participants across 296 studies into e-micromobility. The findings suggest that the male-bias in data collection has persisted into this new domain. The impact that this has on this area will be considered alongside providing areas for future research.

Author
Craig Foster, Katherine Plant & Rich McIlroy Abstract
In the last 20 years, new theories, ideas, and disciplines of safety have emerged to address the evolving nature of safety management in complex sociotechnical systems. The literature increasingly recognises the importance of adaptation; whereby the people in the system use their skills and experiences to make continuous, real-time demand compensations to ensure safety through trade-offs, self-organisation, informal practices and strategies. This paper presents the results of an investigation into the nature of adaptation and the emerging understanding of the role it plays with reference to the safety of UK air traffic control.

Author
Samantha L. Jackson, Gemma J. M. Read, Adam Hulme, & Paul M. Salmon Abstract
This systematic literature review identified peer-reviewed applications of systems HFE methods to determine the range of problems examined and how the methods have been applied. The review revealed a growth in applications of systems HFE methods over time. The review suggests that as problem and system complexity continue to intensify, continual evaluation and potential adaption of methods may be required, including using more than one method.

Author
W. Huw Gibson, George Raywood-Burke, Chris Baber, Andrew Leggatt, Simon Attfield, & Donna Amey Abstract
Distributed sensemaking (DSM) is an important concept in the development of command and control for the future military operating environment. Following from earlier work developing DSM principles and DSM measures, this paper reports on a lab-based experiment which collected data on approaches to support DSM.

Author
Sam Farrar, Samantha Halstead, Callum Thomas & Patrick Ellis Abstract
This paper sets out to present several key Success Factors learned from the coordination and management of Human Factors Issues and Assumptions Register (HFIAR) administrative process’ within the Nuclear Sector. The paper seeks to explore notable themes identified within HFIAR management and detail how the process can be suitably implemented to provide successful Human Factors (HF) Issues management to Nuclear Industry Clients.

Author
Ben Wright, James Blundell, Wojciech Tomasz Korek, & Wen-Chin Li Abstract
The following preliminary study uses subjective measures of situational awareness, workload, and system usability to assess the effect of touchscreen flight deck displays in simple and complex flying environments during a simulated flight task. Eighteen participants were evaluated whilst flying a simulated aircraft, conducting both simple and complex flight operations. Results showed that situational awareness improved, and perceived workload was maintained, when task complexity was increased during touchscreen interaction on the flight deck. This was likely driven by touchscreens providing increased attentional supply. This improves the flight deck humanmachine interface (HMI) from a pilot-centred perspective by improving access to task-relevant information. There was no significant change in levels of touchscreen usability as flight task complexity increased, once again ratifying the use of touchscreens in assisting cognitive function in some task types. The application and limitations of these findings is discussed.

Author
Jenny O’Donnell, Nic Steevenson & Paul Bowie Abstract
This paper highlights the presence of reductionism and consequent blame within safety investigation reports across multiple high-reliability industries. It discusses the use of an innovative Learning Response Review and Improvement Tool, (LRRIT, referred to as the ‘Tool’ in this paper) initially developed for healthcare safety improvement (HSSIB, 2023). This Tool helps to shift the focus from the person, at the sharp end, to drive impartiality and systemic learning in safety investigation reports.

Author
Judy M. Watson, Gemma J. M. Read, Don Kerr & Paul M. Salmon Abstract
Responding to identity theft incidents is complex however our current understanding of the response system is limited. This study applied a systems analysis with the aim of identifying the actors that share the responsibility for victim outcomes following identity theft incidents in Australia. The findings identify a diverse set of 60 actor types involved in the response process and emphasise the lack of a single ‘one-stop-shop’ point of contact for victims. Recommendations for improvement are suggested.

Insert here Author
Darren Doyle, & James Blundell Abstract
The severity of performance shaping factors on human factors (HF) practitioners from safety critical industries in the United Kingdom (UK) is examined. Based on a Human Factors Analysis and Classification System (HFACS) survey, 32 HF practitioners reported that organisational influences were the most disruptive encountered PSF with the vocation (p < 0.01), compared with supervisory and workplace pre-condition factors. Follow-up semi-structured interviews with 5 participants highlighted these organisational PSFs could be attributed to the misperception of the HF role and value within organisational structures, contributing to the perception of HF receiving insufficient budgetary and organisational priority. Furthermore, participants viewed these PSFs to be significantly detrimental to their own well-being and to both the current and prospective health of discipline. Recommendations to address these issues are discussed.

Author
Leanne Verwey, Anna McLister, Urszula Wlodarczyk, Venea Calcot, Chloe Roberts, Molly Smyth & A C B Medeiros Abstract
Usability assessments on medical devices where participants are required to simulate the use of the device and share information about sensitive topics, such as intermittent catheter, ostomy bag or pelvic floor trainer use, can be challenging. This paper explores some of these challenges and how to address them.

Author
Frances Ives, Helen Hunt, Katherine Reynolds & Zamira Jaffer Abstract
Point of Care Ultrasound Scanning (POCUS) is a procedure commonly used at the patient’s bedside, often within acute medicine to aid assessment and management of patients. A Human Factors project was undertaken to consider the implementation of POCUS to improve the diagnosis, treatment and management of Paediatric Haemophilia Patients with suspected joint bleeds. A Human Factors approach was used to support the implementation to ensure a systematic approach was taken to ensure the feasibility, usability, viability, scalability and sustainability was considered. Human Factors data gathering and observations were conducted to fully understand the current patient pathway and to understand how POCUS could be implemented to benefit both staff and patients. By using a Human Factors approach and considering the work system fully, it is anticipated that any potential disadvantages of the new technology are identified and addressed prior to full implementation. The project is currently in the pilot phase with staff trained in the use of POCUS and trialling equipment alongside the original pathway. It is anticipated that benefits to staff, patients, their carers, families and the NHS Trust will be identified.

Author
Aimee M D Ferguson, Rosemary Newham, Emma Dunlop, Kate Preston, Marion Bennie Abstract
The discipline of human factors plays a crucial role for the design, implementation, and evaluations of use of teleconsultations in primary care. This paper provides an overview of a PhD project which used the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model (Holden et al, 2013) to synthesise previous applications of human factors in this area; explore the facilitators and barriers to the use of video consultations in primary care pharmacy services in Scotland; and to understand the extent to which existing video consultation guidance considers each component of the current work system.

Author
Graham Sabine & David J Thompson Abstract
The Interactive Measures of Performance and Assessment of Cognitive Tasks (IMPACT) tool; developed to provide defence with a reconfigurable, repeatable, and scalable battery of military orientated tasks. The design, development, validation, early exploitation, and future use are discussed briefly in this paper.

Author
Steph Simpson Abstract
This paper presents a series of observations of the hazards and challenges faced as part of the cleanup of the UK’s Nuclear Licensed Sites after decades of electricity production. In some hazardous environments, the dynamic decision making of humans is often preferable to the use of robots, however this does not come without risk. Protective equipment, whilst absolutely necessary to reduce the risks to the operator, can impact their performance when undertaking decommissioning operations. Human Factors and Ergonomics play a critical role in ensuring these tasks are undertaken safely, reliably and efficiently.

Author
Suganth Rajendra Kumar Abstract
This paper proposes a novel approach titled ‘New product development integrated with usability’ which integrates usability within the product development cycle of a new product. This approach primarily caters to new products in the rail industry, however can be applied to other sectors also. The approach was developed on the basis of the lessons learnt from a usability study conducted as part of the development of a new Rail Traffic Management software in the U.K. The approach details a series of steps to design and conduct usability studies such that the impact on user satisfaction, system effectiveness, and overall business outcomes is highlighted earlier in the design cycle. This approach is likely to result in ample opportunities to recommend and implement changes with relatively minimal impact on the product development cycle.

Author
Lamyea Ahmed, Michael A. Bromfield Abstract
The need for sustainable aviation has accelerated the development of electric aircraft and propulsion systems. These systems generate less noise compared to conventional piston engines (Moshov & Toropylina, 2022) and provide limited cues to the pilot in the event of a propulsion system’s failure. Not recognising powerplant failure and taking prompt recovery actions in a timely manner may lead to aerodynamic stall and loss of control in flight (Smith & Bromfield, 2022). This research aims to explore how multimodal presentation of electric propulsion system information affects pilot response times during propulsion system failure. A human-centred design approach was employed to develop multimodal presentations of data, incorporating visual, auditory and visual/auditory feedback in combination. Simulated flights were conducted in a fixed-base flight simulator, using control and experimental groups consisting of student pilots (n=eight). Preliminary results indicate that pilot response times are reduced when using a combination of visual/auditory information.

Author
Siddharth Shyamsundar Abstract
Drawing on research spanning multiple decades, different platforms and use cases, this literature review provides an in-depth overview of Field of View (FOV) in fixed wing military aviation Helmet Mounted Displays (HMDs), focusing on its human factors (HF) and performance implications. Expanding on the capabilities of human vision, it highlights how FOV and human vision are interlinked and why the current fixed wing HMD FOV standard is inadequate, failing to leverage the far-reaching capabilities of the human eye. This paper delves into both the preeminent FOV perspectives – the “as small as possible” and the “bigger the better” approaches, and identifies a “middle ground” of horizontal FOVs between 60° and 90°, where the benefits of wide FOV HMDs are at their most advantageous. Using this as a starting point, this study calls for the development of a wide FOV HMD for fixed wing military aircraft to include empirical HF research using appropriate use cases while accounting for platform and sensor capabilities and mission sets.

Author
Raphaël Chirac, Herimanana Zafiharimalala, Arturo Martinez-Gracida, Franck Cazaurang & Jean-Marc Andre Abstract
In this article, we present the methodology we developed to propose an original model of mechanics' risk perception adapted to the aircraft maintenance field. We have identified 20 concepts that can be mobilised to build the model. To focus our study on a limited number of targeted concepts, we carried out a 4-stage selection process. As a result, the model was reduced to 4 factors and 3 measures of risk perception.

Author
Giulia Miles, Eva-Maria Carman,Upasana Topiwala, Benjamin Warren, Sasha Blackwood & Steve Cantellow Abstract
Wellbeing of healthcare staff has been highlighted as a key issue across clinical professions and a focus on professional wellbeing allows us to identify and better understand the system performance shaping factors that affect individual clinicians and ultimately patient care. This paper describes the method of selecting and applying a validated wellbeing tool in a large acute NHS hospital trust as part of a wider project looking at system monitoring tools.

Author
Kevin Hayes & Daniel Boardman Abstract
An F-35B Fighter Jet belonging to the Royal Air Force ditched in the Mediterranean Sea on 17 November 2021 during an aborted take-off from the aircraft carrier HMS Queen Elizabeth (DSA, 2023). While the aircraft was recovered from a depth of two kilometres, all components were found to be beyond economic repair and the airframe was deemed a total loss. The subsequent safety investigation conducted by the Defence Safety Authority determined the causal factor to be that the left intake blank was at the front face of the engine compressor during the aircraft launch. This paper sets out the latent issues with the design of the intake blank and how they combined with a number of local and organisational Human Factor issues to create the conditions in which this accident occurred.

Author
Nicola Legg Abstract
Fatigue has long been known as a risk to safe human performance across many industries, in the UK. However, in 2019, it had not been considered as a risk factor within the gas distribution network industry. This paper summarises some of the work that has taken place so far to implement a Fatigue Risk Management System into an organisation and begins to reflect on what worked well and what needed reflecting upon and revising.

Author
Siddharth Shyamsundar Abstract
Despite having significant human factors (HF) implications, latency in military aviation Helmet Mounted Displays (HMDs) is often seen as purely an engineering problem. This systematic review provides an overview of latency in HMDs, highlights the adverse impact it has on key HF and pilot performance metrics and outlines current latency thresholds and how they may not be relevant to the military aviation context. Drawing from extant literature, this paper provides recommendations for HF involvement, research and technology application in the development of low latency HMDs. It serves as a call to action, promoting significant HF involvement within a multidisciplinary, collaborative approach to exploring latency in the development of future military aviation HMDs.

Author
Robert J. Houghton & Karen Lancaster Abstract
We discuss the importance of “not knowing” as a design imperative in digital and automated systems with examples drawn from a range of different settings together with discussion of how this might be responsibly addressed based on analysis using E/HF methods. Reflection is also offered on situations where the temptation to ignorance should not be acted on in design terms - or simply ignored - but embraced as a sensitive heuristic tool for detecting wider system design challenges made salient by digitalisation.

Author
Rebecca Charles & John Stewart Abstract
Accident investigation requires a structure and framework within which to determine why an accident happened. The Rail Accident Investigation Branch (RAIB) promotes that causal analysis (CA) will be the backbone of its investigation activities. It will capture the logical structure of how events came together to result in the accident. It will also drive the evidence collection and interview strategies by defining what is necessary and relevant to understand the causality. RAIB recognises that there are many CA tools and techniques and encourages use of the most appropriate tools for each investigation. However, it is important to RAIB to define a discipline framework within which the relevant tools are applied and to strive for consistency in this across all investigations. Historically, there has been some variability in this. To achieve this consistency, it is necessary to understand the variability in understanding of CA processes and techniques by inspectors, how they have applied them and the challenges they have faced. To that end, 21 inspectors of varying experience were taken through a structured interview and the key issues elicited. These have been used as the basis for a revision to the RAIB’s approach to CA and its implementation.

Author
David R. Large, Cath Harvey, Emily Shaw, Sparsh Khandeparker, Gary Burnett, Elizabeth Box Abstract
We highlight exemplar behaviours elicited through the observation of driver-passenger interactions in a multiple journey driving simulator study, demonstrating both distractive and protective effects when a front-seat passenger is present during SAE level 3 automated driving.

Author
Lisa Aldridge, Jediah Clark & Mark S. Young Abstract
Whilst maintaining safety remains the top priority, the UK needs to increase the number of aircraft that can fly through its airspace. This study uses task analysis to identify a set of performance metrics that will support air traffic controller training, inform airspace and technology design, and support operational decisions that balance the number of aircraft that can fly through UK airspace. A literature review, a review of existing task analyses and a set of workshops with controllers were conducted. The study concludes that measuring the performance of air traffic controllers holistically and continuously, using objective measures of task performance, is relatively unexplored.

Author
Dhwani Oakley, Esme Flegg, Sam Hodder, Katrina Kemp & Ruth Taylor Abstract
This paper presents a novel methodological approach to safety regulation for the maritime sector. It describes the use of ‘serious gaming’ to explore the impact and support the implementation of emerging and future technologies in the policy-making process. The development and application of the ‘serious gaming’ framework is described and demonstrates the potential benefits of applying a design-led approach to policy development in enabling innovation, contributing to regulatory change, and delivering improved outcomes for seafarers, industry, and the wider society.

Author
Andy Brazier Abstract
Encouragement for us to understand the reality of work is creating a focus on the circumstances in which tasks are performed rather than challenging the work itself or whether best practice is being achieved. Human factors has tools and deeper understanding that could be used to drive more fundamental improvement. However, in some sectors at least, catchy buzz words are causing distractions that mean that the opportunity for human factors to prove its worth being missed. The process industry is one example where frontline workers manage risks on a nearly continuous basis supported by engineers working more remotely who have clear technical bias. Human factors has achieved a toe hold but its scope is often limited. This may not be a universal issue but medicine seems to be another sector where human factors has yet to achieve what it could.

Author
Niamh Tyson & Emily Thorne Abstract
A systematic literature review was conducted to synthesise research into Human Factors Integration and holistic risk management in the implementation of ETCS across Europe. The review highlights a lack of accessible literature in this field and makes several recommendations to bridge the gaps in knowledge and inform best practices in the UK. The importance of fostering collaboration within our discipline and developing new avenues for sharing lessons learned beyond traditional channels is highlighted throughout.

Author
Clare Parker & Carina King Abstract
This paper outlines the Human Factors (HF) integration work that was undertaken at a Sellafield Limited (SL) nuclear waste management facility in the north of the UK. The project consisted of the design and build of a new facility to store Intermediate Level Waste (ILW). The work was delivered by HF specialists at Risktec Solutions Ltd (Risktec) and involved multiple HF activities. A local operability review is presented as a case study that considered the environmental aspects of the new facility. This paper demonstrates the importance and impact of HF integration on a large-scale project.

Author
Barry Peter Kirby Abstract
The Universal Battle Trench (UBT) project is an initiative to develop a novel, rapidly deployable trench system aimed at enhancing the safety and operational efficiency of military personnel. When the project was still in its early conceptual phase it incorporated Human Factors (HF) expertise to guide its early evolution. This involved a task analysis, modelling utilising 3D printing, trials, and an Early Human Factors Assessment, which facilitated early design changes, enhancing safety and cost-effectiveness.

Author
Molly Murphy, Teegan Bowker, Emily Thorne, Steven Newton & Daniel Jardine Abstract
High hazard industries require the consideration of Human Factors in designing methods to mitigate health and safety risks. Robotic solutions in the nuclear industry can improve operator safety through remote teleoperation, however, for these solutions to be successful the human must be considered. This paper presents a Human Factors review of one of these solutions and has received promising usability results whilst identifying areas for future system development – including improvements to the trolley used to move the robot, and recommendations for a comprehensive training program for familiarisation.

Author
Grainne Kelly, Patrick Waterson, Mike Fray Abstract
The paper summarises a study about the work of occupational health and safety consultants (OHSCs) with SMEs (Small and Medium Enterprises). The aim was to identify the factors influencing the effectiveness of their assignments and the practical actions that can increase the chances of success. The results led to the development of a workflow model for OHSC interventions, categorizing the aspects that require emphasis at different stages to increase the chances of a successful outcome.

Author
Steven Shorrock, Tony Licu, Radu Cioponea & Barry Kirwan Abstract
For over 20 years, EUROCONTROL and its partners have pioneered efforts to promote Just Culture at the corporate and judicial levels in aviation and beyond. Human Factors has been integrated into this effort in a variety of ways. This paper outlines three areas in which Human Factors concepts, theories and methods have been integrated: 1. Just Culture at the judicial level; 2. Just Culture at the organisational level in aviation; and 3. Just Culture in the wider world.

Author
Victoria Cutler, Caitlin Moore, David Taylo, Beata-Noemi Balint, Rhys Hunt & Mayowa Olonilua Abstract
This research identified the Human Factors (HF) considerations associated with using Extended Reality (XR) systems for military training, by applying the UK Ministry of Defence (MOD) Early Human Factors Analysis (EHFA) methodology. Fifty-five HF considerations were identified, addressing user characteristics, equipment design, and organisational processes. Specific actions were recommended to address the identified HF considerations and support effective use of XR in training delivery.

Author
Martin Redford Abstract
Lighting of Industrial Control Rooms may disrupt natural circadian rhythms, affecting the health and wellbeing of operators. Human Centred Lighting (HCL) is designed to mimic the natural dark/light cycle, maintaining alertness and to reduce adaptation to night work and therefore avoid a phase delay of the circadian rhythm. Research has emphasised the part played by melanopsin in regulating the production and suppression of melatonin which is directly linked to circadian rhythms. Using the refurbishment of a control room as a case study, the implementation of a HCL design to support circadian rhythms and health and wellbeing of control room operators is illustrated.

Author
Carlotta Vorbeck, Dominika Brzoska-Corenthy, James Thompson & Jodie Lewis Abstract
Gathering meaningful insights from data is a challenge faced by many organisations. In high-hazard industries data is crucial when it comes to identifying and understanding weak signals. These weak signals are important because they can indicate a problem and provide an opportunity for early intervention before an accident or incident occurs. As human factors specialists, when working with organisations to improve safety performance, our projects often involve review and interpretation of data. In this paper we share practical learnings and considerations at each stage throughout the data lifecycle, to maximise the insights that can be gained from health and safety data.

Author
Yifan Ding, Setia Hermawati Abstract
The effects of explainability on perceived trust, transparency, acceptance and usefulness were explored in a within subjects’ study (n=15) using an online shopping recommender system as a context. The study investigated three levels of explainability (low, medium, high) and perceived transparency, trust, acceptance and usefulness were obtained using standardised questionnaires.

Author
Ian Pemberton & Domonic Mooney Abstract
This study involved conducting a cognitive task analysis (CTA) based learning review of a serious accident that occurred at a British Sugar manufacturing plant in the UK. Exploration of the cognitive work, through the use of cognitive task analysis (CTA), delivered deeper understanding of the contributing factors to the accident, and helped to extend significantly the learning beyond that gained through the existing accident investigation. The results of the CTA interviews also provided content for scenario-based training, called decision-making exercises (DMX), which were shown to be effective in developing the tacit cognitive skills that contributed to this accident. This study provides convincing evidence that a CTA-based approach can help extend learning from serious accidents, both in terms of understanding contributory cognitive human factors, as well as providing rich content for cognitive tacit skills training for technical and non-technical skills routinely involved in serious accidents and fatalities (SIFs).

Author
Joy McKay, Em Thorogood & John Preston Abstract
This paper aims to demonstrate how MaaS can be optimised by applying Neisser's Perceptual Cycle Model to the Verbal Protocol collected during user trials of a new MaaS app. The results help identify where users’ expectations are not met and information needs remain, thus making completion of the Plan, Book, Pay, Navigate task difficult. By identifying where the MaaS app does not match the users’ existing mental model design recommendations can be made to increase usefulness and usability.

Author
Adrian Wheatley Abstract
The handling of hazardous materials requires the careful consideration of potential human errors and their consequences. Further to several risk assessment and safety justification activities in support of hoist equipment and hoist operations design, a baseline model of hoisting operations, potential human error and consequences was developed. This model is presented as a useful starting point for any safety assessor undertaking hazard analysis in the context of high hazard hoisting operations.

Author
Edem Yao Tsei, David Barry & Duncan Hewat Abstract
This study combines Bayesian Network (BN) machine learning tool and HFACS to analyse safety risks related to human and organisational factors in hydrogen (H2) accidents in the H2tools database to deduce lessons for aviation. The study statistically identifies significant causal associations between human risk factors and their effect on H2 accidents. Ultimately, the research contributes to the existing human factors knowledge gap in understanding H2 accident risk factors and develops a model for proactive H2 safety management in the aviation domain.

Author
Nick Woodier, Paul Sampson, & Iain Moppett Abstract
Healthcare has long been told that it must improve patient safety. To help improvement, there are repeated calls that it should seek to learn from other industries, such as aviation and nuclear, including around their use of near misses. Near misses are incidents that almost happened, and it is believed that learning from near misses can help avoid harmful incidents. This study, part of a larger project, aimed to understand industrial perceptions of their own safety and translation of safety ideas to healthcare, with a focus on near misses. A qualitative approach was undertaken with a scoping review and interviews with 35 participants across aviation, maritime, nuclear, and rail. Participants had reservations about healthcare translating safety ideas from their industries, with perceptions that healthcare is oversimplifying safety management, including how they learn from near misses. Healthcare may be prone to all-or-nothing thinking, limiting its ability to take evidence-based approaches to improving safety. Healthcare may benefit from considering and implementing safety management principles.

Author
Mahnaz Sharafkhani, Mary Browne, Margaret Codd, Angela O’Dea, Dorothy Breen, Dara Byrne, Maria Chiara Leva, Siobhán Corrigan, Sam Cromie, Eva Doherty, John Fitzsimons, Una Geary, Samantha Hughes, Cora McCaughan, Nick McDonald, Gemma Moore, Maureen Nolan, Paul O’Connor, Leonard O’Sullivan, Lorraine Schwanberg, David Vaughan, Marie E. Ward Abstract
Healthcare Human Factors / Ergonomics (HF/E) involves the rigorous application of multiple academic disciplines (e.g. engineering, psychology) with the aim of improving patient safety, quality of care, efficiency, and staff wellbeing. This paper discusses the establishment of a research collaboration of interested HF/E researchers, academics, frontline staff, quality and patient safety (QPS) practitioners and patient and public partners (PPP) and reports on a snapshot of the HF/E different activities being undertaken in the Irish healthcare system over the past 5 years (2018-2023).

Author
Dr Kirsten Huysamen, Paul Leach, Anna Vereker, Dr Claire Coombes, Tom Hyat, Jasmine Bayliss & Anisha Tailor Abstract
Seven people died in the Sandilands tram accident in 2006 illustrating the impact loss of driver alertness can have. A study into Signal Passed at Danger (SPADs) revealed that driver alertness and attention were factors in 49% of events. The Rail Safety and Standards Board therefore instigated a study to a) determine what driver attention and alertness monitoring technology would be suitable for GB rail (phase 1) and b) determine the benefits of the technology through a live industry trial (phase 2). The phase 1 evidence indicated that loss of alertness and attention has significant safety consequences, and that driver alertness and attention monitoring technology can help to mitigate this risk. The research recommended that a specific GB rail device is required, and 108 functional requirements were developed. These have been used to procure a device that will be trialled live with three train companies from March 2024 for a year (phase 2). The paper details the phase 1 findings, the phase 2 trial methodology and initial findings from the trial.

Author
Charlotte Lenton, Brendan Ryan & Jillian Rickly Abstract
This paper explores the accessibility and support provision in rail passenger environments in the GB rail network for passengers who are identified as late adopters of technology. The research data were collected at focus group sessions with rail industry representatives to gain an industry perspective on late adopters, their support needs, constraints to travel, and factors affecting accessibility of the GB rail network for this passenger group. Findings suggest several stages of the passenger journey which could be impacted by constraints to rail travel for the passenger group of interests and passengers more generally. Additionally, the analysis identifies areas of tension within industry regarding support provision for late adopters of technology in relation to accessibility of services and financial implications.

Author
Khawla Aljammaz, Chris Baber & Hyunyoung Kim Abstract
User interactions with novel technologies have been explored with different approaches. Traditional approaches seem to focus on the abstract form of the artefact. This paper introduces the notion of affording situations as a context-based evaluation approach.

Author
Samarth Vilas Burande Abstract
This study assessed the effectiveness of the "Control, Orient, Organize, and Lead" (COOL) technique in mitigating startle responses among commercial pilots during unexpected in-flight situations. Employing a quasi-experimental design, the experimental group received COOL training, while the control group had no specific training. Both groups encountered simulated startle-inducing emergencies in a flight simulator. Quantitative measurements using the NASA Task Load Index were taken, revealing moderate improvements in the experimental group's workload management, task engagement, stress levels, and flight precision. Despite a lack of statistical significance, these findings suggest potential benefits in integrating COOL into pilot training for effective startle mitigation. Further research with expanded participant cohorts is recommended for a comprehensive evaluation of COOL's efficacy in enhancing aviation safety.

Author
Kate Bonsall-Clarke, Paul Leach & Steven Van Niekerk Abstract
A rail industry organisation sought to develop a proactive approach to safety by better engaging with their contractors and gaining a clearer understanding of challenges, barriers and successes experienced at work. A review of the literature on psychological safety and coaching culture was undertaken to determine how staff engagement and safety conversations can be improved. Practical tools and guidance were developed and delivered to the organisation’s leaders to enhance their ability to enable meaningful candid conversations with staff.

Author
Arzoo Naghiyev, Anthony Coplestone & Nassar Majothi Abstract
High Speed 2 (HS2) is building a new socio-technical system, and the complexity of the project requires early and iterative management of human risks. Collaborative working between Ergonomics and Systems Integration (SI) has allowed for end users to be considered in SI processes, which is critical when designing not only new rail systems and infrastructure, but also a new Infrastructure Manager (IM) organisation. This paper will discuss the development of the early ergonomics risk identification framework (EERIF) that has been developed to integrate ergonomics into functional integration activities that are used to support the design of technical systems. The EERIF will be iteratively updated throughout the design process to map to the maturity of the project and will be re-reviewed against existing HF taxonomies and methods.

Author
Abigail Palmer & Nora Balfe Abstract
This paper describes the baselining of current electrical controller operations on the Irish rail network, and the ongoing work to assess the human factors risks and issues associated with an increase in the level of railway electrification and move to a new operational control centre including new equipment. To support decarbonisation, there are plans to increase the electrified network from 50km of track to at least 150km in the greater Dublin area, with possible further increases in other areas. To understand current work, the existing role was baselined to document the sources of information used, the tasks undertaken, and the current workload. A series of workshops are ongoing to explore the role of new systems and interfaces to be used in future and the expected increase in ECO workload and how this will be managed.

Author
Niall Miranda Abstract
Rating scales are tools that enable researchers to obtain empirical data from a theoretical construct. The quality of data obtained is influenced by subjective interpretation of the rating scale or measurement bias. A survey was conducted on eighty-two participants to determine the subjective interpretation of three distinct linear interval rating scales that employed either words to assign polarity, numbers to assign divisions or an experimental colour gradient. The data obtained in this study identified deficiencies in two commonly used questionnaires and recommended rating scale designs to attenuate measurement bias and improve the quality of data.

Author
Simon Gill, Lisa Fitzsimons Abstract
This paper describes the results of a study commissioned by the Royal Aeronautical Society (RAeS) to develop an aviation industry-wide strategy to enhance human-centred design for aircraft maintenance. The authors will set out the problem, describe the conception of the project and the novel approach taken. The resulting published report (RAeS 2022) will serve as guidance for the aviation industry on how it might proactively and strategically change to embed human-centred design for maintenance into the fabric of the aviation system.

Author
Kirsty M. Lynch, Aaron P. J. Roberts, Mark S. Young, Victoria A. Banks, Dominic J. Taunton & Katherine L. Plant Abstract
A prototype Behavioural Markers System (BMS) is being developed for the operation of Maritime Autonomous Surface Ships (MASS) to assess operators’ non-technical skills for working in a Remote Control Centre (RCC) and assess the behaviours of machine teammates. This paper outlines the initial prototype BMS it includes behavioural markers (BMs) for humans working within a human-machine team, as MASS systems are using higher levels of automation and are changing how the operators will interact with the automated systems. The BMS will also be extended to BMs for machine teammates which could be used in the design and evaluation of future MASS systems. Future work will focus on the further development of the prototype BMS adding further BMs for human-machine and machine-human interactions.

Author
Melanie Mertesdorf, Alan Jones & Neil Clark Abstract
Fatigue management and in particular associated cognitive depletion is of crucial relevance in areas such as occupational health and transport safety, with some estimating that 25-50% of commercial vehicle accidents occur due to the effects of human error through accumulative cognitive fatigue (Davidović et al., 2018). The Driver Innovation Safety Challenge (DISC) was commissioned in response to such concerns and recent high-profile incidents. It was a joint project led by Edinburgh Trams with the support of UKTram and Transport for Edinburgh, and a partnership of public and private sector organisations including the City of Edinburgh Council and the Scotland CAN DO Innovation Challenge Fund. Its remit was to promote the development of technology and processes to help mitigate against the onset of mental fatigue and aid in the prevention of associated incidents. Key criteria for this type of management were to enable real time fatigue monitoring of personnel in an unobtrusive manner. This paper discusses the development and validation of a wrist-worn wearable device for fatigue detection and alerting, with a particular emphasis on validation studies conducted with tram operators in an operationally representative simulator environment. Despite initial focus on tram operators, the device has potential applications for many other domains where mental fatigue could lead to catastrophic events.

Author
Phil Day, Maggie McKendry, Andrew WD Smith & Marshall Munro Abstract
This paper describes the iterative development of instructional decals by means of expert reviews and user testing to solve a field issue. Findings are presented and conclusions drawn on developing language-free, graphical decals to convey note orientation and positioning.

Author
Mahnaz Sharafkhani, Mary Browne, Margaret Codd, Angela O’Dea, Una Geary, Marie E. Ward Abstract
Clinical handover is a core component of healthcare delivery and its optimisation is a recognised enabler of patient safety (DoH, 2015), healthcare quality and positive patient and staff experience of care (HIQA, 2012). There are risks associated with poor handover and communication failure. Observational tools have been used to study and improve handover processes. However, not all of these tools capture the full range of systems factors that can impact on handover processes in clinical settings. In this study, a review of handover observation tools was conducted and a new ethnographic observation tool based on the Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 was developed and piloted.

Author
Eva-Maria Carman, Giulia Miles, Upasana Topiwala, Benjamin Warren , & Steve Cantellow Abstract
A key consideration to work systems are the people within it and the resource and resilience they bring to the system. As a result, professional wellbeing should be considered as a key element for systems monitoring. To work towards developing a professional wellbeing tool associated with work system elements to guide and inform improvement strategies and system redesign, an exploratory study was conducted to capture the relevant concepts. The aim of this phase of the project was to explored what staff thought were key elements of professional wellbeing that should be assessed, how work is organised and managed by staff, how this may be related to professional wellbeing and capture practical considerations for data capturing and tool outputs. A total of eight focus groups and seven interviews were conducted with staff within the Hospital 24 service between January and September 2023 with a total of 28 participants. The results from the focus groups and interviews assisted in addressing three key questions, namely: what should one measure for professional wellbeing, what is currently measured and how should one measure professional wellbeing? In addition to addressing these questions, key work system considerations emerged that are essential for understanding the context of the concepts identified and the potential implications for measurement and data interpretation. These qualitative results provided the building blocks for a conceptual framework that will guide the development of a systems-based professional wellbeing tool.

  Author
Ahmed Yaghi & James Blundell & Wen-Chin Li Abstract
This research paper presents an innovative automated de-icing system designed to enhance operational efficiency, safety, and environmental sustainability at airports during cold weather conditions. Traditional manual de-icing methods, which are labour intensive and pose significant safety risks and environmental concerns, are inefficient and costly. The proposed system incorporates human-centric design principles and advanced automation technologies, including predictive modelling and real-time data analytics, to facilitate safer and more efficient de-icing operations with reduced physical labour and improved aircraft turnaround times. Drawing upon interviews with Bucharest International Airport subject matter experts, the research identified key operational, safety, and environmental challenges in current de-icing processes in order to provide relevant human-centric design requirements. Subsequent system development focused on minimizing human error and physical strain, streamlining equipment preparation, and reducing environmental impact through sustainable practices. The research underscores the need for further empirical testing to validate the system's effectiveness in real-world settings, offering a significant step forward in achieving safer, more efficient, and environmentally responsible airport de-icing operations.

Author
Marie E. Ward, Mark Sujan, Rachel Pool, Kate Preston, Huayi Huang, Angela Carrington, Nick Chozos Abstract
Members of the Chartered Institute of Ergonomics and Human Factors (CIEHF) Digital Health and AI Special Interest Group (SIG) identified a need to provide health and social care professionals with an accessible guide to apply a systems approach in the design of healthcare AI tools. The CIEHF Digital Health and AI SIG came together to co-design a new guidance document: ‘AI deployment in healthcare – beginning your journey with Human Factors / Ergonomics (HF/E) in mind to support the integration of AI into care practices. A guide for health and social care professionals with an interest in AI.’ Group members come from health and social care and HF/E backgrounds. The guide is structured using the Systems Engineering Initiative for Patient Safety (SEIPS) framework.

Author
Ionut Danilescu & Chris Baber Abstract
A well-known approach to Explainable Artificial Intelligence (XAI) presents features from a dataset that are important to the AI system’s recommendation. In this paper, we compare LIME (Local Interpretable Model-free Explanation), to display features from a classifier, with a radar plot, to show relations between these features. Comparative evaluation (with N = 20) shows LIME provides more correct answers, has a higher consistency in answers, and higher rating of satisfaction. However, LIME also showed lower sensitivity (using signal detection), a slightly more liberal response bias, and had a higher rating of subjective workload. Evaluating user interface designs for XAI needs to consider a combination of metrics, and it is time to question the benefit of relying only on features for XAI.

Author
Matthew Woodward, Julie Gore, Fotios Petropoulus & Christos Vasilakis Abstract
Decision-making for hospital patient flow management is a time-constrained task for a dynamic problem, but little is known about the cognitive strategies required for this type of task. The SkillsRules-Knowledge model of cognition was used to study the decision-making strategies of clinical coordinators and patient flow managers in acute medical units in two hospitals. For timeconstrained decisions in an environment with a plethora of dynamic data, a rule-based feedforward strategy was predominant. Additionally, decision makers applied their tacit knowledge of bed demand profiles to project the future situation and to compensate for delays that were inherent in the patient transfer process.

Author
Adrian Wheatley Abstract
The Circles of Influence model is a method of organising Performance Shaping Factors that encourages the user to consider the bi-directional way in which many variables might interact to influence human performance. The model is presented as a tool to aid Ergonomics and Human Factors practitioners when undertaking activities such as project and task scoping, requirements capture, risk assessment, and Human Reliability Assessment.

Author
Emma Ridsdale Abstract
The paper highlights the implementation of relevant good practice Human Factors Integration (HFI) methods on a major nuclear new build project. The Human Factors (HF) team have provided support to the design and safety case since 2017. HF activities have assessed the role of the operation, allocation of function and analysed the proven technologies selection and input into novel design solutions to deliver a safe, operable, and functional design.

Author
Shelley Stiles Abstract
This study evaluates the effectiveness of a novel approach often seen in gaming, (branching narrative storytelling) for safety training within the Construction Industry, seeking to determine the impact on safety performance for a Principal Contractor. Branching narrative storytelling is structured in such a manner whereby the audience choose how the story progresses, exploring decision making on the context of construction site situations and challenges. The case study has established that a branching narrative storytelling approach deployed for training in the workplace has achieved an improvement in safety performance through a reduction of falling object incidents.

Author
Rich C. McIlroy and John M. Preston Abstract
Mobility as a Service (MaaS) aims to facilitate multi-modal, non-car travel by integrating various forms of transportation services into a single, accessible journey-planning and ticketing platform. Literature on MaaS is growing; however, questions remain concerning the features, requirements, and information elements that potential end users themselves consider most important or useful for customer facing MaaS apps, and how those needs depend on factors like gender, age, and where a person lives. This article reports on an on-going project exploring these issues, giving an overview of results from an employer questionnaire and a large focus group study, and introducing a followup questionnaire that is gathering end-user priorities for MaaS systems and interfaces.

Author
Abigail Fowler, Catherine Harvey, Max L Wilson & Sarah Sharples Abstract
This study evaluates railway staff attitudes and perspectives to physiological wearables in the workplace. Findings indicate wearables could suit use in live operational environments, provided data use and data privacy concerns are addressed. The successful application of wearable measures relies on both data being relevant, and wearables being acceptable to staff. The study focuses on signallers, with implications for other staff in transport industries.

Author
Kate Preston, Emma Dunlop, Aimee Ferguson, Calum MacLellan, Feng Dong & Marion Bennie Abstract
Artificial intelligence (AI) technology has the potential to support clinical decisions for sepsis fluid management. However, to ensure the full benefit of the technology is realised, a human factors approach, utilising a work system model, can be applied from the outset in parallel with the AI development to ensure the technology is created for the setting within which it will be integrated.

Author
Ava Udwadia1, Adrian Emck2, Colin Jackson2, Rebecca Grant1 Abstract
While glider performance has improved over the last century, cockpit design has fundamentally not changed. This research aimed to establish if glider pilots are comfortable in flight, and if not, then why and what makes them uncomfortable. A questionnaire was conducted that received 244 valid responses and this found that most pilots had experience cockpit discomfort.

Author
Anita Weltz, Douglas Dick Abstract
This paper outlines a case study of the Human Factors (HF) work that was undertaken for a whisky manufacturer, Whyte and Mackay (W&M), at an Upper Tier Control of Major Accident Hazards (COMAH) site in Scotland. The work was delivered by HF specialists at Risktec Solutions (Risktec) and involved: the incorporation of HF into the company investigation process; the development of a process for identifying and assessing safety critical tasks, including demonstration of the process (whisky loading to a tanker) and the development of a process for producing safety critical procedures and demonstration of application of this process. The project featured a number of firsts – the first whisky project for the HF consultant and the first HF project for the client.

Author
Dominique L M Bovell Abstract
This paper looks at the effect of using agentive language in a simulated investigative interview, to determine if the use of language that assigns agency to human action impacts how interviewees perceive culpability for their role in an accident. The results revealed no significant effect of using agentive language. The research methodology, participants’ disposition, and the customary use of agentive language in English may explain these results.

Author
Edyta Ostrowska Abstract
The paper presents an application of human factors framework to improve airport operations and customer experience. A pilot study was conducted at one of the UK airports and focused on experiences of passengers requiring support and staff working in Assistance Points. The results highlighted that airport operators would benefit from applying more holistic approach to understand passenger experience and should aim to look beyond passenger satisfaction, at the factors that can influence staff satisfaction and performance.

Author
Ben Koskowich , Maryam Attef, Chantal Trudel, Shelley Roberts& Cheryl Dalziel Abstract
While there is evidence to suggest that Canadians over the age of 65 are healthier, more active, and more affluent than past generations of older adults, seniors may experience challenges in air travel due to lack of financial resources or health factors related to the natural process of aging. Such factors, coupled with transportation deficits related to Canadian geography and infrastructure may exclude seniors from engaging in communities beyond their own, whether it be for leisure, work, or health services. Carleton University and the National Research Council have developed a 3-year program to investigate this demographic in air travel with the aim of developing a first-of-its-kind air travel design framework, followed by a demonstration/ proof-of-concept project. Here we share early findings from a rapid scoping review of research focused on older adults in air travel to categorize risks, barriers and opportunities identified by previous researchers.

Author
Richard Brownhill, Clare Carr Abstract
Emergency departments across the country are experiencing high levels of demand and occupancy leading to crowding, creating an environment where those working in at find it difficult to function at their optimum level. The performance influencing factors for these staff impact in a number of ways leading to high cognitive load, stress and a sense of hoping to get through the shift without patients experiencing adverse events. The emergency care improvement support team (ECIST) is part of NHS England’s operational improvement arm, working with healthcare systems to develop understanding and improvement across the urgent and emergency care (UEC) pathway. A team within the emergency department at Ipswich hospital recognised that the acuity of patients walking into their service appeared to be increasing and the number of those unexpectedly deteriorating was increasing. As ECIST was already working with the organisation in relation to their UEC pathways, an approach commenced to understand further the work-as-done in relation to this safety critical area of hospital care. The improvement led to an improvement in perceived safety and speed of intervention for patients with sepsis.

Author
Ahmed ElGharably, Kiran Desai, Aaron Vance, Jon Lester, Emma Bonfiglio, Colin Rigby, Andrew Forrester, Prof Peter Ogrodnik, Jeffrey Faint, Prof Tom Clutton-Brock, Aditi Desai Abstract
Retained vaginal swabs are a well-recognised and recurrent patient safety ‘never event’ with the potential to cause significant morbidity. Surgical swabs and surgical tampons, which are considered a type of surgical swab, are the single largest retained item. There have been 340 incidents of retained vaginal swabs reported in England (2012-2022) and underreporting of these incidents is known. The current practice of manual counting is prone to human error and demonstrates a lack of efficacy in dealing with this issue. A simple, cost-effective device was developed collaboratively based on human factors/ ergonomics principles. This is designed to help users focus on the largest problem space, functioning as a physical checklist and memory aid for accurate counting. The team adopted a systems thinking approach to develop the innovation, progressing through steps such as hierarchical task analysis and human factors systems analysis through the SEIPS framework, AcciMap, barrier analysis and user-centred iterative design. The near-manufacture prototype was user-tested in simulation, and results indicate that the device has the potential to facilitate accurate counts in a time-efficient manner. We acknowledge that there will be a need for training, and culture change for the adoption of design solutions in the current workflow. It is known that around 94% of units have electronic records, and software development in order to integrate the deviceaided count into electronic medical records with a computer vision app is ongoing. With integration into existing software, the system will not complete the birth episode unless the count tallies. With some additional resources, our vision is to develop and introduce a strong systemic barrier to prevent the problem. Initially, it may be practical to introduce only the device, which acts as a physical checklist and increases system resilience. System engineering tools such as the use of checklists are well-accepted models within patient safety science. However, the role of design which complements human behaviour in achieving system improvement is relatively unknown to healthcare professionals and we intended to explore this.

Author
Annabel Moore Abstract
This paper outlines a study for National Highways to better understand drivers’ behaviour, responses and perceptions on dynamic hard shoulder (DHS) motorways. A mixed methods approach, including use of a mixed reality simulator, was used to collect both qualitative and quantitative data from motorway drivers and triangulate the results. This work provided a greater understanding of the perceptions of drivers on DHS motorways and built an evidence base of the aspects of DHS motorways which may cause higher workload for drivers.

Author
Paul Davison Abstract
The project commenced in 2015 initially to deliver Non-Technical Skills (NTS) to train drivers. Success evolved the project, and an Action Research methodology was employed from the boardroom to the classroom to create several Action Learning sets. Appreciative Enquiry, Learning Reviews (LR), a Compassionate Safety mindset and a suite of adult learning techniques were used to deliver sticky learning. The project has generated resilient business interdependence and the production of a Fair Culture Charter for all 4500 employees. This has resulted in a reduction in operational incidents from 277 (13/14), the year before PPWD became involved, to 150 (22/23) per year, and a decrease in the ratio of events to drivers from 0.43 to 0.14.

Author
Lorraine Braben & Carolina Padovan Frias Abstract
The paper presents a case study for a new system to manage the risk of organisational change in accordance with COMAH Regulations at Pharmaron Manufacturing Services UK, a high hazard pharmaceutical site.

Author
Tracey A Herlihey, Jane Carthey, Lauren Mosley, Matthew Fogarty Abstract
Despite huge effort invested in investigating patient safety incidents in the NHS, mounting evidence pointed to a need for a fresh approach. To enable the NHS to move from Root Cause Analysis (RCA) to a more flexible and proportionate approach to learning from safety events, a human factors informed Learning Response Toolkit was developed.

Author
David Nery, John Clarkson & Alaster Yoxall Abstract
Inclusive design research and practice seeks to make everyday tasks more accessible for everyone. Identifying Performance Shaping Factors and assessing their impact on performance is central to estimating difficulty, user cost and potential exclusion from everyday tasks. This paper provides an exploratory Hand Action Framework for examining the extent to which task demands, age and capability Performance Shaping Factors impact performance achieved, difficulty, user cost and task exclusion experienced. A study involving a sample of sixty participants undertaking a range of everyday tasks is provided. The results demonstrate the Hand Action Framework captured a range of hand actions used with Performance Shaping Factors of task demands, age, and capability having a significant impact on hand actions used, performance achieved and user cost experienced.

Author
Simon Gill, Alexandra Watral , Lisa Lim , & Renaldo Blocker Abstract
This study describes a mixed-methods methodology using a survey, focus groups and functional scenario analysis to examine the interplay between the built environment, resilience, and wellbeing within a healthcare setting. Results and implications from a pilot study in three operating rooms at a large US hospital are presented.

Author
Barry Kirwan Abstract
Artificial Intelligence (AI) holds great promise for all industries in improving safe performance and efficiency, and civil aviation is no different. AI can potentially offer efficiency improvements to reduce delays and aviation’s carbon footprint, while adding safety support inside the cockpit, enabling single pilot operations and the handling of drone operations in urban environments. The European Union Aviation Safety Agency (EASA) has proposed six categories of Human-AI teaming, from machine learning support to fully autonomous AI. While AI support may in some cases be treated as ‘just more automation’, one category in particular, Collaborative AI (category 2B) considers the case of AI as an autonomous ‘team-mate’, able to take initiative, negotiate, reprioritise and execute tasks. This category pushes the envelope when it comes to contemporary Human Factors evaluation of human work systems. The question arises, therefore, of whether Human Factors is sufficiently well equipped to support the evaluation and performance assurance of such new concepts of operation, or whether we need new techniques and even new frameworks for Human-AI teaming design and assessment. Four future Human-AI Teaming use cases are considered to help gauge where Human Factors remains fit-for-purpose, where it can be modified to be so, and where we may need entirely new techniques of performance assessment and assurance.

Author
Will Tutton and Jack Martin Abstract
This paper presents an applied assessment by two professional marine accident investigators of ‘Work As’ approaches, used to understand the local rationality of seafarers involved in the Kaami marine accident. The approach used was to consider three different perspectives to how work was conducted onboard the Kaami vessel. The ‘Work As’ approach was found to be highly useful during the investigation providing insights into the perspectives of those involved in the accident that probably would not otherwise been identified.

Author
Gonny Hoekstra Abstract
With an increase of the average age of their employees, a cargo division of an airline company redesigned a part of the operation into “The Golden Bay’. A workplace where the older employee can work in a healthy way and be of added value until retirement.

Author
Rachael A. Wynne & Stephanie Dolman Abstract
Driver distraction is recognised as a leading cause of road deaths and fatalities. Driving is a complex task and with the increasing availability of consumer technology including in-vehicle infotainment systems (IVISs) the potential for distraction and resultant collisions is increasing. Operator event sequence diagrams (OESDs) were created to model use of the Tesla system, allowing operator load scores to be derived as a measure of driver distractibility for the Tesla IVIS across a series of tasks. It was consistently observed that the lowest operator loads involved voice recognition systems, hence greater availability of these systems may help to decrease distraction and thereby improve road safety. Future research will expand to focus on more systems to better understand the interaction between IVISs and drivers and the impact on driver distractibility.

Author
Chia-Jung Kang & Alexandra Lang Abstract
Recently, assistive technology has gained a significant interest in research from various domains due to the rapid increase in the elderly, disabled, and immobile patient populations. This study introduced usability into caregivers’ perspectives in using assistive devices with a particular focus on standing aid devices, facilitating the movement of patients and caregivers in a safer transfer. Furthermore, the techniques for examining the caregiver burden and physical activities delivered the mental and physical aspects concerning the usability and devices. These also combined the approaches commonly used in assessing medical devices in human factors engineering (HFE).

Author
Punthit Kulsomboon, Edem Yao Tsei, Gayatri Rebbapragada & Wen-Chin Li Abstract
This paper makes use of the human factors analysis and classification system (HFACS) to analyse maintenance-related causal factors of two accidents - Japan Air Lines (JAL) flight 123 (JL123) and China Airlines (CAL) flight 611 (CI611). Furthermore, the pathways that could have resulted in the two accidents were identified by applying the HFACS framework. The study also compares the similarities and differences between these accidents. The findings of this paper lend support to past research on HFACS where higher levels at an organisation have been shown to have directly affected the lower levels. Lessons from these accidents have also been identified in order to prevent recurrences.

Author
James Bunn, Simon Dunford, Neil Hunter & Mary Marshall Abstract
Safety Critical Task Analysis (SCTA) is an established methodology in high-hazard industries for identifying and managing the human contribution to the risk of major accidents. It seeks to identify which tasks could contribute to the initiation or escalation of a major accident, and then identifies the steps within those tasks where additional controls may be required to mitigate against the effects of human failure. An incident investigation that incorporates examination of human and organisational factors would also be expected to examine where and how failures occurred, the efficacy of control measures in place and where remedial actions are required. This paper describes how the incident investigation process and investigation findings and the SCTA process can support each other and sets out a case for connection and improved alignment between them. This is a connection that has been underexplored to date, yet which has benefits for both risk management and human factors integration.

Author
Laird Evans, Robert Pringle & Eluned Lewis Abstract
Human Factors Engineers need accurate anthropometric data to design military equipment that is safe, comfortable and enables performance under extreme operational conditions and in the most severe environments. MOD acknowledges that its current anthropometry dataset is becoming increasingly unrepresentative of today’s Armed Forces personnel, particularly women and minority ethnic groups. To address this issue, MOD has launched a new, comprehensive anthropometry survey. This paper describes the requirements underpinning this survey and the planned solution.

Author
John Gunnell Abstract
The development of a true-to-life, cutting-edge Digital Simulation Model of a train drivers experience operating with a future European Train Control System (ETCS) system has provided a platform for robust Human Factors analysis and has proven to be a success with the driver stakeholders.

Author
Richard Farry Abstract
The System Usability Scale (SUS) was assessed for its relevance and ease of use for assessing an AI capable of human-like interaction. Participants used SUS to assess Outlook, a contemporary consumer-grade AI interaction partners (smartphone digital assistants), and human teammates as a proxy ‘system’ for future human-like AI interaction partners. The results show that participants considered SUS to be relevant and easy to use for contemporary consumer-grade AI interaction partners, but not for human teammates. However, there was no meaningful difference in their ability to apply SUS between contemporary digital assistants, human teammates, and an email client. Thus, SUS can be used effectively for all of these kinds of systems.

Author
Deborah Stratford & Susan Whalley-Lloyd Abstract
The literature reports that Asthma Inhaler technique has not improved during the last forty years, despite improvement strategies focused on educating users to improve their technique and compliance. This is particularly critical for reliever inhaler users when ‘use error’ may result in a full asthma attack and possible death. This paper presents a pilot study Human Factors design review of the standard UK reliever inhaler, commonly referred to as ‘the blue puffer’. The results indicate a mismatch between ‘work as done’ and ‘work as imagined’ and that this mismatch appears to be influenced by the design of the inhaler. Conceptually it appears possible to improve the design of technical components of the inhaler system to reduce use errors and hence improve patient safety. This would require appropriate scenario and user testing, with any changes being integrated into the system as a whole.

Author
Jill Poots, Jim Morgan, Matteo Curcuruto, Stephen Elliott, & Andrew Catto Abstract
This paper presents findings from a modified Macroergonomic Analysis and Design (MEAD) study aiming to identify system components and risks in a telephone triage system. Themes identified included: ‘accessibility and availability’; ‘risks on the part of the telephone triage professional’; ‘risks posed by callers’; and ‘barriers to safety incidents’.

Author
Kate Shield & Elaine Thompson Abstract
The paper describes a user centred approach to the development of a Concept of Operations and its application to the Synthetic Environment, which is a digital signalling design tool that will be used to develop seamlessly integrated scheme designs for Network Rail.

Author
Helen Wordsworth, Patrick Waterson & Will Tutton Abstract
Recreational boating has become an extremely popular past-time in the UK, particularly since COVID-19, with boat equipment sales up by 25%, compared with pre-pandemic levels. Wilson (2022) predicts a further 11% growth in sales in 2021-2022 and the market is currently exceeding pre-pandemic trading levels. We used a set of 12 Accimaps to analyse of contributory factors leading to recreational boating accidents documented by the MAIB. The data from the Accimaps was then used to scope a set of questions which formed the basis of two surveys. One survey was for members of the public involved in recreational boating and the other for professional individuals involved in the recreational boating community. Key findings were that lack of training, knowledge and preparation were seen as key reasons leading to unsafe boating situations, in addition to recklessness. Most participants wore lifejackets whilst boating and approximately 50% thought alcohol consumption was acceptable at some point during a boating trip. Boat/sailing clubs were seen to reinforce good safety culture but outside of clubs was less positive. Some recommendations were developed following the study. It would be beneficial to introduce a mandatory qualification prior to the purchase of any motorised vessel, such as that employed in Australia or similar to the International Certificate for Operators of Pleasure Craft (ICC).It may be worthwhile developing more interactive, nationally consistent signage at popular launch locations. A final recommendation would be to place some responsibility on manufacturers.

Author
Tebello Pusetso, Samuel Mekonnen & Hui Lyu Abstract
Hairdressers in their careers are at a high risk of work-related musculoskeletal disorders (MSD). The braiding process requires hairdressers to endure prolonged repetitive hand movements and awkward body postures. This study conducted hand anthropometric measurements of female hairdressers in Lesotho and assessed their risk of muscle injury during hair-braiding activities using the Assessment of Repetitive Task (ART) method. Results found that braiding activity is at high risk of muscular injury.

Author
Lauren J Morgan & Paula Pryce Abstract
In early 2021, the MHRA launched its guidance on applying human factors and usability engineering to medical devices including drug-device combination products in Great Britain (MHRA, 2021). In its guidance it states: A usability engineering process can, and should, be applied by device manufacturers in the identification, assessment and mitigation of potential patient and user safety risks; also in the analysis of incidents that have occurred, in order to identify learning and put into place corrective actions to improve device design However, experience in hospital healthcare is that many devices and IT systems are often poorly designed and continue to contribute to patient safety risks. A seminar Harvard Business Review paper stated: “to fix physician burnout, we must first fix the electronic patient record”. In everyday work in our hospitals we see examples where poor device and IT design is making clinicians lives harder, and decreasing patient safety as a consequence. We have a workforce cataclysm, of which the state of hospital devices and IT is possibly contributing to rather than helping to fix. We explore a simplified multi-method approach to user testing to identify patient safety and usability risks. We present evaluations of 3 clinical IT systems, showing how user testing conducted correctly easily identifies these safety risks. The MHRA guidance as currently stands is not being used fully by suppliers, we need to consider how to strengthen its impact.

Author
Dr Ella-Mae Hubbard, Melissa Schiele & Prof. Paul Lepper Abstract
This paper discusses the importance of understanding various stakeholder perspectives before investigating technology acceptance. Stakeholders are identified, from a systems perspective, with their key requirements and interactions. This is part of wider work towards developing an Augmented Technology Acceptance Model (for example acceptance of drone technology) within the context of marine conservation.

Author
Amy Irwin, Helen Silver-MacMahon, Liz Mossop, Kendyl Macconnell & Luiz Santos Abstract
The current paper applies a biobehavioural model of workplace incivility to explore responses to rudeness within the veterinary context. Veterinarians and veterinary nurses (n=132) were asked to evaluate six fictional scenarios depicting two types of rudeness (direct versus indirect) across three instigators (clients, co-workers and senior colleagues). The findings indicated that direct rudeness (demeaning comments) was appraised more negatively than indirect rudeness (ignoring person). Responses varied across scenarios; direct rudeness was associated with reciprocation, exit, avoidance, discussion with manager and support seeking, whereas indirect rudeness was associated with affiliative and ignoring responses. There was a significant positive association between appraisal and confrontation, exit, avoidance, support seeking and reporting responses. The findings confirm the utility of the biobehavioural model of incivility response and build on this model in terms of variation in response selection according to directness and status effects. From a practical perspective the findings suggest that interventions to manage rudeness in veterinary practice should accommodate variation in rude behaviours and include tailored responses based on instigator.

Author
Kimberley Harding & David Hitchcock Abstract
Inclusive design is fast becoming a talking point for engineers, ergonomists, and designers. With holistic views on accessibility and inclusion in railways at the forefront of modern-day design and culture, it is a novel concept which could drastically change how we live and work. However, despite common interest in pursuing inclusive design strategies for railway passengers, there are significant gaps in inclusive thinking for railway workers – namely those who work in depots and trackside. Despite reforming modern system safety techniques, 2022 saw a significant increase in workforce injuries and little to no assistance in returning to work post-injury (Johnson, 2023). Limited accessibility and manoeuvrability in railway depots and trackside sees a workforce of injured staff unable to properly return to their original place of work and having to re-train in a less demanding sector. In response to this, this paper presents findings and methodologies for quantifying the inclusiveness of depot design from a user-centred approach. The data captured emulates how staff experience working in train maintenance and what aspects could be improved to encourage inclusivity in the workplace whilst enabling staff to work to their highest potential. It is hoped that this research could reduce bias in quantifying inclusive design elements in depots, framing a new scope for what is deemed ‘accessible’ or ‘non-accessible’ to make railway depots a better working environment for all.

Author
George V. Papadopoulos & Michail Maniadakis Abstract
This work focuses on human-robot collaboration for assembly tasks, examining the position of robot-to-human handover of objects. A simulation environment is implemented to ergonomically evaluate the expected posture of the human arm in hypothetical delivery positions in the 3D space.

Author
Adam Sutherland, Suzanne Grant, Stephen Tomlin, Denham L Phipps, & Darren M Ashcroft Abstract
Medication processes are chaotic and complex, and assumed to be undertaken by specific professionals in isolation from other healthcare tasks. However tasks are delivered simultaneously and adaptively because of the complexity of healthcare provision. This study aimed to explore the systemic contributory factors to medication related problems in children’s wards using multiple qualitative methods (230 hours participant observation and 19 semi-structured interviews). There is insufficient resource available to undertake all the processes to ensure safety; decisions about medicines were made with reference to immediate problems only; parents were relied on to administer medicines to children, and; there was widespread non-compliance with interventions to improve safety because they conflicted with day-to-day work.

Author
Kirsty Novis & Thomas A. Norton Abstract
The paper describes how understanding user behaviour and implementing behaviour change initiatives may be the key to changing attitudes to energy consumption and energy transition. The objective of this paper is to explore how four key factors; behaviour centred-design, preventing rebound effects, providing meaningful feedback and, understanding how behaviour scales can make an impact.

Author
Shelley Stiles Abstract
Behavioural safety programmes are widely used across the Construction Industry, largely targeted at influencing behaviours of frontline workers and/or leadership behaviours. However, there is limited application of behavioural safety at the pre-construction (design) phase of a construction project, given the importance of the design community in eliminating and mitigating health and safety risks. This paper details a case study for the application of behavioural safety intervention targeted at the design community for a large infrastructure project.

Author
Hannah Parr, Catherine Harvey & Gary Burnett Abstract
This paper proposes four distinct roles of a remote operator in supporting future SAE Level 4 and 5 autonomous vehicles (AVs). These are Remote Monitoring, Remote Assistance, Remote Management and Remote Driving. A set of scenarios were created based on academic literature and industry reports to represent an extensive range of interactions which might occur between Remote Operators, AVs and other human agents. Operator sequence diagrams were created to represent the task in each scenario and analysed to identify the involvement of the different Remote Operator roles. This is used to draw conclusions on aspects of work for future Remote Operators and as a starting point for further investigation into information requirements and workstation design.

Author
Kyle Hu, Wojciech Tomasz Korek & Wen-Chin Li Abstract
This research aims to investigate the innovative technology of touchscreen inceptor impact on pilots' situation awareness compared to a traditional sidestick. The Pupil Lab eye tracker collected pilots' fixation counts in the Future Systems Simulator (FSS), and subjective measure was the situation awareness rating technique (SART). A significant difference was spotted in the attention demand, understanding, and total score from SART analysis. Furthermore, the visual parameter of fixation counts indicated that pilots spent less time on OTW and more time on PFD when interacting with the touchscreen inceptor compared to the sidestick. The findings show the potential to implement a touchscreen in future flight deck designs.

Author
David Golightly, James Lonergan & David Ethell Abstract
Human performance in the rail freight yard has been identified as source of risk to rail freight operations. It is, however, an area that has received little research attention. Observations and expert elicitation explored work in the freight yard, leading to an understanding of freight yard activities, the impact of freight yard design and environment, and external pressures. Together, these factors make the freight yard a complex and challenging environment, where fluid, cognitive planning optimises physically demanding, cooperative processes. The implications for future management of rail freight operations are discussed.

Author
İbrahim Öztürk & Nazlı Akay Abstract
In the present study, the behavioural intention and factors affecting the use of e-scooters were examined among young people in Turkey. Previous users and non-users of e-scooters were compared in relation to the various variables. The relationships of attitudes, subjective norms, perceived behavioural control, and perceived usefulness were investigated regarding the intention to use e-scooters. While users reported positive socio-psychological factors related to e-scooter use, all different factors were positively related to behavioural intention. The results highlighted the importance of socio-psychological factors in predicting behavioural intention, as well as differences between e-scooter users and non-users in these factors.

Author
Jenny Sutcliffe, Suzi Lomax & Jennifer Macallan Abstract
The interest in employing Human Factors (HF) in healthcare is increasing. The SCReaM HF and Team Resource Management (TRM) programme is aimed at raising the awareness, understanding and application of the science of HF within healthcare to help staff improve their safety and wellbeing and that of their patients. The programme is divided into three strands: rolling training, HF Projects and HF Engineering. The programme has been successfully embedded into an NHS Trust and provides a good model for how HF can be introduced and utilised within healthcare.

Author
Sharon Beza, Lauren Morgan, Andrea Granger, Joe McCloud 4 & Peter Jeffries Abstract
In acute hospital care, sampling a patient’s blood is frequently used to help guide diagnosis, or to understand a patient’s response to treatment. This means many patients will have their blood taken multiple times during an inpatient stay. The work of phlebotomists has been studied before, and acknowledgements made to how they adjust their practice to balance patient safety in the context of fluctuating demands and challenging work environments and equipment (Pickup et al., 2017). A human factors approach was used to analyse the in-patient phlebotomy service within a local National Health Service (NHS) Trust. Multiple systems related issues particularly at organisational level were identified. Recommendations were made on how to improve the safety and reliability of the process.

Author
David R. Large, Madeline Hallewell, Xuekun Li, Catherine Harvey & Gary Burnett Abstract
The absence of a human driver in future autonomous vehicles means that explicit pedestrian-driver communication is not possible. Building on the novel ‘Ghost Driver’ methodology to emulate an autonomous vehicle, we developed prototype external human-machine interfaces to replace existing cues, and report preliminary, qualitative findings captured from a sample of pedestrians (n=64) who encountered the vehicle when crossing the road, as well as reflecting on the method.

Author
Alison Clerici Abstract
This research evaluated and adapted the use of the Early Human Factors Analysis (EHFA) process to create a methodology for assessing the use of human augmentation technologies in defence.

Author
Eva-Maria Carman, Giulia Miles, Bryn Baxendale, Emma Smith & Owen Bennett Abstract
Despite identifying the need for enhancing the use of Human Factors and Ergonomics in healthcare about 20 years ago, progress to date has been slow. A cohesive strategy is required that aligns these methods and expertise with established improvement, transformation and organisational development programmes and which is synergistic with existing work that seeks to address local system and organisational priorities. This paper describes progress to date and proposed future steps for the integration of Human Factors and Ergonomics in one large NHS Hospital Trust.

Author
Eva-Maria Carman, Michael Johnson & Giulia Miles Abstract
Human Factors can inform and enhance traditional procurement processes by capturing the users’ input and considering the wider system into which the products will be implemented. Despite this, traditional procurement processes do not typically consider integrating HFE into the process in a systematic way. This paper describes the role of Human Factors in the different phases of a large procurement project and the lessons learnt for the procurement of hospital beds within one large NHS Hospital Trust. The aim of the procurement project was to determine the best solution that includes a variety of products and service contract from one supplier. A total of six different bedframes and two different types of mattress needed to be considered. The role of the HFE team was to provide advice at strategic project meetings, support the specification design, conduct an HFE evaluation of the products and ensuring a system’s perspective was considered throughout the process. Across all the product types, the HFE evaluation included 27 simulation testing sessions followed by feedback from staff on in-situ use on 23 different wards. Key lessons learnt included the value of qualitative data can add to support the decision-making process in procurement projects, the need to understand clinical needs as in this context there is no one perfect product due to the wide range of applications, and the need for HFE specialists to have a better understanding of the procurement process and their involvement across all phases of this type of project.

Author
Rachael A. Wynne, Angus McKerral, Sophie Withers & Kristen M. Pammer Abstract
Mind wandering while driving has been shown to factor in distracted driving, a critical cause of road crashes in Australia. With the implementation of autonomous vehicles onto the road network proposed as occurring in the near future, lies the potential for increased mind wandering, as cognitive engagement in driving is lessened. Part of the potential appeal of such vehicles is the ability to perform non-driving related tasks while in an automated driving mode. This study presents an analysis of drivers’ subjective experience of two prolonged drives in a driving simulator set to automated driving. Half of the participants were permitted to engage in non-driving tasks, to simulate potential future features. Participants provided summaries of their experience and preparedness to take-over control following two critical events. This study explores the themes of participants’ subjective experience and how this relates to mind-wandering, comparative optimism of driving behaviour, and readiness to respond to take-over events.

Author
Jecha Suleiman Jecha, Samia Rafique & Hui Lyu Abstract
The standard and guidelines of school furniture dimensions have been developed in many countries, but it’s never been explored for university students in Tanzania. This study evaluated the potential mismatch between classroom furniture dimensions and anthropometric characteristics of 289 Zanzibar university students (167 females, 122 males) aged 17- 27 years. The results indicated high rates of mismatches between the body dimensions of the students and the existing classroom furniture, with seat height (100%), desktop height (93.08%), and seat width (81.40%) being the furniture dimensions with higher level of mismatch and backrest height with a lower level of mismatch (66.26%). The findings suggest that the least developed countries should improve school furniture design based on anthropometric results to avoid or minimize student discomfort and MSD problems.

Author
Rahma El Safany, Michael A.Bromfield Abstract
Sixty Uncrewed Aerial Vehicle accident reports were analysed to identify possible causal and contributory factors leading to loss of control in flight and recovery actions where applicable. Manufacturing and design errors were dominant in 22 causal factors (34% of events) and 18 contributory factors (22% of events) (e.g. ingestion of precipitation). Recovery was not attempted in 35 (55%) events. The relationship between age, total hours experience, hours experience on type, recovery attempts and number of accidents increase with operator age or lack of experience was also analysed. As total experience increases the number of accidents and attempted recovery increases. All this information is presented in a framework adapted from the Accident Route Matrix to recognise loss of control in flight in future accidents and improve recovery response.

Author
David A. Hudson & Michael A. Bromfield Abstract
Boeing forecast that globally an additional 602,000 pilots will be needed by 2041 to meet year on year growth of 3.6% in passenger traffic. All pilots need to be trained in accordance with accepted regulatory standards. New technology is continuously being developed to enhance training and reduce training time. Research into the effectiveness of training technologies and how these impact pilot performance and workload is key to future growth. One such technology under review at the University of Birmingham is the ‘audible intelligent assistant’. This artificial voice that provides real-time feedback to the pilot during flight training. The system provides warnings, cautions and instruction to the human pilot to enhance pilot training. Preliminary results of the research showed an improvement in pilot performance against a specified set of target parameters of airspeed and altitude and a corresponding decrease in workload for 80% of pilots when using the audible intelligent assistant. Without AIA, pilot performance improved by 35% due to learning effects alone, with AIA pilot performance showed an improvement of 65%.

Author
Niall Miranda, Jean-Baptiste Bonotaux & Wen-Chin Li Abstract
Devices using voice recognition and verbal auditory alerts have advanced rapidly in the modern world. In an era that drives the world using voice commands, aviation has lagged to implement this technology in cockpits. Contrary to the rapid pace of advancements in cockpit instruments, auditory alerts have also been largely primitive. With such technologies gaining rapid acceptance in many industries, it is about time to consider adopting the same in cockpits, especially to support pilots during enhanced operational workload. This paper conducts a use case study on the prevailing aural technologies in the cockpit whilst exploring the augmentation of contemporary technologies in voice recognition and verbal auditory alerts to aid pilots’ cognition and reduce mental workload.

Author
Diego Cortez & Erin Davis Abstract
This paper presents current challenges of applying human factors engineering (HFE) throughout medical device development, and the opportunity digitalisation creates for innovation in the field. The paper focuses on describing current HFE challenges and examples of how digital tools and software applications can contribute to the work of HF specialists in the medical industry, noting that there is large, unmet need for more HF expertise. Finally, it briefly presents a case study of a software released by Emergo by UL Solutions which aims to address some of these challenges.

Author
Joy McKay, Katie Parnell & Katie Plant Abstract
Active travel, such as walking, running and cycling, are cheap, sustainable, and healthy ways to transit within in the urban environment. Many marginalised groups are either underrepresented in active travel modes or find they are limited using them in certain neighbourhoods or at certain times. These limitations lessen the accessibility of a range opportunities including those of employment, social activities and cultural experiences to a wide range of citizens. This review endeavours to recognise those barriers to active travel which affect a diverse selection of society and understand affordances which encourage use of these modes. It aims to identify solutions which may encourage active travel across a diverse community leading to an urban environment which is more equitably accessible for all.

Author
David Hitchcock, Kimberley Harding & Penny Gazard Abstract
The introduction of a new train to Transport for Wales (TfW) was initially faced with reluctance and resistance from key stakeholders. Consistent with previous train driver projects, TfW elected to adopt an ergonomics approach to identify, clarify and resolve issues of acceptance, safety and performance. The reasons for this were to address cab design issues, and to inform the design and delivery of a training programme intended to facilitate a cultural shift in drivers’ ways of working and those who support them. The ergonomics investigative work embraced consultations, literature review, measurements and observations of cab users, and was conducted alongside, and in harmony with, engineering reviews. This integrated approach led to a successful resolution to the concerns of stakeholders, resulting in accepted changes to working practices and deployment of the train.

Author
Anisha Tailor, Paul Leach, Kirsten Huysamen & Priya Shah Abstract
This paper discusses the use of task observations, semi-structured interviews and thematic analysis to identify and classify Non-Technical Skills (NTS) behavioural data in rail controller and rolling stock maintenance roles. A human-centred design process was applied to develop materials to support rail organisations with observing, evaluating and developing NTS in rail controller and rolling stock maintenance roles. Wider factors influencing human performance in these roles were also identified and are discussed in this paper.

Author
Gary Burnett & Catherine Harvey Abstract
There is considerable potential in the education sector for the use of immersive virtual worlds to enhance student learning and engagement. This paper outlines five key recommendations for teaching University students in future ‘Metaverse’ contexts. These guidelines are based on video/survey data collected from 266 students during a module that has run predominately in virtual reality for the last three years, as well as the reflective experiences of the teachers.

Author
Lauren Morgan, David Higgins & Sue Deakin Abstract
The HF approach places all stakeholders at the heart of any project to identify their needs and ensure these are being met, ultimately to optimise efficiency and safety. With regards to building a new hospital, this includes not only patients’ needs, but also those of hospital staff, support workers, volunteers, and patients’ contacts. This paper discusses the approaches taken, and benefits realised

Author
Jonathan M McCloud & Lauren Morgan Abstract
An acute District General Trust commissioned a new modular building to house a surgical ward. The process of commissioning and design of the building was in accordance with standard trust practice and established building regulations for hospital buildings. The purpose of this project was to assess the ward layout in terms of safety and efficiency and offer mitigations for any problems found. Observation of the ward layout demonstrated significant problems with sight lines in to bays, layout and design of toileting facilities, and layout and positioning of key ward areas including kitchen facilities, office space, drug and fluids stores, and nursing stations. To further examine the ward layout, Hierarchical Task Analysis and link analysis were performed to review two tasks: one an emergency task (treatment of a deteriorating patient) and a routine common task (serving meals). We also considered the Systems Engineering Initiative in Patient Safety (SEIPS) framework to ensure that our analysis was as thorough as possible. This work demonstrated significant problems with the ward layout, in terms of sight lines, workspace, communication, and contributed to significant extra time doing both emergency and routine duties. This led to a series of recommendations to mitigate on the ward, as well as a recommendation that appropriate staff involvement is included at appropriate times in planning future new build and refurbishment projects.

Author
Paul M Salmon, Brandon King, Gemma J. M Read, Jason Thompson, Tony Carden, Chris Baber, Neville A Stanton & Scott McLean Abstract
There are concerns that Artificial General Intelligence (AGI) could pose an existential threat to humanity; however, as AGI does not yet exist it is difficult to prospectively identify risks and develop controls. In this article we describe the use of a many model systems Human Factors and Ergonomics (HFE) approach in which three methods were applied to identify risks in a future ‘envisioned world’ AGI-based uncrewed combat aerial vehicle (UCAV) system. The findings demonstrate that there are many potential risks, but that the most critical arise not due to poor performance, but when the AGI attempts to achieve goals at the expense of other system values, or when the AGI becomes ‘super-intelligent’, and humans can no longer manage it.

Author
Trevor Dobbins, Ryan Meeks, Dan Evans, Stuart Howe & Stephen Barrett Abstract
The Armoured Fighting Vehicle Commander’s role is characterised by having multiple mission critical tasks. They are required to rapidly redirect their attention at short notice as events change. This paper describes how this task-switching is modelled and analysed, within the system model, to manage workload and develop/deliver a useable system

Author
Kate Shield & Elaine Thompson Abstract
The paper describes a user centred approach to the development of a Concept of Operations and its application to the Synthetic Environment, which is a digital signalling design tool that will be used to develop seamlessly integrated scheme designs for Network Rail.

Author
Charlotte Temmink & Yee Mey Goh Abstract
The aim of this study is to assess, through experimentation, the effectiveness of Virtual Reality training when compared to a traditional written instructions in a manufacturing assembly process. The effectiveness was evaluated in terms of perceived workload and task performance, with participants asked to self-report on the experience during both the written and VR training. Findings indicate that VR training reduced the user’s workload perception and errors made during the task, however there was no significant impact on time taken to complete the task.

Author
Leticia Bergamin Januario, Marina Heiden, Svend Erik Mathiassen, Tea Korkeakunnas, Gunnar Bergström & David M Hallman Abstract
We evaluated the impact that (1) voluntariness and (2) extent of telework had on 24h heart rate variability (HRV) measured objectively for three days in white-collar workers during the COVID- 19 pandemic. Workers with high voluntariness had higher root mean square of successive differences between R-R intervals (RMSSD), however high extent of telework did not affect HRV metrics, after adjusting for suitable covariates. These results may indicate higher parasympathetic activity, an indicator of good health.

Author
Joao Paulo Macedo, Kyle Hu, Rani Quiram & Samarth Vilas Burande Abstract
Touchscreen displays are one of the pillars of future flight deck design and it is foreseen that at some point traditional flight control inceptors will be modified to a touchscreen version. However, this transition can only be safe and successful with due regard for human performance implications. This study addresses it by comparing pilots’ mental workload for a traditional sidestick and an innovative touchscreen control inceptor. The results indicate that the new technology increases pilot workload, suggesting that further development is required to use it in future flight decks.

Author
Elizabeth Wilson-Lewis & Gyuchan Thomas Jun Abstract
This study explores how the assumption-based leading indicator approach can be applied to monitor organisational drift of healthcare systems towards failures based on the Mid Staffordshire NHS hospital failure case.

Author
Weixuan Li, Glyn Lawson & Gary Burnett Abstract
Good emergency management is essential when human beings face natural disasters. However, there are many human factors challenges in this area, in particular teamwork amongst those involved with the response efforts, but also communication, navigation, and workload. This article presents the findings from nine interviews with emergency management practitioners based in China, with an emphasis on the potential use of Virtual- and Augmented-Reality to address the aforementioned human factors issues.

Author
Nora Balfe Abstract
This paper describes the background, development, and content of a new tool, H-FIT, to assess the likely human factors impact of proposed railway change projects. The tool provides a structured approach to identifying the scope and requirements for human factors integration at early project stages, around which the human factors activities can be specified and planned. The core of the tool is 14 design scope factors which range from planned changes to the work environment, to the introduction of new HMIs, and changes in working hours. These design scope factors are linked to physical and organisational design outcomes, such as accessibility, usability, and fatigue. Human factors goals can be set for each area of design scope against the related design outcomes.

Author
Gill Gookey & Mike Fray Abstract
Opioids e.g., morphine are high-risk medications that are frequently prescribed using a complex process in general practice. The current opioid prescribing process within six general practices was mapped using template analysis which highlighted high levels of variation. The Systems Engineering Initiative for Patient Safety v2.0 framework was used to identify overall aims for a safe opioid prescribing process and associated facilitators and barriers.

Author
Teemu Reiman, Kaupo Viitanen, Jesse Hakala & Karolina Wrona Abstract
Safety culture related lessons learned from nuclear power plant construction projects in Finland are presented. A set of questions are proposed for organizations to discuss. The implications of these questions and constraining questions are considered.

Author
Katherine L. Plant, Beverley Townsend, & OlTunde Ashaolu Abstract
Healthcare has arguably been the sector most impacted by the Covid-19 pandemic, leaving Emergency Department (ED) medical teams overworked and understaffed. An automated system for ED triage has been developed to help alleviate some of these pressures. Eight ED clinicians were interviewed to capture their views of the automated system. Insights were generated around where this system might add value and areas of challenge or concern. These findings will be used to refine the prototype for end-user testing and support the development of training material for clinicians.

Author
Katie J. Parnell, Siobhan E. Merriman & Katherine L. Plant Abstract
Human Factors methodologies and principles can help to close the ‘gender data gap’ through equitable, user-centered research approaches and sociotechnical systems analysis. This paper presents research conducted into the use and uptake of electric micromobility (e-micromobility) through a gendered lens. Qualitative research is combined with systems methodologies to provide gender-equitable recommendations that highlight how this mode of travel can be more gender-equitable.

Author
İbrahim Öztürk & Natasha Merat Abstract
Night-time driving is associated with higher crash rates, partly due to reduced visibility of the driving environment. Crash data show that young drivers are over-represented in night-time incidents, world-wide. Self-reported driver skills provide an important indicator of driving abilities, which can also interact with night-time driving performance. This study investigated the relationship between drivers’ self-reported driver skills and their perceived night-time driving challenges, comparing responses between young and older drivers. Results found that young drivers with lower self-reported perceptual-motor skills and higher safety skills experienced more difficulties associated with night-time driving.

Author
Rachael L. Martin & Paul Bowie Abstract
Situation Awareness (SA) is commonly defined as “the perception of the elements in the environment within a volume of time and space, the comprehension of their meaning, and the projection of their status in the near future” (Endsley, 1995:36). From this cognitive perspective, SA is synonymous with perception or attention, and involves a continual monitoring of the status quo for changes that might require action by frontline operators (Flin et al 2008). Within the midwifery literature, “loss of situation awareness” has been cited as a contributory factor to adverse events and unwanted clinical outcomes (HSIB 2020; Knight et al 2014; RCOG 2017). This operationalisation of SA is problematic for multiple reasons which are explored in this discussion paper. The paper begins by exploring the transferability of human factors lessons between safety critical industries such as aviation and healthcare. Different theoretical perspectives on SA are evaluated, highlighting that the theoretical concept has been misapplied in midwifery, with distinct differences from Endsley’s original model in how it is defined and measured. The paper provides an overview of the difficulties in measuring SA, which limit the prospective utility of the construct. Furthermore, retrospective identification of loss of SA is value laden and subject to hindsight bias. This stands in opposition to the Human Factors systems approach where “human error” should be viewed as a symptom of systemic problems within an organisation, rather than a causal factor (Amer-Wahlin and Dekker, 2008; Shorrock and Williams 2016). This paper proposes that a more holistic perspective is required which considers the individual clinician within the context of the wider sociotechnical system, rather than focus solely on the performance of individuals. It is vital to identify the system factors which may lead to loss of situation awareness, in order to redesign the work environment to minimise patient harm and maximise safety (Singh et al 2006). Opportunity also exists for further research to investigate whether an alternative model of SA may be more appropriate for use in the healthcare context generally, and maternity care specifically, better reflecting the complex system in which clinicians work.

Author
Abigail Palmer & Nora Balfe Abstract
Situation awareness in the railway is extremely important due to its dynamic nature which means that operators have to perceive, understand, and act on continuously changing information. This is true in engineering work, as well as operations. During engineering works, a PICOP (person in charge of possession) needs to keep track of multiple different factors, such as the number of RRVs/OTMs being used, number of worksites, points movements, and train movements, to ensure the safe running of the requiring high levels of situation awareness. Observations were undertaken to gain an understanding of the job as a whole in order to ultimately generate recommendations on how to better support situation awareness. This paper maps the PICOP role to Endsley’s three levels of situation awareness. Factors include track layouts, and the number of worksites

Author
Siobhan E. Merriman, Katie J. Parnell & Katherine L. Plant Abstract
Collisions between motorised vehicles and cyclists remain a persistent road safety issue worldwide, however the nature of these collisions remain poorly understood as there are currently few mechanisms available for cyclists to report sufficient detail about their collisions and near-miss incidents. Originally developed in Australia, this paper will describe the expansion of the Cyclists Report of Incidents Tool (CRIT) app to the UK road system, to understand the contributory factors involved in current cyclist collisions and near-miss incidents in the UK. Furthermore, it will explore how these factors may change with the introduction of Levels 2 and 3 Automated Vehicles.

Author
Setia Hermawati & Glyn Lawson Abstract
This study investigated the effect of combining analytical (heuristics and cognitive walkthrough) and empirical methods in usability evaluation. Data from two usability studies were used to simulate the outcomes of different combinations of usability evaluation methods. The findings show that the combined analytical methods significantly reduce the number of participants required in the empirical method without compromising the results of the usability evaluation.

Author
Linn Iren Vestly Bergh, Kristian Solheim Teigen & Fredrik Dørum Abstract
The petroleum industry is becoming increasingly dependent on digital systems, and the companies have ambitious plans for increased use of digital technology – along the entire value chain. Increased levels of digitalisation present major opportunities for efficiency in the oil and gas industry and can also contribute to enhanced levels of resilience to major accident hazards. At the same time, new risks and uncertainties may be introduced. Based on developments in the industry and society in general, the Norwegian Petroleum Safety Authority (PSA) has in recent years pursued targeted knowledge development related to digitalisation and industrial cyber security. The PSA’s follow-up activities related to digitalisation initiatives in the industry have been based on input and experience from several knowledge development projects. In this paper we will give insight into the main regulatory strategies we have used to follow-up initiatives in the industry, present results from audits on automated drilling operations and discuss the results from the follow-up activities in light of current regulatory development.

Author
Elise Crawford, Sara Pazell & Nektarios Karanikas Abstract
As we move towards a fifth industrial revolution, concerns about the future of work are heightened. To answer the call for work that we all want, this paper extends the concept of Good Work Design (GWD) introduced by the Human Factors and Ergonomics Society in Australia in 2020. Following an overview of GWD, we present a list of respective features with the purpose to advance a humancentred design-led approach to workplace strategy that reconciles business success with worker health. Moreover, we argue that effective design practice should be regenerative, expanding capacity and capability for design throughout the organisation, while supporting sustainable futures. The goal of this paper is to stimulate ongoing debate, research, and practice in good work design.

Author
Mike Tainsh Abstract
Supervisory control is a common category of system employed for many surveillance applications and is a continuing subject of interest to ergonomists. During their development, following an initial statement of system requirements, capability options need to be assessed to understand the contribution of design features to system effectiveness. One technique that can be employed is capability modelling which aims to generate predictions of outcomes dependent on initiating events. A novel capability modelling technique is proposed based on an integration of ergonomics research results and professional input.

Author
Tracey A Herlihey, Lauren Mosley & Matthew Fogarty Abstract
Any policy developed in a siloed manner and presented for implementation in a straightforward way is limited in its application in complex systems such as healthcare. In this article we describe a process for developing new patient safety policy by taking a user-centred approach and applying a system-based framework. The Patient Safety Incident Response Framework published in 2022 (NHS England, 2022), represents a complete redesign of how the NHS responds to patient safety incidents for the purpose of learning and improvement. The Framework will replace the current Serious Incident Framework (NHS England, 2015). Testing and revision were a formal part of the development cycle. The final version incorporates findings from an early adopter programme and independent evaluation and used SEIPS as a framework specifying the structure of a patient safety incident response system. We found the framework to be a useful tool for informing the revision of PSIRF; however, translating this work into policy form proved difficult and some nuance and direct links to SEIPS may have been lost.

Author
Anna McLister, Chloe Roberts & A C B Medeiros Abstract
Ostomy pouches are used daily by over 13,000 people in the UK each year, to collect effluent from their stomas. Although this Class I medical device has undergone a design revolution since the 1940s, ostomates’ needs are still not being fully realised. Building upon knowledge and insights gained from interviewing and surveying ostomates, this paper will explore how applying key Human Factors considerations could help inform the future design of ostomy pouches and ultimately, improve the quality of life of ostomates.

Author
Victoria E. Wills, Andrew Seaton Abstract
A system safety review to assess the resilience in Trauma and Orthopaedic (T&O) theatres was conducted in response to a number of Never Events. The imminent publication of the Patient Safety Incident Response Framework (PSIRF) paved the way for an alternative to traditional serious incident investigation, proposing a systems-based approach and enabling subsequent improvements to be based on ‘work as done’, rather than ‘work as imagined’. Analysis identified opportunities for interventions that built system resilience, which were developed and tested by front line staff as part of a Quality Improvement (QI) collaborative. The approach demonstrated a practical application of the integration of systems theory, patient safety, resilience engineering and quality improvement approaches.

Author
Jasmine Bayliss, Patrick Waterson & Mark Young Abstract
A trap and drag accident occurs when a passenger gets part of their body, or an object trapped between the train doors and gets dragged along the platform as the train departs causing various consequences of varying severity (Roels, 2018). The primary aim of this study was to understand why trap and drag accidents occur, how they come about and, establish how they can be prevented. A secondary aim was to understand how frequently traps occur and go unreported, and to understand if passengers are aware of the risks at the Platform-Train-Interface (PTI). We found that the majority of participants expect the train doors to work in the same way as lift and automatic shop doors and believe that the doors would automatically reopen if there was an obstruction. This study has also found that 40% of in-person survey participants and 27% of online participants have experienced becoming trapped. 6% of in-person survey participants have experienced being trapped and dragged. None of these incidents were reported. This study shows that passenger mental models of train doors are confused and inconsistent. Passenger’s experiences do not correlate with their expectations of how the doors work, their mental models are incomplete, and this can lead to passengers taking risks when boarding or alighting.

Author
Prabjot Kandola & Chris Baber Abstract
We used a theoretical framework of human-centred explainable artificial intelligence (XAI) as the basis for design of a recommender system. We evaluated the recommender through a user trial. Our primary measures were the degree to which users agreed with the recommendations and the degree to which user decisions changed following the interaction. We demonstrate that, interacting with the recommender system, resulted in users having a clearer understanding of the features that contribute to their decision (even if they did not always agree with the recommender system’s decision or change the decision). We argue that the design illustrates the XAI framework and supports the proposal that explanation involves a two-stage dialogue.

Author
Wenhu Zhang & Chris Baber Abstract
We asked 30 participants to ask questions of an Interactive Voice Assistant (IVA) which we had modified to provide different levels of accuracy in its answers. The levels of accuracy were low (55%) or high (80%). We also told users what level of accuracy to expect (60% or 100%). This produced a set of 6 combinations of actual accuracy with expected accuracy (including the condition when we did not tell the users which level of accuracy to expect). As expected, when users experience a more reliable IVA (i.e., 80% vs. 55%) their rating of trust is higher, and when actual an IVA with high accuracy and they are expecting accuracy to be high, then their trust rating is higher still. However, expected accuracy seems to outweigh actual accuracy, particularly when the actual performance is less than expected. Counter intuitively, this suggests that participants were not able to judge the actual accuracy of the IVA but relied on the expected accuracy.

Author
Laurie Marsman, Jingyi Zhang & Wen-Chin Li Abstract
The present paper reports the results of a four-week study assessing the relationship between psychophysiological coherence training, which aims to improve the synchronisation between one’s physiological rhythms leading to a positive emotional state, and perceived stress levels in commercial air transport pilots. Next to three self-report stress questionnaire measurements, qualitative data were gathered as well to gain more insights into the training effects. Results show significant reductions in the flight crew’s perceived stress levels during the four-week psychophysiological coherence practice period. Finally, the results are discussed.

Author
Emma Smith & Stacey Sadler Abstract
This paper advances the use of Systems Engineering Initiative for Patient Safety (SEIPS) to provide a visual representation of how work system factors interact with each other to shape processes and outcomes. Healthcare professionals identified that deficiencies in work system factors surrounding the person, task, tools and technology, environmental factors, organisational factors and external factors shaped undesirable outcomes for the patient, professionals or organisation around the discharge process. Improving work system factors may decrease the likelihood of negative outcomes for the patient, professionals or organisation.

Author
Prof Alex Stedmon, David McKenzie, Martin Langham, Kevin McKechnie, Richard Perry, Stuart Wlison, Morag Mackay, Stuart Geddes Abstract
This paper presents research of new PRIME road markings in which over 32,000 motorcyclists were manually counted and coded. Analyses indicated that these unique road markings produced statistically significant reductions in motorcycle speed, improved lateral lane position, and reduced braking across 22 sites in the West Highlands of Scotland. This work provides insights into the ‘Safe System’ approach to support safer motorcycling and casualty reduction.

Author
David Golightly, Ann Mills, Dougie Hill & Roberto Palacin Abstract
Rail freight safety is key to delivering effective, low carbon transport. The Great Britain rail sector has identified a number of risks to address and a programme of work in order to improve safety. However, the multi-stakeholder nature of the rail freight sector in Great Britain can present challenges when addressing those risks. This paper presents a study to identify lessons learned in the execution of collaborative work to address one of those risks – establishing Common Safe Systems of Work. Seven interviews with key stakeholders in the Common Safe Systems of Work project were analysed for learning points to take forward in addressing other rail freight safety risks. 16 learning points were identified with an emphasis on effective project scoping, project governance, communications and clarifying responsibilities.

Author
Eylem Thron & Shamal Faily Abstract
Automation improves rail passenger experience but may reduce cyber resilience because it fails to adequately account for human factors. Preliminary results from a study on signallers and automation confirms this, but judicious use of modelling tools may ensure design for automation considers this.

Author
Stuart Smith & Simon Morley Abstract
For HS2 to meet its Strategic Goals of setting new Health and Safety standards within a Digitally-Enabled infrastructure, we need to be able to take possessions and isolations in a safer, more efficient and faster way than current UK rail methods. This paper describes work done to support the vision of the HS2 Infrastructure Management (IM) Team through the analysis of existing incident data, in order to highlight where current possession and isolation strategies fail, and where HS2 can capitalise on opportunities through system and process design to deliver improvements.

Author
Charlotte Kaul, Joanne Smyth & Christopher Patrick Abstract
In 2018, the Department for Transport (DfT) challenged the rail industry to remove all diesel-only trains from the network by 2040. Therefore, over the next 20+ years, the railway will need to undertake large scale electrification programmes in order to achieve this. An increase in amount of electrification on the GB rail network will in turn create an increased demand for monitoring and maintaining this infrastructure. For people to access trackside equipment in electrified areas, electrical isolations are required. The electrified rail network is managed by Electrical Control Operators (ECOs). They are responsible for the electrified network under their control, including granting isolations. It is therefore essential to understand the processes undertaken in Electrical Control Rooms (ECR) and predict the impact that increased electrification will have on ECOs. A workload assessment was undertaken to understand the current workload of ECOs in York ECR to create a baseline model that accurately reflects their planned workload relating to granting isolations. This model was then used to predict the impact of future changes following electrification of new areas. The key inputs to the baseline model were number of isolations, task occurrences, task durations, and task complexity. This model was then used to predict the impact of future electrification projects on ECO workload and inform decisions about future requirements for ECRs and ECOs. The predictive model had the key inputs of baseline number of isolations, baseline and additional single-track kilometres (STK) introduced, future increases to the complexity of the infrastructure.

Author
Arzoo Naghiyev, Anthony Coplestone, Kathryn Montgomery & Hussien Aied Abstract
High Speed 2 (HS2) will be a highly automated rail system, which adds greater complexity to a complex socio-technical system, with potential unanticipated consequences. The Human System Integration workstream is at an early stage and the proposed methodology will allow the identification and management of Human Factors risk profiles associated to each function of the HS2 railway throughout the HS2 design lifecycle, as well as for the identified HS2 Operational Scenarios.

Author
Katie J. Parnell, Joy Richardson & Kirsten Madeira-Revell Abstract
The transport domain suffers from a historic ‘default male’ bias which has disadvantaged women in facilitating their travel needs, limited their choice in transport modes and increased their risk of serious injury. ‘Close the Data Gap’ (CtDG) is a working group of Human Factors and Transport researchers striving for gender-equity within the transport domain. This paper provides a summary of the issues in the domain and how the group is challenging them.

Author
Craig M Kerr & Jim Nixon Abstract
Masks on the flight deck are a part of an overarching biosecurity strategy intended to keep aircrew safe during the COVID-19 pandemic. The objective of this research was to explore pilot perception of the impact of mask wearing on non-technical skills. Four key non-technical skill areas were identified: communication, situational awareness, task management and decision making. Flight-crew perception on how mask wearing affects these skills was captured using a questionnaire. In addition, overall pilot attitude to mask wearing was captured concurrently. Sixty-two pilots with a variety of experience and backgrounds participated in the research. Analysis revealed communication to be a skill heavily impacted by facemasks. Results also align with the IATA risk assessment suggesting facemasks increase the time taken to don oxygen masks in the event of rapid depressurisation. The burden associated with flying whilst wearing masks also became evident. Flight-crew report increased feelings of fatigue when wearing masks, impacts upon crew resource management and performance. Overall, findings suggest that masks impact non-technical skills and subsequently crew resource management. These findings indicate that mask wearing might adversely affect flight safety. These findings should be considered when decisions are made to implement mask wearing in the cockpit.

Author
Ilinca-Ruxandra Tone & Amy Irwin Abstract
The current study examined news media reports of agricultural accidents through a mixed-method content analysis. This was done to identify instances of NTS previously found in agriculture.

Author
Amy Irwin1, Ilinca-Ruxandra Tone, Paulina Sobocinska & Jason Liggins Abstract
Non-technical skills are the cognitive, social and personal management skills considered necessary, alongside technical knowledge, for safe and effective work practice. Despite forestry operations, particularly those involving a chainsaw, being extremely high-risk, these skills have not yet been examined in the forestry context. This study used qualitative interviews to explore the non-technical skills relevant to forestry chainsaw operation, with preliminary findings highlighting skills such as situation awareness, task management and decision-making as vital for forestry worker safety.

Author
Mohammad Babamiri, Elahe Oveisi, Younes Mohammadi, Rashid Heidarimoghadam & Fakhradin Ghasem Abstract
Today, various jobs containing manual tasks can have adverse impacts on people's abilities. Therefore, this study aimed to investigate the impact of different elbow angles of manual load handling on hand dexterity. In this cross-sectional study, 34 males manually carried loads in three different positions (i.e., a 90-degree elbow angle, a 180-degree elbow angle, and one hand) for 5 minutes. Then, the O'Connor test was performed after each effort. The results showed that among various methods of manual load handling, load handling with a 90-degree elbow angle caused a significant increase in the number of errors and duration of the O'Connor test (P≤0.001). Overall, manually carrying the load with one hand was the best alternative among the three methods. The findings revealed that a 90-degree elbow angle causes the most remarkable drop in people's performance. Therefore, attention should be paid to how to carry loads and choose the correct method of cargo transportation, and danger signs should be taught to the employees in related jobs.

Author
Michael A. Bromfield & Nils Jamieson Abstract
Lion Air JT610 departed Soekarno-Hatta International Airport, Jakarta Indonesia for Depati Amir Airport, Pangkal Pinang on the 29th of October 2018 at 06:20 AM local time. As the aircraft passed through 2,000 ft during the initial climb-out, it pitched down and the crew attempted recovery but were unable to do so. At 06:32 AM the aircraft crashed into the sea with an airspeed in excess of 400 knots. All 189 persons on board lost their lives. This fatal accident was a loss of control in flight (LOC-I) or “unintended deviation from flightpath”, the number one category of fatal accident type over the last 60 years. Aircraft technology has seen significant development over this period with a corresponding reduction in fatal accident rate, yet LOC-I still persists. With technological advancements how could an accident like this have happened? This paper will explore contributory and causal human factors and what is proposed to prevent future occurrences.

Author
Hanna J. Neroj & Jim Nixon Abstract
A new scale measuring pilot subjective mental workload was developed as part of the Horizon 2020, Future Sky Safety Project: The validity of new measures needs to be established for effective and reliable implementation. This article investigates the validity of this new scale through assessment of psychological distances between linguistic variables on the scale and subsequent transformation from discrete to continuous scale using fuzzy sets theory. Although the new scale has claimed ordinal properties for the items, no evidence exists to support the interval properties of the scale and any subsequent analysis using statistical methods. The results in this article show linear progression of the items on the scale, supporting the order of the items. To establish the interval properties of the scale, the distances between the ordered items were evaluated using fuzzy sets theory using the Fuzzy Logic Designer in MATLAB. Transformation to continuous scale using fuzzy sets may allow the capture of the dispersion of the data around specific points, showing the degree to which each score belongs to different linguistic category of mental workload. Finally, a proposal for incorporating the validated performance measure was presented.

Author
Ryan Gamble, Phoebe May Asquith1, David Greeno, Jessica Evans & Phil Morgan Abstract
This short paper presents a collection of scenario-based case studies, illustrating how matters of equality, diversity and inclusion (EDI) may operate as human factors. This paper aims to highlight that by placing EDI at the heart of human factors research and practice, future work can ensure a more informed and inclusive practice that avoids reinforcing systemic bias and injustice.

Author
Mike Tainsh Abstract
The handling of diversity of user characteristics in maritime developments has become increasingly important. A novel technique is proposed for use when designing for diversity in cases where optimum solutions cannot be attained and when trades must be made between variables within design options. A brief review is provided on the technique of “trade-offs” in design. A novel “trade-off” technique is proposed. This approach enables an acceptable design to be identified which includes a statement to support risk assessment. The approach is being developed within BAES for maritime systems and helps ensure that individual, including gender differences, are addressed successfully.

Author
Kunjira Kingphai & Yashar Moshfeghi Abstract
Deep learning-based approaches have recently received much attention and managed to accurately capture variance characteristics in the Electroencephalography (EEG) signals. In this paper, we aim to classify the subject’s mental workload (MWL) level from EEG signal by using deep learning models named Stacked Gated Recurrent Unit (GRU), Bidirectional GRU (BGRU), BGRU-GRU, Stacked Long-Short Term Memory (LSTM), Bidirectional LSTM (BLSTM), BLSTM-LSTM and Convolutional Neural Network (CNN). The classification was performed on a publicly available mental workload dataset, STEW. Our encouraging results show the potential of deep learning models for MWL level detection.

Author
Abigail Palmer, Gyuchan Thomas Jun & Will Tutton Abstract
The aim of this study is to compare two accident analysis models: Casualty Analysis Diagram (CAD) used by Marine Accident Investigation Branch (MAIB) and a model developed/used by Norwegian Safety Investigation Authority (NSIA). The study explored the similarities and differences between the two models when applied to a real marine accident involving a collision of two vessels. The views of investigators working at MAIB and NSIA were collected using a questionnaire and interviews. This paper discusses various issues on usability of these models and provides insights into effective use of accident analysis models in practice.

Author
Paul M Salmon, Neville A Stanton, Guy H Walker, Patrick Waterson & Adam Hulme Abstract
Risk assessment and accident analysis methods based on systems thinking are currently popular, but few can be used together in an integrated manner. This article describes and demonstrates the Systems Thinking Accident and Risk Toolkit (START) which comprises the Networked Hazard Analysis and Risk Management System (Net-HARMS) risk assessment method, the Accident Network (AcciNet) accident analysis method, and the Safety Network (SafetyNet) intervention evaluation method. The three methods were designed to be used in an integrated manner as part of organisational safety management activities. START is described and demonstrated via a case study focussed on autonomous vehicles. The findings highlight the benefits of integrating risk assessment and accident analysis activities, including how accident data can be used to strengthen risk assessment outputs, and how the efficacy of specific risk controls can be considered in accident analysis efforts. Practical guidance on using the methods is offered, as well as recommendations for future research and applications in practice.

Author
Teodora Stefanova, Gab Parris & Tracey Milne Abstract
This paper discusses the use of the AcciMap technique for the analysis of the Waterloo Underground station accident, where a 59 year old man has lost his life following a fall at the Platform-Train Interface (PTI). In addition to mapping the factual sequence of events, the AcciMap allowed us to reflect on latent risk-contributing factors that are worth exploring in view of developing and implementing secondary controls.

Author
Johnny Mitchell & Lorraine Braben Abstract
This paper describes how an online game (‘Control Panel’) was used as part of Human Factors (HF) training to effectively introduce key concepts and engage participants. The game process will be explained and the results compared with available research. Finally, there will be some reflections from a practitioner on the impact the game has made in delivering HF training events.

Author
Natalie Shortt Abstract
This paper provides an overview of usability engineering requirements in the UK, now that it is not a part of the EU. Notably, Human Factors vendors do not need to be local to any region to perform usability engineering activities, but human factors processes need to adhere to local requirements.

Author
Anna Kaminska, Amy Irwin, Devin Ray & Rhona Flin Abstract
Culture relates to shared norms, values and practices associated with one’s nation, organisation or profession. While being a key input factor contributing to team performance and mission accomplishment, culture is often overlooked. The current paper summarises previous findings on the influence of professional culture (military- vs. civilian-trained) in helicopter pilots and proposes using of the Implicit Association Test as a behavioural measure of reported risk-taking behaviours.

Author
Paul Liston, Alison M Kay & Emma Delemere Abstract
The development of technologies for improved evacuations of large cruise ships necessitates a sociotechnical approach to requirements elicitation, technology development activities, and the evaluation of the solutions produced. The concept of Social Licence to Operate (SLO) offers the opportunity to address concerns around ethics, regulations and de-skilling in planning for implementation and operation. This paper outlines the approach taken in advancing this SLO.

Author
Nejc Sedlar, Amy Irwin, Doug Martin & Ruby Roberts Abstract
Through the use of content analysis, incident reports were analysed from the normalisation of deviance perspective in order to identify underlying causes and core components of the phenomenon. Preliminary findings highlight the importance of various organisational factors (e.g. production pressure, leadership etc.) in the propagation and maintenance of deviance among operators.

Author
Barry Kirwan, Ben Wood & Beatrice Bettignies-Thiebaux Abstract
For two decades, Swiss Cheese theory has been an influential metaphor in safety science and accident prevention. It has made barrier theory and the impact of safety culture on operational safety more understandable to the upper echelons of high-risk organisations in many industrial sectors. Yet sometimes the Swiss Cheese model is used to focus on the operational ‘sharp end’ and unsafe acts, like a magnifying glass that acknowledges organizational influence, but still targets the human operator. It is time to ‘turn this lens around’, and allow organisations to focus on the upstream factors and decision-making that can engender these unsafe acts in the first place. This paper reports on an approach to do this, under development in the Maritime sector, called Reverse Swiss Cheese.

Author
Shelley Stiles & David Golightly Abstract
Safety improvement is required for UK construction Project Delivery Organisations (PDOs). However, existing safety culture maturity tools tend to focus on a single organisation and have not been thoroughly tested for PDOs which are multi-organisational, and time-bound. Stiles (2021) presented the first stages of development for a tailored maturity tool for PDOs. This paper gives an update on that work, presenting emerging outcomes of a pilot of that tool within 14 construction projects classified as normal commercial building and infrastructure projects.

Author
Valerie J. O’Keeffe, Arvind Rajagopalan, Kosta Manning, Sara Howard, Ann-Louise Hordacre & John Spoehr Abstract
Pipe alignment is a critical task in shipbuilding, requiring high precision. Accurate measurement can be assisted by digital technology, with potential benefits for operators and business. This paper summarises a trial comparing a manual and technology-assisted pipe alignment task in shipbuilding.

Author
Jisun Kim, Henrietta Howarth, Joy Richardson & John Preston Abstract
This study discusses how a MaaS app could be designed and optimised to maximise acceptance by users. Design considerations are suggested based on the analysis of the utility of eleven mobility apps for the general public focusing on the main content and features.

Author
Phil Day, Maggie McKendry & Marshall Munro Abstract
In this paper we present the results from six user tests conducted between 2014 and 2017. These tests investigated the usability of depositing and withdrawing money from a pocket-style cash recycler; where the notes are inserted into and removed from an open receptacle rather than from a slot. Some of these involved working modules, some used purely static models of pockets, and others used early prototypes. Results are presented from these evaluations, along with broader conclusions as to the usability and acceptability of pocket-style cash recyclers for use in self-service devices such as automated teller machines (ATMs).

Author
David R. Large, Madeline Hallewell, Leah Briars, Catherine Harvey & Gary Burnett Abstract
This paper showcases the novel application of Mozilla Hubs in the context of interface design for future, autonomous taxis. It demonstrates that repurposing pro-social virtual reality as a design collaboration tool enables an embodied and spatialised experience affording the co-creation and visualisation of novel interfaces, scaffolded by real-world social dynamics, but unfettered by its physical limitations. The approach has proved to be beneficial during the COVID-19 pandemic, but it also provides genuine opportunity for virtual, “non-contact” collaborative research beyond this.

Author
Xia Liu & Setia Hermawati Abstract
Manufacturing is a domain that is heavily influenced by and relies on future technology which have direct effects on its employees. It is known that user studies are required to ensure that products or systems meet requirement from and are accepted by potential users. However, it is difficult to explore users' responses for future technology that users have no direct experience and knowledge. ContraVison is one of user study methods and is commonly used to study perceptions and acceptance of new future technology. Participants are typically exposed to positive and negative scenarios. This study investigates how different format of scenarios delivery (video, audio and text) in a modified ContraVision affects the richness of information that could be obtained from potential users. Thirty participants were recruited and divided evenly into three groups of user studies. Data was collected through semi-structured interviews and thematic analysis was used. There was no significant effect of the scenarios format delivery on the richness of information that could be obtained from participants in these three groups, although there was a trend that video offers richer information than audio and text. However, further study was required to ascertain this finding as limited characteristics and number of participants in this study might have an impact on the results of current study.

Author
Mark Andrew Abstract
Design goals guide design efforts but complex systems can lead to designers’ intentions being eclipsed. This paper’s proposition is that sociotechnical systems design offers scope for improved reliability and is built on three features of current design practice. First, design teams seek cooperative cognition to work together but inadequately understood outcome scenarios can impoverish joint understanding. Second, design team collaboration is bounded by innate psychological biases, which can spoil design decisions. Third, some views of risk in design thinking suffer from a limited conception of uncertainty and its influence. These constraints in design practice are examined (referencing the reach of Artificial Intelligence as one example design domain) and how such constraints may be addressed in design practice.

Author
Adedoyin A. Adeleye Abstract
In most industrially developing countries, artisans/tradesmen in the Informal work-systems are significant drivers of the economic life. Some simple, intuitive participatory ergonomics interventions hold great potentials to make a big difference, even if sometimes subtle, in this work milieu. The application of such interventions would increase the practitioners’ productivity and income.

Author
Anne Aidla, Helen Poltimäe, Kärt Rõigas & Eneli Kindsiko Abstract
Our results indicate that dealing with the consequences of physical and social isolation may be an issue not only for teleworkers but also for non-teleworkers. What is more, both types of isolation may manifest differently depending on the office type (single cell, shared cell, activity-based or open-plan) and the amount of time one works in the same room with co-workers.

Author
Stephanie McLay Abstract
This paper highlights some mental health challenges for seafarers during Covid-19, what has been done, and the priorities going forwards for the maritime industry.

Author
Amy Irwin, Helen Silver-MacMahon & Stephanie Wilcke Abstract
Workplace incivility is defined as disrespectful, insensitive behaviour that violates social norms, and has been found to have a variety of adverse consequences on workers ranging from performance decrements to reduced mental health. This study investigated the impact of incivility from three sources (clients, co-workers and supervisors) on veterinary staff (n = 252) using an online survey. The key findings suggest that veterinary staff experience rudeness frequently from all three sources, with incivility linked to increased reported burnout levels, decreased mental wellbeing, decreased job satisfaction and increased quitting intention.

Author
Lydia Elvin & Ella-Mae Hubbard Abstract
This study aims to assess the impacts working from home has had on employee wellbeing, due to the COVID-19 pandemic. Using data collected from a flexible working trial within a manufacturing organisation and a mixed method approach, the wellbeing scores between UK lockdown one and lockdown two will be compared, and different demographics considered. The findings revealed that participants experienced various impacts, which both positively and negatively affected their wellbeing.

Author
Shahrzad Riaei, Hadi Daneshmandi, Mohsen Razeghi, Bahram Kouhnavard & Zahra Zamanian Abstract
Surgeons usually work with sharp tools and sophisticated equipment that create many opportunities for neck, finger, hand, arm or wrist injuries. Despite their limited knowledge of ergonomics, they try to reduce pain during surgery. The most commonly used approach is position change. Today, surgeons use minimally invasive methods. These procedures often impose more physical needs on the surgeon than open surgery. Ergonomic chairs designed for surgeons do not provide the ergonomic position required for microscopic surgery but they can prevent back pain during open surgery. Over the past two decades, new innovations have led to a significant increase in the prevalence of microscopic surgeries, so this study aimed to investigate the characteristics of an ergonomic surgeon chair and its design for use in microscopic surgeries.

Author
Nick Woodier, Karen Whiting & Owen Bennett Abstract
For many years the classical approach to healthcare incident investigation has been Root Cause Analysis (RCA). However, healthcare has faced increasing criticism for failing to learn from when things go wrong and for investigations that are ineffective. There is a need to better support healthcare staff, who may have limited training and experience in investigation, to undertake more effective patient safety investigations. The authors aimed to identify an appropriate and usable patient safety investigation method for use by healthcare staff. The result of a literature review and engagement with experts led the authors to focus on the Human Factors Analysis and Classification System (HFACS) and AcciMap. Prior to evaluating the methods, HFACS was adapted to the acute hospital context by developing a coding set based on the original codes. Through workshops the authors identified a clear preference for HFACS. Its prescriptive nature appealed to investigators in that it considered all aspects of their systems and highlighted the potential contributory factors; it was felt to have face and content validity. HFACS presents a much-needed prescriptive model for investigators from varying backgrounds and experience. It is usable, appropriate, valid and reliable. The HFACS codes may require further development for different contexts, having been developed here for acute hospitals.

Author
Laura Pickup, Saskia Fursland, Mairi Alexander, Suzy Broadbent, Paul Davis, Kathryn Whitehill & Sian Blanchard Abstract
Fatigue and the implications on human performance are well recognised in the literature and many safety critical industries. This is not currently the case in healthcare, where there are no formal approaches to monitor or investigate the impact of fatigue on clinical performance and patient safety. The Healthcare Safety Investigation Branch (HSIB) was set up in 2017 and its core function is to provide independent investigations of healthcare incidents. HSIB adopts a systems approach to investigations and this paper will describe the work in progress to develop a standardised approach to consider fatigue.

Author
Maryam Karimi, Masoud Shafiee Motlagh, Rostam Golmohammadi, Mohsen Aliabadi & Maryam Farhadian Abstract
A questionnaire was designed consisting of 7 main sections and a section entitled "Suggestions for improving brightness". The validity of the questionnaire was determined based on expert comments and the CVI index. Its reliability was assessed by completing the questionnaire by hospital staff. According to the North American Society of Lighting Engineers (IESNA) standard, illumination was evaluated and compared with the questionnaire results. The Cronbach's alpha coefficient and CVI value of the questionnaire were estimated to be 0.901 and 0.97, respectively. There was a significant positive relationship between the mean score of the questionnaire and the illuminances in the workstations (P = 0.001). 72.8% of the workstations had good lighting, and the results of the questionnaire evaluation in these stations showed good and excellent lighting conditions.

Author
Matthew Woodward, Rounaq Nayak & Peter McCulloch Abstract
Irradiation of the wrong patient or wrong site is a reportable adverse event for hospital radiology departments. This study applied a systems human factors/ergonomics (HFE) approach in an NHS trust to develop interventions across work system levels. Changes were implemented to address interruptions in radiography control rooms, to standardise identification checks and to run workshops to raise awareness of a systems approach for near miss reporting.

Author
Saydia Razak Abstract
The Children’s and Adolescents Mental Health Service (CAMHS) in-patient unit scoping exercise was a qualitative exploration to understand the increase in Non–Fixed Ligaturing (NFL) incidents at an NHS Mental and Community Health Trust. This exercise aimed to answer 3 questions: (1) What are the reasons behind NFL on the CAMHS unit? (2) When does NFL behaviour occur? and (3) How can staff better respond to and reduce NFL incidents? A Resilience Engineering approach by understanding safety-I (increased incidents of NFL) and extracting examples of Safety-II was combined with an insight to how work processes on the unit were carried out in line with “Work as Imagined” (policy) vs “Work as Done” (procedure). A triangulation of methods was used which consisted of analyses of incident reports, an observation of a shift, and semi-structured interviews with 9 members of staff. The highest number of incidents occurred between 16:00 and 19:59. The semi-structured interviews revealed a psychological underpinning behind NFL through the theme of the act of ligating. Seeing Work as Done (observation) resulted in an instant change of staffing. Safety-II was evident in effective workarounds such as accommodating unfamiliar staff through a succinct induction. The methods aligned with the safety management mode of guided adaptability providing a novel approach to produce usable tools and interventions in sensitive, volatile, and emotionally charged work environments. The CAMHS unit scoping exercise provides insights, implications, practical applications, and improvement opportunities to reduce and better respond to NFL across CAMHS units by adopting a HF/E approach.

Author
Victoria Laxton, Edward J.N. Stupple, Frances Maratos & Andrew Baird Abstract
This paper provides an overview of a project evaluating compartmentalised coloured-coded trays for organising and storing anaesthetic syringes. Interviews with consultant anaesthetists and an online error detection experiment to test the trays under secondary cognitive load were conducted. Findings indicated workspace organisation issues in theatre, and that the use of colour-coded compartmentalised trays could help organise the theatre workspace, enhance visual search and mitigate cognitive load.

Author
Eva-Maria Carman, Giulia Miles, Steve Cantellow & Patrick Waterson Abstract
Healthcare needs to provide services 24 hours a day, seven days a week, 365 days a year. This includes out-of-hours from 17:00 to 09:00 weekdays, weekends and Bank Holidays. To provide this care, which has been estimated to be about 75% of the working week, dedicated out-of-hours teams have developed within the healthcare system. At one large NHS Hospital Trust, the focus of this study, the out-of-hours care is provided by the Hospital 24 service, a small team with limited resources covering a wide range of medical and surgical specialities across two large and complex hospital sites. In light of the increasing demand on this service, changes in available technology and with the numerous changes as a result of the COVID-19 pandemic, the Out-of-Hours Review aims to capture the current state of this service to determine the potential requirements for the future. This component of the Out-of-Hours Review aims to provide a high-level description of the system elements of the Hospital 24 Service. The systems analysis was compiled from three different data sources, namely a survey, data from the task management system and observation sessions. Using the SEIPS 2.0 model, high-level descriptions of the different work system components and a preliminary list of the barriers staff encounter, and facilitators staff use in this work system were generated. This analysis also identified the perspectives, system components and interactions that need to be explored in more detail in the next phase of this review.

Author
Adam Sutherland, Denham L Phipps, Andrea Gill, Dr Kirsten Wolffsohn, Stephen Morris & Darren M Ashcroft Abstract
Previous attempts to improve medication safety for hospitalised children have been ineffective because they take limited account of the sociotechnical context in which the interventions occur. To address this problem, we used work domain analysis to examine medicines management for hospitalised children in England. The analysis was based on data from documentary analysis and from observation of healthcare staff and patients. Our findings identified features of the work system that should be taken into account when planning improvement interventions for this setting.

Author
Kevin Michael Hoy, Enda Fallon & Martina Kelly Abstract
Paediatric homecare is an advancing field of healthcare and risk management is an integral component of these services. This study is part of a larger study into integrated risk management in paediatric homecare risk management. Through interviews with nursing staff using Grounded Theory methodology, analysis of the risk management components was undertaken using Function Resonance Analysis Method (FRAM). The results indicated a clear mapping of the functionality of the process for incident reporting and the assessment of risks. Resonance was evident in several key functions allowing system changes for organisational improvements to enhance quality of care. KEYWORDS

Author
Eva-Maria Carman & Giulia Miles Abstract
Human Factors as a discipline provides the theories, methods, and tools to assess work and work systems. Likewise, these theories can be adopted to assess and support change to the way HF work is done, especially when the work environment drastically changes, as has occurred with the pandemic. This would require applying Human Factors theories and methods to the work done by Human Factors specialists themselves, to enhance their own working processes and systems. This paper describes the development and application of the Lessons Learnt Reflection Approach, a tool aimed at capturing aspects that work well at an operational level for Human Factors work within healthcare, with special consideration for the impact of the COVID-19 pandemic. This approach was developed in response to the increased awareness of the limitations that the pandemic created in the work environment and the need to modify methods in response. The CIEHF’s guidance “Achieving sustainable change: Capturing lessons from COVID-19” was used to provide the structure and fundamental basis for this approach. This paper will describe the method and application of this approach for three different human factors projects in healthcare, namely (1) understanding the work system changes for a physiotherapy department during the initial response to the pandemic, (2) supporting the procurement process for a large volume general medical device and (3) supporting simulation testing of a commercial medical product.

Author
Mark Sujan, Mudathir Ibrahim, Lesley Booth, Saydia Razak, Laurie Earl & Peter McCulloch Abstract
A 5-year applied research project is described, which uses Resilience Engineering principles to design interventions to improve the management of deteriorating patients following surgery. A rigorous stepped-wedge trial design is used to help construct a more persuasive case for the benefit of Resilience Engineering and Human Factors / Ergonomics in healthcare.

Author
Jan Healey, Sue Hignett & Diane Gyi Abstract
A resilient healthcare theoretical framework was applied to identify the performance obstacles and corresponding adaptations home care workers make in the delivery of home care support to provide an understanding of the relationship between home care resilience and quality of care.

Author
Simon P Carter-Graham, Jennifer Davies, Emma Milser, Debbi Poles & Shruthi Narayan Abstract
A presentation of data submitted to Serious Hazards of Transfusion (SHOT), the UK's Haemovigilance scheme. Data subject is training and competency of healthcare professionals in temporary roles, such as locum or agency.

Author
Nick Woodier, Charlotte Burnett, Bryn Baxendale & Iain Moppett Abstract
A near miss in healthcare represents a situation where a negative outcome for a patient was avoided, but it was a near thing. Healthcare has long struggled to embed reporting and learning from near misses, with limited clarity on what a near miss is. This study aimed to learn from industries beyond healthcare to identify the features of a near miss and clarify a definition for healthcare. A mixed methods study was undertaken with healthcare and industry safety experts providing their views on an example case study. The study found that definitions may not be completely clear in industries beyond healthcare, but there is still opportunity to learn. The features of a near miss were found to be orientated around the role of controls in an event sequence, that almost resulted in events reaching and impacting on a patient. The authors advocate for a broad definition for healthcare, with value in identifying where humans are required to intervene to prevent incidents occurring. These situations may offer opportunities to develop more robust controls in healthcare systems to provide barriers to incidents.

Author
Natalie Sanford, Mary Lavelle, Ola Markiewicz, Gabriel Reedy, Anne Marie Rafferty & Janet E. Anderson Abstract
Healthcare is challenged by pressures on every level of the system. This short paper introduces the Pressures Diagram as a tool to communicate pressures and the prioritisation of pressures, affording greater insight into the complexity of healthcare work.

Author
Jon Mason, Joshua Fox & Kiki Veenhof Abstract
For people with disabilities, accessing healthcare services can be problematic, uncomfortable and potentially unsafe. Whether it is situational, temporary or permanent impairment, disability can affect everyone. When the healthcare company Philips Healthcare embarked on designing their next generation MRI machines, we, the human factors team, applied an inclusive design approach from the outset. In this paper, we will share details of a research study we conducted into how people with disability currently experience MRI. Data were collected via qualitative online interviews, with ten participants experienced disabilities from the UK. The findings showed that access to MRI radiology is an uncomfortable experience, both physically and cognitively. Accessibility issues were found throughout the process from travelling to the appointment, preparing for the scan, accessing and exiting the MRI machine. The general findings from the study are shared and recommendations for how to improve access to MRI radiology are presented.

Author
Jill Poots, Jim Morgan, Matteo Curcuruto, Stephen Elliott & MaryAnn Ferreux Abstract
The NHS 111 telephone triage service is a complex sociotechnical system that likely carries specific safety risks not present in traditional face to face care. Despite apparent system safety risks, there is a paucity of research in telephone triage. This paper outlines the use of a macroergonomics approach to identify system components, their interactions and risks in telephone triage

Author
Tara Marshall & Amy Dolben Abstract
This paper uses thematic analysis to explore the effectiveness of using a digital platform to support the use of deterioration monitoring tools in care homes across Suffolk and Essex. The benefits to staff, residents and the wider healthcare landscape are numerous, but significant system-level challenges must be addressed in order to ensure the successful adoption and spread of these tools across the social care sector.

Author
Nicola Swarbrick, Jennifer Davies, Emma Milser, Alison Watt, Debbi Poles & Shruthi Narayan Abstract
Effective incident investigation is an integral part of the provision of a safe blood transfusion service, with the aim to prevent recurrence of adverse events and harm to patients. Determining how an incident has taken place allows understanding of the gaps or failures within the system and identification of effective corrective and preventive measures that can be implemented to reduce risk of recurrence. Consideration of human factors supports a more sophisticated understanding of the factors that cause incidents, optimising human performance through better understanding of human behaviour and the factors that influence this behaviour, thus improving patient safety.

Author
Nick Woodier, Paul Davis, Laura Pickup, Kathryn Whitehill & Robert Hutton Abstract
Applied Cognitive Task Analysis is an appropriate method to investigate challenging cognitive tasks and the role of expertise in healthcare contexts. Healthcare needs to support the accelerated development of decision-making skills in its novices and also create the optimum conditions in which to make decisions.

Author
Shane Kenny & Wen-Chin Li Abstract
Through consideration of human-system integration (HSI) during airspace design, ATCOs who operate in a Point Merge environment can benefit from increased situational awareness, reduced workload and increased performance levels (Eurocontrol, 2021). This short paper outlines the advantages of implementing Point Merge operations to increase ATM safety, by considering the role of the ATCO and the importance of HSI when implementing air traffic control procedures.

Author
Takashi Nagasawa Abstract
Single pilot operations (SPO) is an operational concept which commercial aviation industry is considering. Artificial Intelligence (AI) hosted on Electronic Flight Bag (EFB) has a potential to become a buddy for pilot in SPO. This short paper presents an operational concept of SPO with EFB/AI and further discussion based on empirical exploration to achieve the objective on integration AI with EFB design.

Author
Jediah R. Clark, Mohammad Divband Soorati & Sarvapali D. Ramchurn Abstract
In the field of swarm robotics, human factors research is deficient. Human-swarm interaction, the process in which humans work with collections of unmanned and autonomous aerial vehicles (UAVs) to conduct activities, require an operator to track and manage vast numbers of robotic agents. Due to increasing complexity in communication requirements, visualising a swarm is challenging and requires usable visualisation methods that do not detract from user-interpretability and swarm transparency. This study explores two initial swarm-displays for swarm geographical coverage and density – an individual point display, and a heatmap display. 100 users viewed a simulation of each display, provided subjective usability and acceptance ratings, and gave their display preferences related to eight contextual factors related to time constraints, swarm size, communication-constrained environments, displaying coverage and motion, time-criticality, error detection and transparency. It was found that heatmaps improved usability and acceptance, and were preferred for displaying coverage and motion, and when UAV numbers are high or when time is limited. Individual point displays, although being overall less usable, acceptable, and preferable, were still deemed as being a useful tool for detecting errors in swarm operation. It is therefore concluded that aggregated data displays are a promising display method for visualising swarm coverage and density. The study is limited due to participants not being able to interact with the displays, therefore further research is required to further test the effects reported in this study.

Author
Wen-Chin Li, Yung-Hsiang Liang & Wojciech Tomasz Korek Abstract
Although the integration of multifunction touch screen controls (TSCs) in future flight decks is under development, some safety concerns still exist from pilots’ point of view. It is important that usability and human factors considerations are therefore studied in realistic operational environments. This short paper investigates the usability and human-computer interaction associated with TSCs, using eye tracking technology for future flight deck design.

Author
Laurie Marsman, Dominique Bovell, Stuart Christie, Brian Green & Beatriz Martinez Gutierrez Abstract
The present paper reports the results of a trial investigating pilots’ situation awareness in the Future Systems Simulator (FSS). Both PF and PM positions and accompanying tasks in the simulator are considered. Moreover, a follow-up session with current airline pilots in the study provides perspectives on the practical application of the FSS.

Author
David R. Large, Madeline Hallewell, Madelaine Coffey, Jenna Evans, Leah Briars, Catherine Harvey & Gary Burnett Abstract
Autonomous, self-driving taxis are a commonly cited solution for future mobility but inevitably raise myriad human-centred design and usability challenges. However, conducting usability and user experience studies in imagined, future vehicles is troublesome, given the absence of safe, road-worthy exemplars (and indeed, recent COVID-19 restrictions). Applying a novel virtual reality (VR) Wizard-of Oz methodology, fifty-two participants were presented with immersive 360° videos (VR360-videos), which captured interactions with a range of potential human-machine interface (HMI) solutions, aiming to address vehicle identification and on-boarding tasks. Interactions and experiences were acted out by members of the research team, with potential HMIs and constituent tasks informed by a participatory design study, literature review and user requirements elicitation exercise also conducted by the authors. To evaluate the methodological approach, the VR360-videos were presented using either a VR-headset or laptop web-browser, with respondents offered the opportunity to participate in the laboratory or from their home, thus affording a 2×2 between-subjects study design with fixed factors of Method and Location. An overview of the user experience results indicated that all HMIs were generally received positively, with subjective ratings unaffected by Method or Location. Qualitative data suggested potential for greater immersion/presence using a VR-headset, although there were indications of higher “simulator sickness” using this approach. The study provides a novel methodology to deliver immersive user experiences for evaluation. Results will be used to inform HMI design and future evaluations associated with remaining journey stages (in-transit, arrival, payment etc.).

Author
Phil Day, Maggie McKendry & Marshall Munro Abstract
Formative user tests are presented investigating use of QR code and NFC to enable a user to use a smartphone with self-service devices from their vehicle.

Author
Eddie Brown, David R. Large, Hannah Limerick, William Frier & Gary Burnett Abstract
Mid-air haptic technology has enabled a new research arena in spatial interaction to emerge. Various efforts have attempted to pair mid-air haptics with gestural input for In-Vehicle Infotainment Systems but have not explored the higher reaches of semiotic information transfer during these interactions. Building on a participatory design study in which participants’ metaphors for seven infotainment features were “haptified”, twenty-five participants were recruited to evaluate the perceptual efficacy of the sixteen resulting mid-air haptic icons. Four perception metrics (Instant Identification, Recognition Rate, Instant Articulatory Directness and Distinguishability) were collected through stimulus matching and descriptive tasks. The haptic icons which offered the best saliency (i.e. received the highest cumulative scores for all four metrics) were subsequently selected to represent their respective features in a prototype Mid-Air Haptic Gesture Interface, which will be evaluated in further, ongoing work. The study highlights an important stage in the development and deployment of semiotic mid-air haptics for gestural interfaces.

Author
Henrietta Howarth, Joy Richardson, Jisun Kim & John Preston Abstract
This study evaluated the interface usability of a range of mobility apps using a set of adapted heuristics aimed at inclusive design. Identified strengths and weaknesses informed interface design recommendations for a future MaaS app to enhance usability and support travel across all ages and genders of adults in the Southampton area.

Author
Joy Richardson, Henrietta Howarth & Jisun Kim Abstract
Mobility as a Service (MaaS) mobile phone applications are being launched in many towns and cities worldwide and are heralded as the ultimate modern mobility solution by combining private, public, micro and active travel options. However, in order to encourage adoption by the public the user-experience (UX) is of high importance. A useful way to evaluate the UX of an app interface is to use heuristics analysis, yet none of the existing heuristics tools are tailored towards mobility apps. This means they are not suitable for a systematic evaluation of MaaS interfaces. Therefore a new heuristics tool was developed in order to evaluate the interfaces of mobility apps, including MaaS. This was achieved through the evaluation of existing heuristics combined with the determination of the needs of the mobility app user. A number of iterations were developed, tested and revised in order to design a useful and usable tool.

Author
Sophie M. Hallam, Neville A. Stanton, Aaron P. J. Roberts, Kiome A. Pope & Daniel Fay Abstract
The Command Team Experimental Test-Bed (ComTET) project aims to investigate the operation of contemporary and future submarine control rooms. Previous ComTET research has found that facilitating non-verbal communication between Sonar Operators (SOPS) and Target Motion Analysts (TMA) helped reduce a communications bottleneck and better manage their workload. The present study explores workload in a novel circular control room configuration which enables non-verbal communication between all operators. Participants completed low and high demand versions of Return to Periscope Depth (RTPD), In Shore Operations (INSO) and Dived Tracking (DT), six scenarios in total. After each scenario was completed the NASA-Task Load Index (NASA-TLX) was filled out. The present work looks at a subset of four teams from each configuration as a preliminary analysis to provide insight into the direction of trends in the data. Results show that perceived workload is affected by the configuration, with the circle layout producing slightly greater overall workload (except for DT and INSO high demand).

Author
Trevor Dobbins, Ryan Meeks, Michael Hespley, Stuart Howe & Kerri Garland Abstract
Contemporary military platforms are designed within a Systems Engineering environment. This paper describes how the use of the System Model and HCI wire-framing are being utilised to replace the traditional tabular task analysis as the Single Source of Truth of vehicle’s design.

Author
Shaun C. Lamb, Mohammad Naiseh, Jediah R. Clark, Sarvapali D. Ramchurn & Timothy J. Norman Abstract
We studied the experimental adoption of an image classifying tool as an organisation plans the adoption within its teams of intelligence analysts. We identified that existing models of expert decision-making and function allocation can be employed to inform the design and adoption of these tools.

Author
Ronald W. McLeod & Nora Balfe Abstract
Automation rarely if ever removes people from a system: rather, it changes their role in ways that can sometimes be difficult to predict. Learning from innumerable incidents has shown that organisations involved in developing and introducing highly automated systems must give sufficient attention during the design, development and deployment of automation to the role of people in the system. This paper suggests a structured analysis method that could be used early in the development of potentially any automated system to identify where a focused effort on Human Factors issues is likely to be needed.

Author
Katie J. Parnell, Neville A. Stanton & Katie L. Plant Abstract
Future trends in public mobility highlight the integration of autonomous technologies to our road transportation systems alongside a recent rise in popularity of active travel and micromobility. The interaction between autonomous vehicles and other vulnerable road users is a complex issue. Ongoing work by the authors aims to understand how our road transportation systems can incorporate these future trends, whilst also maintaining safety and resilience by reducing conflict between modes.

Author
Sue Ottley, Jaina Mistry, Kerry Tatlock & Chris Vance Abstract
Human Machine Teaming (HuMaT) systems are expected to become increasingly important and common in the UK military domain as a result of changes in both technology and the Battlespace; however the role of the human user is expected to be retained, though it may change. HuMaT systems are sociotechnical systems where needs and behaviours may be emergent and hard to predict from previous systems behaviours, therefore framing formal requirements prior to design can be difficult and sometimes counterproductive. The complex and variable nature of interactions within Human Machine Teams (HMT) means that traditional technology centric design processes do not easily support them, if the best use is to be made of both human and technology actors then a process more focused on user goals and constraints is required. This paper outlines the considerations for applying a Human Centred Design (HCD) process to developing HuMaT systems and how HCD addresses the challenges presented by a technology centric process.

Author
Siddharth Shyamsundar & Dr Nigel Hunt Abstract
This exploratory study investigates commercial pilots’ lived experiences with their automated cockpits. Using interpretative phenomenological analysis, a unique dual-impact theory of automation on situational awareness is uncovered. Recommendations focusing on integrating adaptive automation, pilot-in-the loop systems, system transparency, effective autonomy and promoting opportunities for applying manual flying skills are provided.

Author
Barry P Kirby, Ryan Gamble, Rob Honey & Phil Morgan Abstract
Establishing Gaia, a Command-and-Control Centre focused on climate activity, based in Wales. It aims to apply command and control principles to the evolving map of climate data and explore how such data can be integrated with policy, and with other information: resources and vulnerabilities to influence behaviour change on a regional and national level.

Author
Thomas A. Norton, Oluremi B. Ayoko & Neal M. Ashkanasy Abstract
We explore the potential for offices to provide organisations with the adaptive capacity to respond to the chronic challenge of environmental sustainability. We apply a socio-technical systems perspective and green ergonomics principles to investigate the relationship between an office environment, the occupants working within it, and the wider environmental context. To do this, we explore technical and cultural perspectives, and integrate these in a socio-technical viewpoint. In doing so, we consider the interaction between technical factors, such as green technology, and social factors, including social norms, which influence occupant activity and the contribution of this to the overall environmental performance of an office. We also consider how a green office might provide non-carbon benefits such as improving occupant well-being, creativity, and supporting the emergence of a green organisational culture, particularly through the application of biophilic design. Our investigation highlights several avenues through which an office designed with green ergonomic principles could benefit occupants, the organisations they work for, and the natural environment of which they are a part and on which they depend. We find reason to suspect that green offices could play an important role in sustainable development and exemplify how “going green” may be good for business.

Author
Barry Kirby & Ryan Gamble Abstract
The aim of this qualitative research study was to establish whether Ergonomics and Human Factors (E/HF) and its associated practices and principles could be applied to the issue of climate change. Furthermore, it aimed to explore how these professionals could help address the climate crisis through climate-conscious systems, processes, and designs and by considering human interactions with the climate as an interactive system. The following paper is therefore a first step towards establishing ‘Climate Ergonomics’ as a field, defining it based on expert opinions and suggesting where the E/HF professional is best situated to address climate change. The research team conducted three focus groups, with six E/HF professionals in each group, to establish how the profession could best support efforts in the climate crisis. Thematically analysed data suggested that three themes best explained the role and function of Climate Ergonomics and those working within this multi-disciplinary sphere. First, professionals must establish the position of ergonomics in the fight against climate change. Second, the appropriate methods, measures and tools must be established; be those repurposed from the E/HF toolkit or new measures which will need to be developed. Third, the inherent social inequality that is bound to matters of climate change must also be considered. E/HF professionals should work towards remedying, not reinforcing social inequalities. Future research should look to establish measures and tools to support the measurement of sustainable and socially responsible practice in the E/HF domain.

Author
Micheala Lawes, George Havenith & Simon Hodder Abstract
A protocol was developed to test theoretical assumptions associated with the interrelationship between thermal sensation, thermal discomfort, and physical contact temperatures in humans. To achieve this, perceptual responses (thermal sensation and thermal discomfort) to the application of seventeen absolute physical temperatures, ranging from cold to hot (18 - 42°C) were examined. In addition, the present study tested the confidence of participants in their thermal sensation ratings also, across a wide spectrum of thermal stimuli. Seventeen Western European university students volunteered and consented to participate in the study. The location of the application of the probe was marked on their skin, ensuring consistent application across temperatures, and all participants were blinded to the environment conditions, as well as the temperature of thermal probe controller unit, to avoid expectation bias. Physical temperatures were applied with a conductive thermal probe (Physitemp Instruments Inc., USA) consisting of a 25 cm2 metal surface, applied with a pressure of 4 kPa, in a mixed counterbalanced order. The probe was applied to the skin for 10 seconds for all applications, at the end of which participants rated their local thermal sensation, the confidence of thermal sensation, and local thermal discomfort. A recovery time between thermal probe applications of at least 20 seconds was used. Local skin temperature has been reported to have returned to its baseline value using a single spot infrared thermometer (FLUKE 566, Fluke Corporation, USA) prior to each subsequent thermal probe application.

Author
Karl J. Rich, Joy Ho & Cameron Edgar Abstract
New South Wales (NSW) Ambulance Aeromedical Operations Division (AOD) is standardising helicopter types with increased reliance on the Leonardo AW139. The AW139 has specified limits for the height and weight of medical crew (doctors and paramedics) when harnessed to the front and rear anchor points within the helicopter, and specified limits for the combined weight of medical crew, patients and equipment during stretcher winching operations. An anthropometric analysis was conducted to provide guidance on the height and weight ranges applicable to crew members based on the limitations of three system components: cabin seated height, hardpoint limit and winch limits (during stretcher winching operations). It was determined that seated height is a key dimension that would limit crew ability to interact with the cabin, this was at 935mm with helmet, clothing and seat depression correction factors included. This corresponds to 91st%ile Australian male seated height and 99th%ile Australian female seated height. Therefore, most of the Australian population should be able to sit in the cabin based on this dimension. In the analysis, hardpoint and winch weight limitations do not exclude a significant portion of the Australian population (e.g., 3% of males with a hardpoint weight limit of 130kg). However, it was found that the higher the weight of the crew member, the lower the weight of the patient that can be safely winched, especially when winching occurs below 0°C. Tables were developed to illustrate the effect of the limitations of system components on crew weight. It is concluded that the interaction of the analysed system component with patient weight would be key in understanding applicable crew height and weight ranges. It is recommended that seated height be formalised as an initial guidance, followed by ensuring crew understand the interrelationship between the safe working load on the hardpoint, weight on the winch and patient weight. This presented a good opportunity for NSW Ambulance AOD to integrate calculations of system component limits into formalised training. The operational context and general health/fitness to fly would also need to be considered for effective aeromedical operations.

Author
Nikolaos Gkikas, Paul Salmon & Christopher Baber Abstract
The present paper sets the scene for a recorded workshop exploring the critical role of Human Factors and Ergonomics in the development, operation and evaluation of Artificial Intelligence. First, we lay out some foundations of the multidisciplinary developments commonly placed under the umbrella of “Artificial Intelligence/AI” and propose some fundamental definitions to facilitate the structure of our arguments and the foundations for the workshop. Then we explore the role of Human Factors and Ergonomics methods in ensuring that AI systems contribute to our disciplinary goal of enhancing human health and wellbeing. In closing we propose a research agenda designed to ensure that Human Factors and Ergonomics is applied in future AI developments.

Author
Chris Baber, Emily McCormick & Ian Apperley Abstract
The issue of ‘explanation’ has become prominent in automated decision aiding, particularly when those aids rely on Artificial Intelligence (AI). In this paper, we propose a formal framework of ‘explanation’ which allows us to define different types of explanation. We provide a use-cases to illustrate how explanation can differ, both in human-human and human-agent interactions. At the heart of our framework is the notion that explanation involves common ground in which two parties are able to align the features to which they attend and the type of relevance that they apply to these features. Managing alignment of features is, for the most part, relatively easy and, in human-human explanation, people might begin an explanation by itemizing the features they are using (and people typically only mention one or two features). However, providing features without an indication of Relevance is unlikely to provide a satisfactory. This implies that explanations that only present features (or Clusters of features) are incomplete. However, most Explainable AI provides output only at the level of Features or Clusters. From this, the user has to infer Relevance by making assumptions as to the beliefs that could have led to that output. But, as the reasoning applied by the human is likely to differ from that of the AI system, such inference is not guaranteed to be an accurate reflection of how the AI system reached its decision. To this end, more work is required to allow interactive explanation to be developed (so that the human is able to define and test the inferences and compare these with the AI system’s reasoning).

Author
Chris Baber & Natan S. Morar Abstract
As the use of Uninhabited Aerial Systems (UAS) increases, e.g., for commercial delivery, for surveillance or for hostile action, there are challenges of monitoring and appropriately responding to a crowded airspace. Providing automated support could reduce the challenges. However, such support might also have an impact on the strategy that a human operator deploys. In this paper we present a simulation of Air Defence (in the form of a single-player, interactive game) which is used to study human performance under three conditions. Provision of decision support, i.e., through management by consent, produced better performance, even though it provided a limited situation awareness. A hybrid display produces performance that is superior to the manual control condition and similar to the management by consent condition. We note that provision of the air picture alone resulted in a different form of suboptimal performance, in which sensitivity was significantly lower. In this respect, providing the decision support (in the form of the polygon display) helps to limit tendency for false alarms.