The following papers have been published by CIEHF in Contemporary Ergonomics & Human Factors 2018, Eds R Charles & J Wilkinson, ISBN 978-1-9996527-0-8
Contemporary EHF 2018
The effect of ladder climbing on forearm function
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Author Arthur Stewart & Dawn Mitchell |
| Abstract Wind energy technicians are required to be capable of manual ascent of turbines before conducting essential maintenance. This mandates vertical ladder ascent which involves considerable forearm exertion which may have implications for such maintenance tasks. This study aimed to quantify the effect of a simulated and continuous climb of an 80m turbine on: grip strength; a pegboard test assessing fine motor control; and a hand-tool dexterity test. These were performed prior to and immediately post-climb and 15 minutes post-climb for the data collection. A convenience sample of ten healthy adults was recruited and underwent two familiarisation sessions with ladder climbing and manual tests. Results displayed wide inter-individual variability and indicated significant loss of grip strength (21-25%) and a tendency towards a loss of fine motor control (pegboard, mean 5% loss, NS) although hand-tool test data were equivocal. The scores acquired 15 minutes post-climb suggest task learning was incomplete, and that this may have masked an immediate post-climbing loss in function. Taken together these results have implications for: tasks expected of wind technicians; recruitment to a burgeoning wind energy industry; and for the design of future studies which will fully quantify these factors and thereby increase the effectiveness of individuals undertaking manual tasks after vertical ladder climbing. |
Non-technical skills: the foundation for a fair safety culture
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Author Paul Davison |
| Abstract This paper highlights three vital Human Performance (HP) themes that are required to generate and support Fair Safety Cultures. It is based on rail industry observations over five years as an external consultant. A specific cultural change programme with Southeastern Railways forms the basis of the case study. The three themes are firstly, a Train Operating Company’s (TOCs) orientation towards and handling of error. Secondly, the use of accident investigations to establish understanding and learning to prevent recurrence, and thirdly, the knowledge, understanding and employment of Non-Technical Skills (NTS) for staff development, whereby, the NTS provides the armour and tools within a human resilience toolbox for frontline operators to handle the challenges brought by the United Kingdom’s 21st century railway. |
Training to prevent and manage fatigue in the rail industry
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Author Andrew Smith, Gareth Jones, David Evans & Gwilym Bowen |
| Abstract Fatigue is a major health and safety issue in the rail industry and it also reduces the wellbeing of staff. Mathematical modelling is often used to schedule working hours to prevent fatigue, but there are other risk factors for fatigue (e.g. workload; lifestyle) that need to be addressed by a fatigue policy. The research described in this article came after an audit of fatigue in a train operating company. The company developed a policy to prevent and manage fatigue and one aspect of this, fatigue training, was developed and assessed. The key features of the training were: education; consideration of the personal experience of fatigue; small changes to prevent and manage fatigue; and commitment to preventing and managing fatigue. A pilot version of the course was given to a small group (N=22) of staff and modified according to feedback. Even at this stage, the general response was that such a course could be extremely beneficial. The course was then incorporated into the Safety Training Update Delivery (STUD) programme and delivered by an experienced trainer from the rail company. General information on fatigue was supported by specific video footage incorporating the experience of rail staff. The training was evaluated within three months of delivery, and the results showed that it was perceived as one of the best parts of the training. The aim for the future is to make the training available to other train companies. |
“Taxiing down the runway with half a bolt hanging out the bottom”: affective influences on decision making in general aviation maintenance engineers
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Author Kate Kingshott & Anjum Naweed |
| Abstract Maintenance engineers of aircraft in General Aviation work in a highly time pressured, complex and dynamic environment where errors in decision making could have far reaching consequences. However, few studies have investigated the role and influence of affect on the decision-making process in this setting. Using interviews and a scenario invention method, this study investigated the affective influences in decision making and corresponding responses in General Aviation maintenance engineering work in the Australian context. Preliminary findings based on inductive analysis identified a number of themes including affective response to task interruption specific to work colleagues and customers or management personnel, impact of negative rumination and the role of pride as a safety factor. Findings are discussed in terms of the impact of different affective states with implications for future research directions on crew resource training and non-technical skills development. |
Social network analysis in submarine command and control
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Author Neville A. Stanton and Aaron P. J. Roberts |
| Abstract This is a world’s first-of-a-kind study that compares three operational scenarios in a simulated submarine control room: Returning to Periscope Depth (RTPD), Inshore Operations (INSO) and Dived Tracking of Contact (DT). The Event Analysis of Systematic Teamwork (EAST) method was used to model the social networks. 10 teams were recruited for the study. Results indicate that, across all scenarios, the Operations Officer (OPSO) and Sonar Controller (SOC) are particularly loaded, with communication between these operators being revealed as a potential bottleneck. The type of operation being performed affected the type of information used significantly, with a higher reliance on sonar information (and the sonar operators) during a RTPD and a higher reliance on visual information (and the periscope operator) during INSO. Implications are discussed alongside suggestions for future work. |
The NHS health check for developing HFE competencies
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Author Helen Vosper, Paul Bowie & Sue Hignett |
| Abstract Patient safety is an emergent property of complex sociotechnical healthcare systems. Human Factors and Ergonomics (HFE), with its design-based systems focus, offers frameworks for developing resilient systems, although use in healthcare has been limited to date. Most healthcare educational curricula articulate requirements for students to develop patient safety competencies, but there is scant direction as to how this might be achieved. The authors have produced guidance on embedding HFE in healthcare curricula, but recognise that examples of effective HFE teaching would further support educational practice. This case study outlines a related set of activities based around the NHS Health Check, a population-wide screening programme designed to identify and manage cardiovascular risk. The Health Check represents a cardiovascular risk management system and is amenable to analysis using HFE frameworks. The educational activities described support students in developing a deep awareness of HFE theory, and early development of HFE competencies. The Health Check is a highly relevant professional activity for pharmacy students but would also be relevant to medical and nursing students, as well as healthcare management staff. This case study will form the focus of a discussion that will provide delegates with an opportunity to share experiences of different approaches to HFE education. |
Evolution of the PARRC model of driver distraction: methodologies, findings and recommendations
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Author Katie J. Parnell, Neville A. Stanton & Katherine L. Plant |
| Abstract The Prioritise, Adapt, Resource, Regulate, Conflict (PARRC) model of driver distraction was developed as an explorative model to capture the key factors involved in distraction from in-vehicle technology. The model aims to facilitate a systems view of driver distraction and the role that systemic actors have on the factors involved in distraction. This paper will detail the novelty of the PARRC model of driver distraction from in-vehicle technology, its development through grounded theory and further application to real world data collected from an interview study as well as a simulator and on-road driving study. The evolutionary steps the model underwent through these applications and what they reveal about the phenomenon of driver distraction is discussed. Furthermore, recommendations to practise are presented that target the actors within the sociotechnical system surrounding distraction related events that have been realised through the model and its application. |
Can we enhance transfusion incident reporters’ awareness of human and organisational factors?
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Author Alison Watt, Gyuchan Thomas Jun & Patrick Waterson |
| Abstract The importance of considering human and organisational factors when reporting transfusion incidents has been highlighted recently. The UK haemovigilance scheme, Serious Hazards of Transfusion (SHOT), has established over the past two decades that most incidents are caused by human errors in the transfusion process. To enhance the incident reporter’s awareness of human and organisational factors, we implemented two interventions and evaluated the effects. First, we created and incorporated a bespoke human factors investigation tool (HFIT) which explicitly asks for the level of contribution of individual staff member(s), the local environment or workspace, organisational or management and government or regulation. Second, we created and incorporated a self-learning package linked to the UK national haemovigilance reporting database, showing both good and poor examples of human and organisational factors reporting with discussions about the merits of these different reports. Data from this tool have been analysed to investigate whether increased learning is possible. The main conclusion after one year’s use of the HFIT, was that incident reporters tended to attribute culpability mostly to individuals (62.6%). It is possible this result is due to lack of system awareness amongst incident reporters. Six-month initial data analysis after the inclusion of the self-learning package shows that if the incident reporter has studied the self-learning package before scoring the level of contribution associated with an incident, there is a slightly lower tendency to attribute most responsibility to individuals. |
Can the NHS learn about human factors from the Ministry of Defence?
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Author Giulia Miles & Sue Hignett |
| Abstract The National Health Service (NHS) in England has ambitious plans to drive innovation in health information technology (HIT) to improve patient safety, quality and cost effectiveness. Acute trusts are complex socio-technical systems that are required to implement a number of large information technology projects in order to meet national targets for digital maturity. This research explored whether the Ministry of Defence (MOD) Human Factors Integration Model for the acquisition process could be applied to a HIT project. A qualitative research study was undertaken in a large English NHS acute trust using the experience of implementing an electronic observation system to explore transferability of the MOD approach to acute healthcare. Data were collected using semi-structured interviews and focus groups and analysed thematically with reference to SEIPS 2.0 (Holden et al, 2013) healthcare systems model and the MOD framework. Key findings included limited awareness of Human Factors in healthcare; information system design/specification to deliver positive outcomes around patient safety and financial savings. Human Factors negative systems issues included alert fatigue, changing mental models, inability to maximise data for patient benefit, system resilience, local and national interoperability issues. |
Inception, ideation and implementation: developing interfaces to improve drivers’ fuel efficiency
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Author Craig K. Allison, Neville A. Stanton, James M. Fleming, Xingda Yan, Forough Goudarzi & Roberto Lot |
| Abstract Cognitive Work Analysis has become a staple methodology for human factors and ergonomics researchers and practitioners. Despite this popularity, limited guidance is available to take the insights of the methodology forward into the development of newer systems and interfaces. This paper describes the use of the established design toolkit ‘Design with Intent’ as a suitable approach to help progress the insights of Cognitive Work Analysis towards the development of novel interfaces. An abridged account of developing a Cognitive Work Analysis for fuel efficient driving is presented, alongside the application of the Design with Intent toolkit to progress the insights from the Cognitive Work Analysis to generate novel design ideas which can be incorporated into future interfaces. Finally, early development work, compiling the ideas generated using the Design with Intent toolkit, is presented, demonstrating the potential for this combination of methods to produce interfaces for future testing and validation. |
Introducing contactless technology into the financial self-service environment
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Author Elina Jokisuu, Eleanor Forrest, Maggie McKendry, Marshall Munro & Phil Day |
| Abstract The use of contactless technology has grown; this led to a development to integrate it on an automated teller machine (ATM). This case study illustrates the importance of maintaining a holistic view of the entire system (including the physical interface, the onscreen experience, and the person using the technology), particularly when introducing new technology or interaction paradigms. It also demonstrates the benefit of multiple iterative rounds of ideation, concept creation and evaluation; without multiple cycles an acceptable solution would not have been found. Wider lessons are drawn for the design of hardware. |
Handover assist trials in highly automated vehicles: participant recommendations for future design
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Author Jediah R Clark, Neville Stanton & Kirsten M A Revell |
| Abstract Automated vehicles with situation-specific limited driving capabilities will soon be on our roadways. With this, comes the issue of the handover of control. This is required as the automated system reaches a design or capability boundary and requires the human-driver to take control. This is a profound issue, as the driver will have reduced ‘situation awareness’ due to being ‘out-of-the-loop’ for an extended period of time. To compensate for this, vehicle designs must make use of handover assist to ensure that situation awareness is effectively transmitted to the driver prior to taking control. In the case of an approaching pre-planned geographical boundary of operation, the handover is non-critical. We draw upon strategies currently practiced in domains such as healthcare, aviation and energy manufacturing / distribution and test four methods of verbal handover in a simulated road environment with a dual-control vehicle. Participants took part in four handover conditions and provided recommendations for the future design of highly automated vehicles. We found six core themes that summarise the recommendations made by the participants of these trials, and draw upon five core implications for future design. Researchers and designers should now look to integrate a number of viable approaches to the handover to create a unified efficient, safe and usable handover protocol for highly automated vehicles. Based on user preferences, we provide some insight on possibilities for application to future design and tests. |
Intensive care unit referrals: making decisions
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Author Marta Weronika Wronikowska, Verity Westgate, Jody Ede, James Malycha, Lauren Morgan & Peter Watkinson |
| Abstract Referral to an Intensive Care Unit (ICU) is a complex medical process. The decision making involved can be cognitively challenging and subjective. We aimed to identify variables used by clinicians to make decisions during the ICU referral process, define the requirements for cognitive decision making and to detect commonly repeated errors. Applied Cognitive Task Analysis (ACTA) interviews were carried out with 17 doctors and nurses of varying specialties and levels of seniority to create a high-level task analysis of the participant’s role in the ICU referral process. Interviews were audio recorded, transcribed and analysed by two researchers in NVivo 11 software. We identified 188 variables used for clinical decision-making during an ICU referral. Removal of duplicates created 30 discrete variables. We found that there was not one key variable or piece of information that was significant to clinicians. Instead a ‘big picture’ approach was described, where all the data about a single patient was assembled and cognitively processed. ‘Often missed’ factors in the referral process were also identified. The most common was failure to consult family to discern patient wishes. The 30 variables used in the ICU referral process will inform the development of an interface for the Hospital Alerting Via Electronic Noticeboard project. This aims to identify patients at risk of deterioration in hospitals. Patient wishes were often neglected during the process and mechanisms to address this will form part of future work. We propose the addition of ‘F’ for ‘functional status/family’ to the ‘ABCDE’ acronym that is commonly used to evaluate a patient’s condition. |
Fatal tram accident at Croydon – human factors investigation
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Author Mark S. Young & Nora Balfe |
| Abstract At about 06:07 hrs on Wednesday 9 November 2016, seven people lost their lives and 62 were injured when a tram overturned on a sharp left-hand curve in Croydon, south London. The tram was travelling at a speed of approximately 73 km/h as it entered the curve, which had a maximum permitted speed of 20 km/h. The Rail Accident Investigation Branch (RAIB) investigation focused on how the speed of trams is controlled, as well as issues linked to the design, operation and management of trams. This paper describes the findings associated with the driving of the tram, in particular why the driver did not apply sufficient braking for the curve. The RAIB concluded that the most likely cause was a temporary loss of awareness of the driving task during a period of low workload, which possibly caused a microsleep. It is also possible that when regaining awareness, the driver became confused about his location and direction of travel. Fifteen recommendations were made addressing these factors as well as wider aspects of safety and risk management. |
Critical care outreach: impacts of electronic observations and alerting technology
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Author Sophie Glazik |
| Abstract Information technology is an increasingly pervasive aspect of the healthcare environment, but introduction of new technology into complex systems like healthcare can create new opportunities for failure. Whilst literature on the unintended consequences of technology is extensive, less is known about the impacts it has on clinical work and patient safety. This paper reports the findings of a case study conducted at a large National Health Service (NHS) Trust in England, where electronic observations and alerting technology was introduced to replace paper charts. Using a qualitative approach, the study aimed to explore the impacts of this technology on a critical care outreach team’s performance and patient safety. Data from observation and ten semi-structured interviews with critical care outreach nurses were thematically analysed. The new technology has not only changed the way that patient observations data is recorded, displayed and viewed, it has also introduced a new mode of communication between groups of clinical staff: electronic alerts. Four main themes emerged that characterise the main changes brought about by the technology: communication, situation awareness, professional issues and workload. The relationship between aspects of these themes and patient safety was not perceived to be straightforward. |
The usability of F1 driving interfaces
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Author James WH Brown, Neville A Stanton & Kirsten M Revell |
| Abstract The complexity of driver’s interfaces in Formula One has increased dramatically in the last 25 years. This has resulted in criticisms from drivers and has been blamed in several cases for accidents due to distraction or mode error. Technologies adopted by Formula One to improve performance have led to additional interface requirements and the resultant interface design adaptations. Specific regulatory changes have also been identified as significant factors in dictating the driver’s interface workload. Research is currently ongoing into the empirical analysis of the interfaces. Even minor design decisions can have a large effect on usability. These findings have confirmed the challenges facing human factors engineers tasked with designing interfaces featuring large amounts of functionality for use within high cognitive workload conditions. |
A preliminary investigation towards the development of an emotion-aware partner agent for training control
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Author Federico Colecchia, Joseph Giacomin, Kate Hone |
| Abstract Simulator-based training platforms have become increasingly popular on the grounds of their potential to facilitate skill acquisition within safe and controlled environments. However, current technology is limited in its ability to adapt to individual trainees. Tailoring is in fact typically based on recorded simulation inputs and outputs, or relies on costly and time-consuming trainer-driven interventions, as opposed to direct monitoring of trainee state. This research explores whether automated detection of trainee emotional state can be used to drive real-time changes to the simulator control. The present paper reports on preliminary work to establish the technical viability of such an intervention using current emotion detection technology within a state-of-the-art fixed-base driving simulator environment. Data on the accuracy of the emotion detection software supports the feasibility of the approach, thereby suggesting the possibility of implementing emotion-driven training trajectories bespoke to the needs of individual trainees. |
Do our complex systems meet requirements? An example from naval ergonomics
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Author Mike Tainsh |
| Abstract Throughout the produce or services lifecycle, the assessment of the ergonomics contribution to system development evolves to ensure that designs meet requirements. This is particularly important towards the final stages when assessment is against operational scenarios. Current assessment techniques are examined, and exemplified using experience from current work on naval systems, and User System Architectures (Tainsh, 2016). Assessment techniques for contributions to operational scenarios are proposed using risk-based metrics which include the criterion ‘Risks At Operationally Acceptable Levels (RAOAL)’. |
Exploring workload and performance through the use of visual analytics
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Author Joanne Kitchin & Chris Baber |
| Abstract In Visual Analytics, the output of automated analysis is presented to users in an interactive visualisation. By responding to this, the user can modify the parameters of the computer visualisation. This raises questions about the design of the visualisation and the appropriate level of interaction for users. This paper focuses on the impact of visualisation on user performance. A simple air target detection task (in which automated support identified possible threat aircraft) was combined with a secondary task (in which target letters had to be detected against a background). Four visual analytic displays were used to complete a target detection task over two studies. The first study explored how the displays affected workload, attentional demand and performance, and the second how workload, attentional demand and performance are affected by task load (using the same displays). Results show that the use of visual analytic displays maintains response time and primary task performance when task load increases. This suggests that the demand on attention is easier to manage when visual analytic displays are used. |
Using human factors to enhance drug prescribing safety
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Author Joanne Carling, Gillian Janes & Dave Murray |
| Abstract Preventing harm by ensuring medications are prescribed accurately for patients on admission to hospital is a patent safety priority and one that should be achievable. A human factors systems analysis of the process of medicines reconciliation revealed some possible solutions to reducing drug prescribing errors for patients admitted to a hospital in England. Medicines reconciliation is a process that ensures the medication prescribed for adults in hospital corresponds to pre-admission. It aims to avoid errors such as unintended omissions, over prescribing, dosing errors or adverse drug reactions. Inadequate medicines reconciliation on admission is commonly identified as a major cause of patient morbidity. Poor access to patients’ regular medications lists is recognised as a particularly important factor. The System Engineering Initiative for Patient Safety model was used to analyse the barriers to effective medicines reconciliation in adults on admission. This model clearly recognises the interrelated nature of the five major aspects of work systems: people, tasks, tools and technologies, physical environment and organisational conditions. Adopting this approach enabled a broader, more effective analysis of the problem which identified some fundamental issues with the current process and barriers to effective medicines reconciliation which were otherwise unknown. The findings revealed how work system elements interact and the importance of acknowledging this when trying to resolve a problem like improving medicines reconciliation, rather than focusing on the behaviour of individuals. Dissemination of the findings and implementation of the recommendations arising from these also helped the organisation to appreciate the value of human factors in understanding human performance and enhancing safety. |
Modelling user interactions in the Internet of Things
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Author J. Waldo Cervantes-Solis & Chris Baber |
| Abstract User experience with ‘smart’ objects determines the device’s adoption. One important consideration, therefore, is whether it is possible to model the interactions prior to development, so that design decisions can be made which could enhance user experience. In this paper, we focus on the use of Task Analysis for Error Identification (TAFEI) as a tool for Internet of Things (IoT) systems modelling. Based on the concept of identifying and characterising the purpose of the social-like interactions, we analyse how goals are achieved when using an instrumented object. TAFEI provides a perspective in which Human-Internet of Things Interaction (HII) is analysed from the context of system’s goals and sub goals. As such, this approach not only provides system’s failure scenarios, but more appropriately for IoT enabled objects, it also enables the identification of new scenarios for the system to provide knowledge to the user, and allow it to predict a user’s intent and pre-emptively take action on the user’s behalf. This methodology allows Internet of Things development to not only consider sensor data, but also system usability, promoting meaningful HII, and improving user engagement with IoT systems. |
Beyond user-centred design. Crowdsourcing with Serious Games for Design.
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Author Edward Oates |
| Abstract Designers rely on direct access to ‘users’ (those who will use the product) to assist in their design process. User-centred design strongly emphasises the full involvement of users in the design process; but what happens when they aren’t available? This study investigates the extent to which Serious Games may offer an asynchronous remote alternative to ‘face-to-face’ design processes through Crowdsourcing. A design process completes with summative usability testing of the product. Again, a lack of access to users is a serious limitation and one that may be ameliorated by remote unmoderated usability testing. The extent to which Serious Games may be the vehicle for remote usability testing is also explored in this research. Results from the Crowdsourcing activity show, from contributed design ideas, that a Serious Game may provide a credible tool for Crowdsourced Design. Remote unmoderated testing has known limitations and the use of Serious Games provides some mitigation, with careful implementation being required. This is a mid-study report on UK Ministry of Defence sponsored research under the Royal Navy ‘DARE Innovation’ initiative. |
Taking a ‘7 E’s’ approach to road safety in the UK and beyond
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Author Katherine L. Plant, Rich C. McIlroy & Neville A. Stanton |
| Abstract Road traffic accidents claim the lives of more than 1.25 million people each year, 90% of these deaths occur in Low-and Middle-Income countries (LMIC). The Socio Technical Approach to Road Safety (STARS) project brings together a consortium of four LMICs (Bangladesh, China, Kenya and Vietnam) and a leading Transport Research Group in the United Kingdom (UK) in order to tackle Road Safety. Traditional road safety research has been characterised by the ‘3 E’s’ of Engineering, Enforcement and Education. Although these have provided guidance to engineers and policy makers, they do not go far enough to providing a holistic and integrated approach to road safety and fail to consider fully the wider system factors that shape road user performance and outcomes. STARS intends to tackle road safety from a ‘7 E’s’ perspective, with the inclusion of Economics, Emergency response, Enablement, and the overarching ‘E’ of Ergonomics, i.e. applying contemporary socio-technical systems methods to develop systemic solutions to the seemingly intractable problem of road safety. This paper provides a status review of the ‘7 E’s’ of road safety from a UK perspective and the poster will contrast road safety across the five countries using the Actor Map component of the Risk Management Framework to model the road safety system. |
Systems approach to analysing suicide incidents in community-based mental health care
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Author Nye Canham, Gyuchan Thomas Jun, Satheesh Kumar & Fabida Noushad |
| Abstract Mental health services in the UK are now predominantly community-based, rather than inpatient-based. Managing patients with suicidal risk within the community setting is challenging and suicides from those currently using or having recently used these services do occur. More than half of the people who commit suicide have visited their doctor in the month before their death. In current practice within the UK health service, patient suicides are investigated as serious incidents and analysed using Root Cause Analysis (RCA) but this method has limitations in exploring deep system problems. This study reanalysed 41 of these RCA incident reports using Systems Theoretic Accident Modelling and Processes (STAMP). The analysis revealed the weaknesses within the system safety control structure and the themes around those control flaws. An inherent weakness in the control structure is the need to monitor the patient’s risk without constant observation and relying on the patient to report issues and adhere to their treatment plan. Patient engagement issues are a major theme with loss of control and feedback on the patient status due to their lack of willingness to engage with services and treatment options. In some cases, patients have presented at a time of crisis but then declined the crisis support or inpatient treatment offered to them. Patients new to services present a problem where decisions on their care have to be made with limited knowledge of the patient. Certain coordination and communication issues between the multidisciplinary teams and multiple services are also found. In this study, STAMP application enabled effective aggregation of multiple incident analysis and system-wide remedial action prioritisation. |
An assessment of workload in a simulated submarine control room
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Author Kiome A. Pope, Aaron P.J. Roberts & Neville A. Stanton |
| Abstract The Command Team Experimental Testbed (ComTET) is a programme of work designed to study the operation of current and future submarine command teams. As part of this work a submarine control room simulator was designed and built for testing purposes. Baseline testing was conducted to establish current functionalities, with recommendations forming the basis for Manipulation One where some operators were co-located. During testing, 32 participants (four teams of eight individuals) were given general maritime, and role specific training. Each team completed a high and low demand version of three scenario types: return to periscope depth, inshore operations, and dived tracking. On completing each scenario, the workload of participants was assessed using an electronic version of the Bedford scale. Preliminary results suggest the workload of operators was affected by scenario demand and type. Results also suggest that the co-location of operators had a positive effect on the demand placed on them. The results are discussed, along with future analysis plans. |
Human factors: emergency department suspected heart attack process
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Author Frances Ives & Deborah Jackson |
| Abstract Early recognition of a heart attack is essential as delayed treatment can result in death. A Human Factors (HF) review of the process for treating suspected heart attack patients in a busy inner-city Emergency Department (ED) was completed to help decrease risk, improve patient safety, care and patient and staff experience. To provide timely treatment for a heart attack, a diagnostic electrocardiogram (ECG) must be performed within 15 minutes of arrival at ED. However, concerns had been raised by staff relating to patient experience and delayed ECG, due to the number of process steps the patient had to complete from arrival at ED reception to the ECG being taken. Observations of the process were carried out along with multidisciplinary staff focus groups to understand the patient journey. A Hierarchical Task Analysis (HTA) and Failure Modes Effects Analysis (FMEA) were also completed to identify process failures and impact. The FMEA and observations identified that the patient journey was complex due to: the distance they were required to walk; having to enter the department through the ambulance entrance; and the requirement to speak to a specific member of staff in the department to obtain further directions. The process was changed to: reduce the distance the patient had to walk; decrease the likelihood for them to get lost; improve patient visibility for staff; and to facilitate more timely ECGs. As result of the Human Factors review, ED staff felt empowered to make immediate, no-cost and sustainable improvements. |
Encouraging eco-driving: the case for accelerator–based haptic information
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Author Rich McIlroy and Neville Stanton |
| Abstract Over the course of two driving simulator experiments, various types of eco-driving support were investigated. In the first experiment, sensory mode was examined. Driving performance in conditions with visual, auditory, and vibrotactile stimuli, and all combinations thereof, were compared with each other, and with performance when driving without information. The stimuli aimed at discouraging excessive acceleration, and at encouraging an enhanced coasting phase when approaching events necessitating deceleration. Following results from that experiment, the second experiment looked only at vibrotactile information for the support of enhanced coasting phases. As with experiment one, the vibrotactile alerts were presented via the accelerator pedal; however, where in experiment one coasting alerts were provided at a fixed eight seconds before a slowing event, experiment two manipulated this timing (using four, eight, and twelve second thresholds). The general conclusion was that vibrotactile information, presented through the accelerator pedal, represents a promising and as yet under investigated method of supporting eco-driving and, moreover, that coasting as a fuel-saving strategy is more deserving of support via in-vehicle information than is the discouragement of harsh accelerations. |
“That was scary…” exploring driver-autonomous vehicle interaction using the Perceptual Cycle Model
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Author Kirsten Revell, Joy Richardson, Pat Langdon, Mike Bradley , Ioannis Politis, Simon Thompson, Lee Skrypchuk, Jim O’Donoghue, Alex Mouzakitis & Neville Stanton |
| Abstract Semi-autonomous cars are already on the road and highly autonomous cars will soon be with us. Little is understood about how drivers will adapt to the changing relationship with their vehicle, but to ensure safety and consumer acceptance, it is vital to gain this insight. This paper highlights evidence of poor synergy between driver and vehicle in semi-autonomous mode when preparing for a manoeuvre on a UK motorway. As part of an on going study, six UK drivers were observed using a semi-autonomous vehicle whilst employing the ‘think aloud’ technique. Video and audio footage of their interaction with the vehicle was captured and analysed using Neisser’s (1976) Perceptual Cycle Model (PCM). A case study of a single driver is presented in this paper to provide a practical demonstration of the utility of PCM to gain a system’s view of driver-vehicle interaction. The need to consider the drivers schemata of automation capability in the context of use is demonstrated, and implications for interaction design are discussed. |
Streamlining experimental processes using bespoke software
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Author Daniel Fay, Neville A Stanton & Aaron PJ Roberts |
| Abstract The Command Teamwork Experimental Test-bed project was a programme of work that evaluated future ways of working in control rooms through a series of command team studies. Each study required a large software stack to record the necessary data. For each study, teams of participants operated stations that required configuration before each scenario. This configuration was performed by giving spoken instructions to participants. While these instructions worked, they had issues that negatively affected the experimental procedure. To alleviate these issues, software was developed to configure the software stack for each participant. This software, the ComTET Laboratory Automation and Management Shell, has yielded benefits to both experimenters and participants. It is put forth that similar results could be achieved in other experiments by practitioners using software to bolster their experimental procedure. |
Development of a Usability Evaluation Framework for the flight deck
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Author Victoria A. Banks, Katherine L. Plant & Neville A. Stanton |
| Abstract Systems design is often criticised for bringing human factors (HF) expertise into the design process at the end of a product’s development – often too late to have much impact on the design and usability of products and/or systems. This paper proposes a new Usability Evaluation Framework for the Flight Deck that can utilise HF expertise throughout the design lifecycle. It incorporates widely accepted design practices with a more user-centred approach that enables simultaneous usability testing and evaluation at every stage of the design lifecycle. |
Leading behaviours in Highways England
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Author Claire Philp & Nigel Heaton |
| Abstract As part of a 5-year health and safety plan, Highways England has embarked upon an ambitious leadership and behavioural safety Programme. We provided leaders with a wide range of tools to try when they went back to work. We found that the most popular tool in these leaders’ action plans is COM-B, a model used to explain behaviours. Leaders also adopted other tools to support the development of a just culture, improvements in wellbeing, and mapping risk at a local level. The training programme has improved the self-evaluations of key management areas and appears to have driven safer behaviours. Overall, we have found that if leaders are equipped with tools and understanding of the problems they face, are followed up, and are offered on-going support, they are willing to make real changes to the way they work and approach health and safety. |
Drawing in time: time-series analysis and human action
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Author Chris Baber & Zonglin Xu |
| Abstract We are concerned with analysing the temporal dynamics of simple skills, and whether such analysis can allow us to distinguish between different levels of ability. In order to do this, we focus on the task of drawing simple shapes. The challenge is to develop a means of collecting both force and movement data, and then describing these data in terms of time-series analysis. In this paper, we apply two methods for time-series analysis (1/f scaling and Approximate Entropy) to drawing. Ultimately, the goal of the work is to consider whether these measures allow us to differentiate ability in human performance. We show that it is possible to separate ‘good’ and ‘poor’ performers using these methods, and that this separation agrees with the self-identified ability of participants. If it is possible to provide ways of describing performance, then we can evaluate whether this is improving (as the result of rehabilitation or training) or whether it is deteriorating (as the result of injury or illness). |
Evaluating the use of tactile navigation for motorcycle taxis and couriers
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Author Crisman Silban and Chris Baber |
| Abstract In this paper we describe the design and evaluation of a simple prototype device that provides tactile cues to support navigation by motorcyclists. A comparative evaluation shows that the device supports equivalent performance to the use of a visual display. The evaluation was performed by licensed motorcycle taxi drivers in Thailand, on a University campus. The evaluation showed that, in terms of journey time and route accuracy, there was little difference between the two technologies. A further evaluation, of the tactile belt, was conducted in a busy town. Participants were able to follow the route and responded positively to the concept and its implementation in our prototype. We propose that tactile navigation aids can help motorcyclists and that, compared to visual displays, these can be used with reduced risk of distraction. |
Temporal investigation of information transition in submarine command teams
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Author Aaron P. J. Roberts, Neville Stanton & Kiome Pope |
| Abstract The Command Team Experimental Testbed (ComTET) is a program of work tasked with making evidence based recommendations for future submarine control room design. Previous work from the program described information flow between a submarine command team when completing a Return To Periscope Depth (RTPD) operation. A number of bottlenecks were revealed with regard to information exchange, and particular operators were required to act as information brokers. The current pilot study aims to build on such work by examining the temporal implications of operator overload and information bottlenecks. The work was conducted in a submarine control room simulator, built specifically for research purposes. A non-commercial version of Dangerous Waters was used as the simulation engine. The creation of networked workstations allowed a team of nine operators to perform tasks completed by submarine command teams during a RTPD operation. A frequency count of information attainment (i.e. task completion) and transition of information between operators was completed. The time taken for information to transit through all stages of the tactical picture development was also recorded. The volume of information reduced in a linear fashion as it was passed between multiple operators in the command team. The time taken for information to pass between operators was greater in higher demand scenarios. The reduction in information exchange may be a product of the quality checking process. However, it may also reflect limitations in information exchange due to bottlenecks in the command team. It is recommended that the current pilot study be built upon; recruiting more teams across different operation types. This would afford statistical comparisons of information transition times during different levels of demand and different operations. This could provide valuable insight into where optimisation of information transition might best be targeted in future submarine platforms. |
Breaking bad systems: using work domain analysis to identify strategies for disrupting terrorist cells
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Author Paul M. Salmon, Tony Carden & Nicholas J. Stevens |
| Abstract Terrorism represents a major global issue. Despite decades of research, interventions designed to prevent or disrupt terrorist activities are failing to adequately control the problem. This paper argues that a human factors systems-thinking approach may support the identification of novel, holistic and impactful interventions. To demonstrate, a systems analysis of a generic Islamic State terrorist cell, created using the work domain analysis phase of cognitive work analysis, is presented. The analysis is subsequently used to identify opportunities for disrupting terrorist cells and their activities. In addition to well-known and already applied interventions, the analysis identified a series of other opportunities for disrupting terrorist cell activities. Examples discussed include strategies designed to disrupt propaganda activities and the planning of terrorist attacks. The analysis also showcases the potential use of systems ergonomics for disrupting, as well as optimising, sociotechnical systems. The implications for ergonomics generally as well as counter-terrorism activities are discussed. |
Developing a leadership behaviours programme
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Author Nigel Heaton, Claire Philps & Andy Stocks |
| Abstract Highways England has engaged in an ambitious evidence-based programme to address the behaviours of their leadership teams with regards to health and safety. The training provides them with a tool kit to deliver more effective safety leadership. This paper will explore how the programme was developed and what decisions were taken to ensure the content was effective. |
Patient-maintained propofol sedation for orthopaedic surgery: patient variability in system use
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Author David Hewson, Nigel Bedforth, James Sprinks, Philip Breedon & Frank Worcester |
| Abstract In the UK, operations not requiring general anaesthesia may be carried out under sedation. This is generally provided by a doctor. As the patient is not controlling the sedation, they may often be either under or over-sedated, due to the doctor misjudging patients’ anxiety and sedation requirements. A potential solution is to allow the patient to control their own depth of sedation. We conducted a case series to examine the efficacy of patient-maintained propofol sedation for patients presenting for lower limb orthopaedic surgery under regional anaesthesia. Twenty-six patients undergoing lower limb surgery were given a handheld button to indicate their request for deepening sedation from a baseline propofol concentration of 0.5 g.ml-1 by 0.2 g.ml-1 increments to a maximum of 2.0 g.ml-1. Twelve patients chose not to press their button. The remaining 14 patients pressed the button a median (range) of 6 (1–29) times, obtaining a mean (SD) estimated effect-site blood propofol concentration of 0.91 g.ml-1 (0.34 g.ml-1). Feedback revealed that patients were satisfied with their sedation, were happy to have control over it, and would use the system again. Despite this consensus, sedation level profiles revealed variability in how patients used the system in terms of button press frequency and timing, associated with their pre-op anxiety and reaction to environmental events during the operation. Whilst this technique can be a safe and effective way of controlling sedation during these types of surgery, future research needs to consider the different ways patients interact with the system. |
