Human Factors Work Research Articles

Recommendations for promoting user agency in the design of speech neuroprostheses.

Brain-computer interfaces (BCI) that directly decode speech from brain activity aim to restore communication in people with paralysis who cannot speak. Despite recent advances, neural inference of speech remains imperfect, limiting the ability for speech BCIs to enable experiences such as fluent conversation that promote agency - that is, the ability for users to author and transmit messages enacting their intentions. Here, we make recommendations for promoting agency based on existing and emerging strategies in neural engineering. The focus is on achieving fast, accurate, and reliable performance while ensuring volitional control over when a decoder is engaged, what exactly is decoded, and how messages are expressed. Additionally, alongside neuroscientific progress within controlled experimental settings, we argue that a parallel line of research must consider how to translate experimental successes into real-world environments. While such research will ultimately require input from prospective users, here we identify and describe design choices inspired by human-factors work conducted in existing fields of assistive technology, which address practical issues likely to emerge in future real-world speech BCI applications.

Perceived Patient Workload and Its Impact on Outcomes During New Cancer Patient Visits: Analysis of a Convenience Sample.

Studies exploring the workload in health care focus on the doctors' perspectives. The ecology of the health care environment is critical and different for doctors and patients. In this study, we explore the patient workload among newly diagnosed patients with cancer during their first visit and its impact on the patient's perceptions of the quality of care (their trust in their doctors, their satisfaction with the care visits, their perception of technology use). We collected data from the Hackensack Meridian Health, John Theurer Cancer Center between February 2021 and May 2022. The technology use considered during the visit is related to doctors' use of electronic health records. A total of 135 participants were included in the study. Most participants were 50-64 years old (n=91, 67.41%). A majority (n=81, 60%) of them were White, and only (n=16, 11.85%) went to graduate schools. The findings captured the significant effect of overall workload on trust in doctors and perception of health IT use within the visits. On the other hand, the overall workload did not impact patients' satisfaction during the visit. A total of 80% (n=108) of patients experienced an overall high level of workload. Despite almost 55% (n=75) of them experiencing a high mental load, 71.1% (n=96) reported low levels of effort, 89% (n=120) experienced low time pressure, 85.2% (n=115) experienced low frustration levels, and 69.6% (n=94) experienced low physical activity. The more overall workload patients felt, the less they trusted their doctors (odds ratio [OR] 0.059, 95% CI 0.001-2.34; P=.007). Low trust was also associated with the demanding mental tasks in the visits (OR 0.055, 95% CI 0.002-2.64; P<.001), the physical load (OR 0.194, 95% CI 0.004-4.23; P<.001), the time load (OR 0.183, 95% CI 0.02-2.35; P=.046) the effort needed to cope with the environment (OR 0.163, 95% CI 0.05-1.69; P<.001), and the frustration levels (OR 0.323, 95% CI 0.04-2.55; P=.03). The patients' perceptions of electronic health record use during the visit were negatively impacted by the overall workload experienced by the patients (OR 0.315, 95% CI 0.08-6.35; P=.01) and the high frustration level experienced (OR 0.111, 95% CI 0.015-3.75; P<.001). The study's findings established pathways for future research and have implications for cancer patients' workload. Better technology design and use can minimize perceived workload, which might contribute to the trust relationship between doctors and patients in this critical environment. Future human factors work needs to explore the workload and driving factors in longitudinal studies and assess whether these workloads might contribute to unintended patient outcomes and medical errors.

Considering Team Dynamics during Human Factors Work in Healthcare

A significant body of human factors (HF) work has focused on how people collaborate on teams in various operational settings such as aviation and nuclear power. Less work, however, has focused on the team dynamics of groups conducting HF studies. This paper describes a collaborative effort led by HF practitioners to understand and document user needs and challenges associated with the adoption of a new electronic health record (EHR) at a medical facility. By examining the challenges and opportunities presented by the interdisciplinary nature of the team, we can identify best practices for future study and change management efforts that may ultimately lead to greater organizational maturity and the development of better, safer systems.

Examining the relationship between human factors related quality risk factors and work related musculoskeletal disorder risk factors in manufacturing

This study addresses the relationship between human factors (HF) related quality deficits in manufacturing and work-related musculoskeletal disorder (WMSD) risk factors in production staff. A recent systematic review identified 60 HF-related quality risk factors (QRFs) in manufacturing related to product, process and workstation design stages. We investigate the extent to which these identified QRFs are also WMSD risk factors. Each QRF was examined for its relationship with WMSD using a 0 (no relationship) to 10 (strong relationship) scale rubric. The authors rated each QRF separately and then discussed and adjusted their ratings in a review session. Results showed that average median ratings were the highest for QRFs related to product design (8/10), intermediate for QRFs related to workstation design (7/10) and the lowest for QRFs related to process design (5/10). This emphasises the significant role of HF in system design in reducing both quality deficits and risk of developing WMSDs for manufacturing personnel. Practitioner summary: This study investigates whether human-related risk factors for product quality are also risk factors for work-related musculoskeletal disorders in manufacturing. Results showed a substantial relationship between quality risk factors and WMSD risk factors. This indicates the significant role of human factors in operations design in improving both system performance and human wellbeing.

Mapping Usability Heuristics to Medical Ethical Principles in Clinical Decision Support Design

Human factors professionals voice concerns about the slow and uneven adoption of human-centered design (HCD) principles in healthcare. With good intentions and best efforts, human factors work in healthcare continues, but to understand and to be understood we must share a language that speaks to one another. One way to facilitate this understanding is by bringing attention to how we talk about decision-making approaches in medical ethics and HCD. Both disciplines suggest efforts should be participatory, guided by a set of principles applied thoughtfully, with critical consideration to context and trade-offs. Considering the connections between usability heuristics for design and medical ethical principles may offer a bridge between disciplines and their associated dialects. In this paper, we provide three representations mapping ethical principles to design principles, including usability heuristics: a word tree visualization, narrative passages, and a table format. We believe this mapping demonstrates both that ethical design is inherently human-centric and that human-centered design is ethical design.

Usability of Electronic Health Record-Generated Discharge Summaries: Heuristic Evaluation.

BackgroundObtaining accurate clinical information about recent acute care visits is extremely important for outpatient providers. However, documents used to communicate this information are often difficult to use. This puts patients at risk of adverse events. Elderly patients who are seen by more providers and have more care transitions are especially vulnerable.ObjectiveThis study aimed to (1) identify the information about elderly patients’ recent acute care visits needed to coordinate their care, (2) use this information to assess discharge summaries, and (3) provide recommendations to help improve the quality of electronic health record (EHR)–generated discharge summaries, thereby increasing patient safety.MethodsA literature review, clinician interviews, and a survey of outpatient providers were used to identify and categorize data needed to coordinate care for recently discharged elderly patients. Based upon those data, 2 guidelines for creating useful discharge summaries were created. The new guidelines, along with 17 previously developed medical documentation usability heuristics, were applied to assess 4 simulated elderly patient discharge summaries.ResultsThe initial research effort yielded a list of 29 items that should always be included in elderly patient discharge summaries and a list of 7 “helpful, but not always necessary” items. Evaluation of 4 deidentified elderly patient discharge summaries revealed that none of the documents contained all 36 necessary items; between 14 and 18 were missing. The documents each had several other issues, and they differed significantly in organization, layout, and formatting.ConclusionsVariations in content and structure of discharge summaries in the United States make them unnecessarily difficult to use. Standardization would benefit both patients, by lowering the risk of care transition–related adverse events, and outpatient providers, by helping reduce frustration that can contribute to burnout. In the short term, acute care providers can help improve the quality of their discharge summaries by working with EHR vendors to follow recommendations based upon this study. Meanwhile, additional human factors work should determine the most effective way to organize and present information in discharge summaries, to facilitate effective standardization.

Forensic Human Factors 101: Interactive Transportation and Product Liability Case Studies

This special joint session with shared interest from multiple technical groups (Forensics Professional Group, Product Design Technical Group, Safety Technical Group, and Surface Transportation Technical Group) provides audience members with an opportunity to conduct a forensic analysis of two cases involving human factors issues. The audience will form four groups in order to conduct their analysis of the behavior and actions of either the plaintiff or the defendant(s) involved in their assigned case. Participants in this session will be provided with information about the case they are analyzing, including descriptions of the circumstances surrounding the case and other factual information required to conduct a forensic analysis. One case will involve a collision between a commercial vehicle and a pedestrian, while the other will relate to the alleged failure of an air regulator utilized in diving. The teams will be asked to develop outlines of expert opinions relying on their knowledge, experience, and familiarity with applicable research. At the conclusion of the teams’ discussions, each team will briefly present the opinions reached by the team. To conclude the session, the audience will have the opportunity to discuss both cases and the value of human factors professionals in litigation. This session will emphasize the broad application of human factors and that forensic human factors work is accessible to a variety of practitioners.

Framework for Developing a Brief Interview to Understand Cyber Defense Work: An Experience Report

Cyber defense is increasingly important for the wellbeing of our economy and our national defense. Universities can help meet our growing cybersecurity needs by training the next generation of cyber defenders, and it is crucial that the curricula for such programs are designed to prepare students for the type of work that is performed in the field. Unfortunately, collecting data about cyber work is hindered in situations where cybersecurity professionals are uncomfortable with traditional human factors work analysis methods. Four potential constraints are 1) no naturalistic observations, 2) anonymity and safety, 3) short data collection time, and 4) no deep process questions. We developed a brief interview technique that allowed us to measure the importance of knowledge, skills, and abilities related to offensive and defensive cyber work. Based on our experience using this technique, it fits within the four potential constraints to cyber research and produces information that is directly applicable to the development of cybersecurity curricula. Our technique could potentially be used for other research purposes and personnel selection and by researchers interested in other high-security populations.

Human Factors in Pharmacy

Medication errors in the ambulatory setting are common and contribute to significant morbidity and mortality. Given the Institute of Medicine’s recommendation of adopting a systems-based approach to improving medication safety, research has been conducted utilizing human factors and ergonomics conceptual frameworks, approaches, and methods to study pharmacies and pharmacists. This panel will focus on how human factors principles and models have been adapted for contexts where medications are managed. Individual projects address pediatric patients’ medication-related needs, over-the-counter medication safety for older adults, anticoagulation management, automated prescription tracking, and medication safety-related decision making by healthcare professionals. These studies span settings from community pharmacies to inpatient pharmacies to specialty clinics and patients’ homes. By presenting a sample of the growing body of human factors work in pharmacy, this panel will offer unique implications for human factors theory, methods, and application in this important domain.

A Clinical Residency in Sausage Making

Gaining the perspective of users is an essential goal of anyone performing human factors work in product design. Within medical product design teams, engineers have the frequent opportunity to interact with medical professionals. This embarrassment of riches in access to the user experience presents unique benefits and challenges to developing a usable product interface. This panel will provide insight into situations and perspectives of when human factors engineers work with medical device users (healthcare providers such as doctors, nurses, pharmacists, biomedical engineers) who were also part of the product development teams. The scope will include: what interactions are involved to work effectively on a project team; what was expected compared to what actually happened; effectively providing recommendations for designing usable products; what user experience / use testing methodologies were learned and performed by someone outside of human factors; and best practices for team interactions.

Medication Errors in Intravenous Drug Preparation and Administration: A Brief Review

Medication errors in intravenous drug administration can be defined as any mistakes in the preparation, dispensing and administration of these drugs. Medication errors can be classified based on the stage of intravenous therapy in which the error occurs (pre-preparation phase, preparation of medication by nurse, drug labelling, and drug administration). In intravenously administered medications, errors may have particularly serious consequences. Medication errors are more likely to be recorded during the morning hours. Inappropriate speed of administration was found to be the most common type of error in intravenously administered drugs, with slow bolus injection being the route of administration associated with the most risk. Greater safety of the medication process can be achieved by eliminating risk factors and by using different strategies to detect errors. In addition to eliminating the most dangerous human risk factors (work overload of nurses, their fatigue, and general lack of personnel), the use of various supportive technologies, such as computerized prescription of drugs, barcode scanning, and the use of electronic infusion pumps, effectively decreases the risk of medication errors.

Heavy Vehicle Automation: Human Factors Lessons Learned

Although passenger car automation has captured the public's attention in recent years, heavy truck automation has also been a major research topic around the world. In the U.S., the California PATH program at U.C. Berkeley has been engaged in heavy vehicle driver assistance and automation research for trucks, buses, and snow removal equipment for over 15 years. Until recently, much of the human factors work in the field has been limited to driving simulations because the state of the technology is only just now reaching the level of maturity required to move beyond pure research. Despite still being in the early stages of gaining practical, real-world experience with automation, lessons have been learned over the past two decades of heavy vehicle automation development. With the many different automation concepts being discussed, there are bound to be differences between passenger car and heavy vehicle automation because the motivations for automation differ between the two industries, resulting in different automation use cases and potentially leading to different design solutions. Similarly, since heavy vehicles tend to be engaged in commercial operations, institutional considerations can influence design, but commercial fleets also provide opportunities for driver training that might not otherwise be possible with the general public. Finally, the special use cases for heavy vehicle automation can challenge conventional design wisdom, and not all designs or conclusions coming from passenger car experience will necessarily apply to heavy vehicles.

The contributions of human factors and ergonomics to a sustainable minerals industry

This article describes examples of the application of human factors research and development work to a sustainable minerals industry. It begins by outlining human-related aspects of the minerals industry and the key human factors work previously undertaken in this domain. The focus then switches to sustainability in the minerals industry. Sustainability principles are introduced and illustrations provided of how human factors research and development work fits within such a framework. Three case studies of human factors in the minerals industry research are presented and the sustainability implications in each case study are highlighted. Finally, future trends related to human factors work in a sustainable minerals industry are addressed, in particular the opportunities and possible adverse consequences that increasing deployment of mining automation might bring. Practitioner Summary: Minerals industries are a major global activity with significant sustainability implications. Aspects of sustainability in mining are examined using three case studies. These illustrate the contribution of human factors/ergonomics in reducing risks; developing emergency response management systems; and the value of participatory ergonomics in improving the design of mining equipment.

A Roundtable Discussion … Increased Focus on Human Factors Drives Device Safety Improvements

<i>A Roundtable Discussion</i> … Increased Focus on Human Factors Drives Device Safety Improvements

Understanding safety and production risks in rail engineering planning and protection

Much of the published human factors work on risk is to do with safety and within this is concerned with prediction and analysis of human error and with human reliability assessment. Less has been published on human factors contributions to understanding and managing project, business, engineering and other forms of risk and still less jointly assessing risk to do with broad issues of ‘safety’ and broad issues of ‘production’ or ‘performance’. This paper contains a general commentary on human factors and assessment of risk of various kinds, in the context of the aims of ergonomics and concerns about being too risk averse. The paper then describes a specific project, in rail engineering, where the notion of a human factors case has been employed to analyse engineering functions and related human factors issues. A human factors issues register for potential system disturbances has been developed, prior to a human factors risk assessment, which jointly covers safety and production (engineering delivery) concerns. The paper concludes with a commentary on the potential relevance of a resilience engineering perspective to understanding rail engineering systems risk. Design, planning and management of complex systems will increasingly have to address the issue of making trade-offs between safety and production, and ergonomics should be central to this. The paper addresses the relevant issues and does so in an under-published domain – rail systems engineering work.

Human Factors and the Nuclear Renaissance

Following the Three Mile Island incident and the Chernobyl accident, there was a general decline in public acceptance of nuclear power plants. Consequently, there was a heavy push to ensure the safety of existing plants coupled with a large-scale decline in the development of new plants. This situation has posed unique challenges to human factors within the nuclear industry. The emphasis of research came in the form of ensuring the safety of as-built systems. This approach clashed with broader human factors work, which used a variety of innovative approaches to design novel or incrementally improved interfaces. The situation is changing now. As current plants near the end of their operational life, there is an urgent need to develop new plants and modernize aging plants to sustain current energy production levels and, in many countries, to meet growing power demands. The resurgence of interest in nuclear energy has been called the “nuclear renaissance.” The challenge for human factors is now to go beyond as-built safety requirements and provide innovative interface concepts that maximize human performance in new plants. The purpose of this panel is to bring together established and new human factors professionals in nuclear energy to discuss the opportunities and challenges for research, practice, and regulation of this nuclear renaissance.

Making ‘Human Factors’ Truly Human: Cultural Considerations in Human Factors Research and Practice

Traditionally, human factors research has been conducted in Western nations to answer the questions of Western practitioners. This approach was appropriate in the past and still works well in many situations. However, as the world of work is becoming more international it is important to consider how national differences affect human factors applications. We review recent issues of the Human Factors journal to see how cultural differences are being addressed in research. Five domains where important cultural difference may influence research findings are reviewed. These areas are physical design, visual displays, symbolic communication, information technology and managing complex processes. We present recommendations for incorporating greater cultural variation into Ergonomic and Human Factors work.

The Forensics Human Factors Consultant

Over 55 members of the Forensics Professional Group (FPG) completed a survey about their forensics human factors work. The survey included items about experience, degrees and certifications, areas of specialty, and rates, as well as aspects of forensics practice such as advertising and ethics. Part of the survey results provided information about issues that interest and concern FPG members, including continuing education, networking, speaker bureau, fee structures, managing a forensics business, advertising tips, update on trends in forensics human factors, impact of Daubert, professional liability insurance and professional ethics. This panel will summarize the results of the survey, present information about selected issues based upon the panelists' experience, and provide opportunities for members to discuss these issues.

Relational database as a tool in industrial design. Experience from a human factors engineering analysis of a module for manned space-flight

A human factors engineering analysis was carried out to verify that the CUPOLA—a module developed by the European Space Agency for the International Space Station—complies with an extensive set of human factors requirements. Analysis was carried out in three steps: task analysis, computer simulation of tasks and empirical test of tasks in a physical mock up. In advance to each step the method of assessment and type of information to be obtained were determined in detail and the way of documentation was established as input forms to a relational database. Advantages and drawbacks of this early formalisation as seen by project members are discussed in the present paper. Relevance to industry The method of early formalisation by a relational database used throughout the project showed to be a suitable tool in this human factors analysis of a working place under design. Early formalisation of the results and documentation served as a quality system supporting a homogeneous high standard of data collection and documentation. In industry, the use of relational databases underlying Product Data Management systems increases. This makes it relevant to try and link human factors work to these methods of documentation in order to promote the integration of human factors work at an early stage of product and production development.

Aging, Executive Function, and Human Factors

Over the past decade the role of executive function (ECF) in behavioral assessments has become well-known in the neurological and cognitive aging literature. With the exception of working memory, the assessment of ECF and situations that might enhance or detract from ECF have received little focus in human factors work. Part of this omission stems from a lack of understanding of the scope of ECF as it affects behavior, and lack of a well-known means of quickly assessing or screening for ECF failure. A framework for understanding ECF as it relates to human factors is presented and follows the acronym SOS-MOMMI. The discussion follows the role of selection, organization, sequencing, monitoring, mentoring (self), working memory, and inhibition as components of the ECF system that are affected by age, fatigue, stress, depression, and alcohol use. Examples of ECF failures and conditions that produce them are discussed as well as brief screens that can be used to gather data to assess ECF