Healthcare practitioners, patient safety leaders, educators and researchers increasingly recognise the value of human factors/ergonomics and make use of the discipline's person-centred models of sociotechnical systems. This paper first reviews one of the most widely used healthcare human factors systems models, the Systems Engineering Initiative for Patient Safety (SEIPS) model, and then introduces an extended model, 'SEIPS 2.0'. SEIPS 2.0 incorporates three novel concepts into the original model: configuration, engagement and adaptation. The concept of configuration highlights the dynamic, hierarchical and interactive properties of sociotechnical systems, making it possible to depict how health-related performance is shaped at 'a moment in time'. Engagement conveys that various individuals and teams can perform health-related activities separately and collaboratively. Engaged individuals often include patients, family caregivers and other non-professionals. Adaptation is introduced as a feedback mechanism that explains how dynamic systems evolve in planned and unplanned ways. Key implications and future directions for human factors research in healthcare are discussed. Practitioner Summary: SEIPS 2.0 is a new human factors/ergonomics framework for studying and improving health and healthcare. It describes how sociotechnical systems shape health-related work done by professionals and non-professionals, independently and collaboratively. Work processes, in turn, shape patient, professional and organisational outcomes. Work systems and processes undergo planned and unplanned adaptations.
Mental workload (MWL) is one of the most widely used concepts in ergonomics and human factors and represents a topic of increasing importance. Since modern technology in many working environments imposes ever more cognitive demands upon operators while physical demands diminish, understanding how MWL impinges on performance is increasingly critical. Yet, MWL is also one of the most nebulous concepts, with numerous definitions and dimensions associated with it. Moreover, MWL research has had a tendency to focus on complex, often safety-critical systems (e.g. transport, process control). Here we provide a general overview of the current state of affairs regarding the understanding, measurement and application of MWL in the design of complex systems over the last three decades. We conclude by discussing contemporary challenges for applied research, such as the interaction between cognitive workload and physical workload, and the quantification of workload 'redlines' which specify when operators are approaching or exceeding their performance tolerances. Practitioner Summary: The study of workload in ergonomics has risen in popularity since the 1980s. Applied problems, particularly in transport, have taken centre stage in recent years. New developments in neuroergonomics measurement techniques offer promise in quantifying both the interaction of physical and mental workload, as well as the elusive 'redline' performance limit for overload.
Human factors/ergonomics (HFE) has great potential to contribute to the design of all kinds of systems with people (work systems, product/service systems), but faces challenges in the readiness of its market and in the supply of high-quality applications. HFE has a unique combination of three fundamental characteristics: (1) it takes a systems approach (2) it is design driven and (3) it focuses on two closely related outcomes: performance and well-being. In order to contribute to future system design, HFE must demonstrate its value more successfully to the main stakeholders of system design. HFE already has a strong value proposition (mainly well-being) and interactivity with the stakeholder group of 'system actors' (employees and product/service users). However, the value proposition (mainly performance) and relationships with the stakeholder groups of 'system experts' (experts fromtechnical and social sciences involved in system design), and 'system decision makers' (managers and other decision makers involved in system design, purchase, implementation and use), who have a strong power to influence system design, need to be developed. Therefore, the first main strategic direction is to strengthen the demand for high-quality HFE by increasing awareness among powerful stakeholders of the value of high-quality HFE by communicating with stakeholders, by building partnerships and by educating stakeholders. The second main strategic direction is to strengthen the application of high-quality HFE by promoting the education of HFE specialists, by ensuring high-quality standards of HFE applications and HFE specialists, and by promoting HFE research excellence at universities and other organisations. This strategy requires cooperation between the HFE community at large, consisting of the International Ergonomics Association (IEA), local (national and regional) HFE societies, and HFE specialists. We propose a joint world-wide HFE development plan, in which the IEA takes a leadership role. Practitioner Summary: Human factors/ergonomics (HFE) has much to offer by addressing major business and societal challenges regarding work and product/service systems. HFE potential, however, is underexploited. This paper presents a strategy for the HFE community to strengthen demand and application of high-quality HFE, emphasising its key elements: systems approach, design driven, and performance and well-being goals.
The aim of this review was to provide an overview of assistive exoskeletons that have specifically been developed for industrial purposes and to assess the potential effect of these exoskeletons on reduction of physical loading on the body. The search resulted in 40 papers describing 26 different industrial exoskeletons, of which 19 were active (actuated) and 7 were passive (non-actuated). For 13 exoskeletons, the effect on physical loading has been evaluated, mainly in terms of muscle activity. All passive exoskeletons retrieved were aimed to support the low back. Ten-forty per cent reductions in back muscle activity during dynamic lifting and static holding have been reported. Both lower body, trunk and upper body regions could benefit from active exoskeletons. Muscle activity reductions up to 80% have been reported as an effect of active exoskeletons. Exoskeletons have the potential to considerably reduce the underlying factors associated with work-related musculoskeletal injury. Practitioner Summary: Worldwide, a significant interest in industrial exoskeletons does exist, but a lack of specific safety standards and several technical issues hinder mainstay practical use of exoskeletons in industry. Specific issues include discomfort (for passive and active exoskeletons), weight of device, alignment with human anatomy and kinematics, and detection of human intention to enable smooth movement (for active exoskeletons).
Traditional efforts to deal with the enormous problem of workplace safety have proved insufficient, as they have tended to neglect the broader sociotechnical environment that surrounds workers. Here, we advocate a sociotechnical systems approach that describes the complex multi-level system factors that contribute to workplace safety. From the literature on sociotechnical systems, complex systems and safety, we develop a sociotechnical model of workplace safety with concentric layers of the work system, socio-organisational context and the external environment. The future challenges that are identified through the model are highlighted. Practitioner Summary: Understanding the environmental, organisational and work system factors that contribute to workplace safety will help to develop more effective and integrated solutions to deal with persistent workplace safety problems. Solutions to improve workplace safety need to recognise the broad sociotechnical system and the respective interactions between the system elements and levels.
The issues being tackled within ergonomics problem spaces are shifting. Although existing paradigms appear relevant for modern day systems, it is worth questioning whether our methods are. This paper asks whether the complexities of systems thinking, a currently ubiquitous ergonomics paradigm, are outpacing the capabilities of our methodological toolkit. This is achieved through examining the contemporary ergonomics problem space and the extent to which ergonomics methods can meet the challenges posed. Specifically, five key areas within the ergonomics paradigm of systems thinking are focused on: normal performance as a cause of accidents, accident prediction, system migration, systems concepts and ergonomics in design. The methods available for pursuing each line of inquiry are discussed, along with their ability to respond to key requirements. In doing so, a series of new methodological requirements and capabilities are identified. It is argued that further methodological development is required to provide researchers and practitioners with appropriate tools to explore both contemporary and future problems. Practitioner Summary: Ergonomics methods are the cornerstone of our discipline. This paper examines whether our current methodological toolkit is fit for purpose given the changing nature of ergonomics problems. The findings provide key research and practice requirements for methodological development.
Our review addresses one of the most used, but debated, topics in Ergonomics: Situation Awareness (SA). We examine and elaborate upon key SA models. These models are divided into individual SA, team SA and systems SA categories. Despite, or perhaps because of, the debates surrounding SA it remains an enduring theme for research and practice in the domain of Ergonomics, now for over two decades. A contingent approach, which seeks to match different models of SA to different types of ergonomics problem, enables the differences between positions to be revealed and reconciled, and the practitioner guided towards optimum methodological solutions. Practitioner Summary: Measuring SA in individuals, teams and systems has become a key objective in Ergonomics. One single approach to SA does not fit all problems encountered. This review shows the importance of considering all three types of models and achieving a match between them and the problem at hand.
This paper presents the Event Analysis of Systemic Teamwork (EAST) method as a means of modelling distributed cognition in systems. The method comprises three network models (i.e. task, social and information) and their combination. This method was applied to the interactions between the sound room and control room in a submarine, following the activities of returning the submarine to periscope depth. This paper demonstrates three main developments in EAST. First, building the network models directly, without reference to the intervening methods. Second, the application of analysis metrics to all three networks. Third, the combination of the aforementioned networks in different ways to gain a broader understanding of the distributed cognition. Analyses have shown that EAST can be used to gain both qualitative and quantitative insights into distributed cognition. Future research should focus on the analyses of network resilience and modelling alternative versions of a system. Practitioner summary: This paper presents a practical method for analysing and evaluating distributed cognition in complex systems. The Event Analysis of Systemic Teamwork (EAST) method presents task, social and information network models both individually and combined. The network models can be analysed qualitatively by visual inspection and quantitatively using network analysis metrics.
Although there is a trend in today's organisations to implement activity-based flexible offices (A-FOs), only a few studies examine consequences of this new office type. Moreover, the underlying mechanisms why A-FOs might lead to different consequences as compared to cellular and open-plan offices are still unclear. This paper introduces a theoretical framework explaining benefits and risks of A-FOs based on theories from work and organisational psychology. After deriving working conditions specific for A-FOs (territoriality, autonomy, privacy, proximity and visibility), differences in working conditions between A-FOs and alternative office types are proposed. Further, we suggest how these differences in working conditions might affect work-related consequences such as well-being, satisfaction, motivation and performance on the individual, the team and the organisational level. Finally, we consider task-related (e.g. task variety), person-related (e.g. personality) and organisational (e.g. leadership) moderators. Based on this model, future research directions as well as practical implications are discussed. Practitioner Summary: Activity-based flexible offices (A-FOs) are popular in today's organisations. This article presents a theoretical model explaining why and when working in an A-FO evokes benefits and risks for individuals, teams and organisations. According to the model, A-FOs are beneficial when management encourages employees to use the environment appropriately and supports teams.
This article provides a general ergonomic framework of cooperative guidance and control for vehicles with an emphasis on the cooperation between a human and a highly automated vehicle. In the twenty-first century, mobility and automation technologies are increasingly fused. In the sky, highly automated aircraft are flying with a high safety record. On the ground, a variety of driver assistance systems are being developed, and highly automated vehicles with increasingly autonomous capabilities are becoming possible. Human-centred automation has paved the way for a better cooperation between automation and humans. How can these highly automated systems be structured so that they can be easily understood, how will they cooperate with the human? The presented research was conducted using the methods of iterative build-up and refinement of framework by triangulation, i.e. by instantiating and testing the framework with at least two derived concepts and prototypes. This article sketches a general, conceptual ergonomic framework of cooperative guidance and control of highly automated vehicles, two concepts derived from the framework, prototypes and pilot data. Cooperation is exemplified in a list of aspects and related to levels of the driving task. With the concept 'Conduct-by-Wire', cooperation happens mainly on the guidance level, where the driver can delegate manoeuvres to the automation with a specialised manoeuvre interface. With H-Mode, a haptic-multimodal interaction with highly automated vehicles based on the H(orse)-Metaphor, cooperation is mainly done on guidance and control with a haptically active interface. Cooperativeness should be a key aspect for future human-automation systems. Especially for highly automated vehicles, cooperative guidance and control is a research direction with already promising concepts and prototypes that should be further explored. The application of the presented approach is every human-machine system that moves and includes high levels of assistance/automation. Practitioner Summary: The aim of this article is to sketch a general ergonomic framework of cooperative guidance and control. After a general description, the framework is illustrated through descriptions of two examples for which prototype embodiments have been developed and preliminary evaluations conducted. Major findings of pilot studies show good system performance and acceptance.
The present study examines changes in a variety of oculomotoric variables as a function of increasing sleepiness in 129 participants, who have been passed through a broad range of subjective alertness. Up to now, spontaneous eye blinks are the most promising biosignal for in-car sleepiness warnings. Reviewing the current literature on eye movements and fatigue, experimental data are provided including additional indicative oculomotoric parameters; inter-individual differences in the experiments were also assessed. Here, self-rated alertness decreased over six steps on average and proved itself a reliable measurement. Regarding oculomotoric parameters, blink duration, delay of lid reopening, blink interval and standardised lid closure speed were identified as the best indicators of subjective as well as objective sleepiness. Saccadic parameters and fixation durations also showed specific changes with increasing sleepiness. Substantial inter-individual differences in all of these variables were illustrated. Oculomotoric parameters were linked to three different components of sleepiness while driving: a) deactivation; b) decreasing attention, resulting in disinhibition of spontaneous blinks and reflexive saccades; c) increasing attempts of self-activation. Finally, implications for the development of drowsiness detection devices were discussed.
The purpose of this study was to develop and test a senior technology acceptance model (STAM) aimed at understanding the acceptance of gerontechnology by older Hong Kong Chinese people. The proposed STAM extended previous technology acceptance models and theories by adding age-related health and ability characteristics of older people. The proposed STAM was empirically tested using a cross-sectional questionnaire survey with a sample of 1012 seniors aged 55 and over in Hong Kong. The result showed that STAM was strongly supported and could explain 68% of the variance in the use of gerontechnology. For older Hong Kong Chinese, individual attributes, which include age, gender, education, gerontechnology self-efficacy and anxiety, and health and ability characteristics, as well as facilitating conditions explicitly and directly affected technology acceptance. These were better predictors of gerontechnology usage behaviour (UB) than the conventionally used attitudinal factors (usefulness and ease of use). Practitioner Summary: Previous studies have not given much consideration to age-related health and associated abilities when examining acceptance of technology by the ageing population. By encompassing conventional technology acceptance constructs together with age-related health and ability characteristics, the present study was able to identify more factors affecting gerontechnology acceptance by older Hong Kong Chinese.
This study aimed to examine differences in muscle activity between young people with and without neck-shoulder pain (n = 20 in each group), when they performed texting on a smartphone. Texting was compared between using both hands ('bilateral texting') and with only one hand ('unilateral texting'). Texting tasks were also compared with computer typing. Surface electromyography from three proximal postural muscles and four distal hand/thumb muscles on the right side was recorded. Compared with healthy controls, young people with neck-shoulder pain showed altered motor control consisting of higher muscle activity in the cervical erector spinae and upper trapezius when performing texting and typing tasks. Generally, unilateral texting was associated with higher muscle loading compared with bilateral texting especially in the forearm muscles. Compared with computer typing, smartphone texting was associated with higher activity in neck extensor and thumb muscles but lower activity in upper and lower trapezius as well as wrist extensors. Practitioner Summary: This study demonstrated that symptomatic individuals had increased muscle activity in the neck-shoulder region when texting on a smartphone. Contemporary ergonomic guidelines should include advice on how to interact with handheld electronic devices to achieve a relaxed posture and reduced muscle load in order to reduce the risk of musculoskeletal disorders.
Risk assessments in Sociotechnical Systems (STS) tend to be based on error taxonomies, yet the term 'human error' does not sit easily with STS theories and concepts. A new break-link approach was proposed as an alternative risk assessment paradigm to reveal the effect of information communication failures between agents and tasks on the entire STS. A case study of the training of a Royal Navy crew detecting a low flying Hawk (simulating a sea-skimming missile) is presented using EAST to model the Hawk-Frigate STS in terms of social, information and task networks. By breaking 19 social links and 12 task links, 137 potential risks were identified. Discoveries included revealing the effect of risk moving around the system; reducing the risks to the Hawk increased the risks to the Frigate. Future research should examine the effects of compounded information communication failures on STS performance. Practitioner Summary: The paper presents a step-by-step walk-through of EAST to show how it can be used for risk assessment in sociotechnical systems. The 'broken-links' method takes a systemic, rather than taxonomic, approach to identify information communication failures in social and task networks.
The purpose of this paper is to propose foundations for a theory of situation awareness based on the analysis of interactions between agents (i.e. both human and non-human) in subsystems. This approach may help to promote a better understanding of technology-mediated interaction in systems, as well as helping in the formulation of hypotheses and predictions concerning distributed situation awareness. It is proposed that agents within a system each hold their own situation awareness, which may be very different from (although compatible with) that of other agents. It is argued that we should not always hope for, or indeed want, sharing of this awareness, as different system agents have different purposes. This view marks situation awareness as a dynamic and collaborative process binding agents together on tasks on a moment-by-moment basis. Implications of this viewpoint for the development of a new theory of, and accompanying methodology for, distributed situation awareness are offered.
Long uninterrupted sedentary periods, independent of total sedentary time, are risk factors for poor health. There is little objective data relating to workplace sedentary behaviour and adherence to current recommendations. The sitting behaviour of office workers (n = 83) was quantified objectively using body-worn accelerometers (activPAL™) over a working week. Adherence to three different recommendations (maximum length of a sitting event of: 20 min; 30 min; 55 min) were assessed. Participants were seated at work for 5.3 ± 1.0 h/d (mean ± 1 SD), equivalent to 66 ± 12% of the working day, accrued in 27 ± 7events/d individual sitting events. Dependent on the recommendation applied, 5-20% of sitting events and 25-67% of time was accumulated in sitting events longer than current guidelines. No participants met the 20 or 30 min recommendations on every working day but seven (8%) participants met the 55 min recommendation. In conclusion, office workers spend a considerable period of their day sitting, accumulated in uninterrupted sitting events longer than current recommendations. Statement of Relevance: Emerging evidence suggests prolonged sitting has negative health effects. In this study of office workers, 25-67% of time sitting was accumulated in events longer than minimum recommended durations. Adverse sitting behaviour is prevalent in the office, making it an appropriate setting to target the reduction of this behaviour.
This literature review focused on passenger seat comfort and discomfort in a human-product-context interaction. The relationships between anthropometric variables (human level), activities (context level), seat characteristics (product level) and the perception of comfort and discomfort were studied through mediating variables, such as body posture, movement and interface pressure. It is concluded that there are correlations between anthropometric variables and interface pressure variables, and that this relationship is affected by body posture. The results of studies on the correlation between pressure variables and passenger comfort and discomfort are not in line with each other. Only associations were found between the other variables (e.g. activities and seat characteristics). A conceptual model illustrates the results of the review, but relationships could not be quantified due to a lack of statistical evidence and large differences in research set-ups between the reviewed papers. Practitioner Summary: This literature review set out to quantify the relationships between human, context and seat characteristics, and comfort and discomfort experience of passenger seats, in order to build a predictive model that can support seat designers and purchasers to make informed decisions. However, statistical evidence is lacking from existing literature.
Occupational slips, trips and falls on the same level (STFL) result in substantial injuries worldwide. This paper summarises the state of science regarding STFL, outlining relevant aspects of epidemiology, biomechanics, psychophysics, tribology, organisational influences and injury prevention. This review reaffirms that STFL remain a major cause of workplace injury and STFL prevention is a complex problem, requiring multi-disciplinary, multi-faceted approaches. Despite progress in recent decades in understanding the mechanisms involved in STFL, especially slipping, research leading to evidence-based prevention practices remains insufficient, given the problem scale. It is concluded that there is a pressing need to develop better fall prevention strategies using systems approaches conceptualising and addressing the factors involved in STFL, with considerations of the full range of factors and their interactions. There is also an urgent need for field trials of various fall prevention strategies to assess the effectiveness of different intervention components and their interactions. Practitioner Summary: Work-related slipping, tripping and falls on the same level are a major source of occupational injury. The causes are broadly understood, although more attention is needed from a systems perspective. Research has shown preventative action to be effective, but further studies are required to understand which aspects are most beneficial.
In his 1993 IEA keynote address, Neville Moray urged the ergonomics discipline to face up to the global problems facing humanity and consider how ergonomics might help find some of the solutions. In this State of Science article we critically evaluate what the ergonomics discipline has achieved in the last two and a half decades to help create a secure future for humanity. Moray's challenges for ergonomics included deriving a value structure that moves us beyond a Westernised view of worker-organisation-technology fit, taking a multidisciplinary approach which engages with other social and biological sciences, considering the gross cross-cultural factors that determine how different societies function, paying more attention to mindful consumption, and embracing the complexity of our interconnected world. This article takes a socio-historical approach by considering the factors that influence what has been achieved since Moray's keynote address. We conclude with our own set of predictions for the future and priorities for addressing the challenges that we are likely to face. Practitioner Summary: We critically reflect on what has been achieved by the ergonomics profession in addressing the global challenges raised by Moray's 1993 keynote address to the International Ergonomics Association. Apart from healthcare, the response has largely been weak and disorganised. We make suggestions for priority research and practice that is required to facilitate a sustainable future for humanity.
Many companies move from open-plan offices (OPO) to activity-based workplaces (ABWs). However, few studies examine the benefits and drawbacks following such a change. The aim of this study was to explore how physical conditions, office use, communication, privacy, territoriality, satisfaction and perceived performance change following a company's relocation from an OPO to an ABW. A mixed methods approach included pre- and post-relocation questionnaires and post-relocation focus groups, individual interviews and observations. The questionnaires enabled comparisons over time (n = 34) and broader analyses based on retrospective ratings of perceived change (n = 66). Results showed that satisfaction with auditory privacy, background noise, air quality, outdoor view and aesthetics increased significantly after relocation. Negative outcomes, such as lack of communication within teams, were perceived as being due to the high people-to-workstation ratio and lack of rules. Overall satisfaction with the physical work environment increased in the ABW compared to the OPO. Perceived performance did not change significantly. Practitioner Summary: Activity-based workplaces (ABWs) are commonly implemented although their effects on performance and well-being are unclear. This case study gives advice to stakeholders involved in office planning. Despite shortcomings with the people-to-workstation ratio and rules, employees showed improved satisfaction with auditory privacy and aesthetics in the ABW compared with the previous open-plan office.