The problem with professional appropriation: The case of ‘human factors’ and ‘ergonomics’

In a recent article in the Sydney Morning Herald newspaper by journalist Liam Mannix (A difficult position: Experts question whether ergonomics holds up), a Sydney University Professor calls out physical ‘ergonomics’ as bad science and practice:

Every year, companies around the world spend hundreds of millions of dollars on ergonomic chairs, keyboards and consultants, believing they are taking science-backed steps to care for their workers.

Ergonomists are regularly called as expert witnesses in court, where their findings can decide workplace injury claims worth hundreds of thousands of dollars. Ergonomics is promoted by work safety organisations around the country.

Yet “ergonomics does not have a firm basis in science”, says Sydney University professor Chris Maher, a leading authority on back pain.

But it seems that some who operate under the label of ‘ergonomics’ and ‘ergonomist’ are neither qualified nor experienced. The article notes that there are only 82 certified professional ergonomists in Australia, according to the Human Factors & Ergonomics Society of Australia, plus another 250 or so full members qualified to practice. (There would be many more, however, who are full members of other professional Human Factors and Ergonomics [HF/E] societies.)

“But there are thousands of people calling themselves ergonomists who aren’t,” says Associate Professor Jodi Oakman, head of the Centre for Ergonomics and Human Factors at La Trobe University.

“People will go out doing ergonomic work station assessments, they’ll call themselves an ergonomist – and they have no training whatsoever. It’s not a protected title,” she says.

Leon Straker, a Distinguished Professor at Curtin University added:

I don’t like a product being given the title ‘ergonomic’ – it’s not correct. If you don’t know who I am, what my job is, you cannot know my ergonomic requirements.”

Stephen Hehir, chair of the Human Factors & Ergonomics Society of Australia’s professional affairs board, remarked to Liam Mannix that many of the studies weren’t published in leading ergonomics journals, and most of the interventions they tested weren’t done by qualified ergonomists. 

“Imagine if they were reviewing surgical outcomes and including those operating without a medical licence rather than only qualified surgeons,” he said.

So it seems that the primary problem may not be with the evidence-based discipline and profession, so much as what I will call ‘professional appropriation’.

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“There are thousands of people calling themselves ergonomists who aren’t,” says Associate Professor Jodi Oakman, head of the Centre for Ergonomics and Human Factors at La Trobe University. Photo: Jisc infoNet C BY-NC-ND 2.0 https://flic.kr/p/8N9izX

Professional appropriation

If we accept that HF/E is a profession, with registration schemes, codes of conduct, etc, then the next question is whether it is ethically acceptable to appropriate a professional title. Here, I define professional appropriation as taking as one’s own professional identity the label of a recognised profession, without undertaking the requirements to practise the profession, as accepted by professional bodies. The requirements to join a profession typically involve the following:

  • extended study, resulting in an appropriate qualification (for HF/E, these can include human factors /ergonomics or allied disciplines such as HCI, psychology, industrial engineering, biological sciences)
  • supervised experience
  • registration with a recognised regulator or professional body (professional society, association, or government body)
  • adherence to the Code of Professional Conduct of a professional society
  • other requirements, such as continuing professional development.

Professional appropriation seems to happen when individuals with limited exposure to a discipline appropriate an associated title based on this limited exposure. With limited explosive and experience, it may not be clear that professional appropriation is problematic.

The title ‘human factors specialist’ is sometimes appropriated, and this has happened historically with the title with ‘psychologist’, a term that is now legally protected in some countries. Despite being a discipline (with academic courses, journals, text books, professors, etc) and a profession (with certification, chartership, Codes of Professional Conduct, etc), HF/E professional titles are widely appropriated. Some describe themselves as ‘human factors experts’ without qualifications in human factors and without professional accreditation by a professional body. In most cases, this is probably done quite innocently, without understanding the unintended consequences.

Professional appropriation has occurred with a number of professions. The world of user experience/UX (an emerging profession) is apparently experiencing a growth in the use of terms such as ‘UX Psychologist’ by individuals who are not suitably qualified and experienced in psychology (e.g., Chartered or Registered Psychologists, in the UK). While some titles are legally protected (such as ‘Psychologist’ in Australia), other titles are only protected in their variant forms (e.g. ‘Psychologist’ is not legally protected in the UK, but ‘Counselling Psychologist’ and ‘Occupational Psychologist’ are legally protected). Other than legal protection of titles, we are left with legal protection of services, and associated laws (e.g., advertising laws, health and safety laws).

Equivalency

One could argue that professional titles are archaic, and that anyone should be able to choose whatever title one chooses. This argument seems to fall down quickly once one considers just a few professions, for instance physicians and surgeons, nurses and pharmacists, architects and structural engineers, accountants and solicitors, social workers and psychologists.

If one accepts that appropriate qualifications and experience are necessary to work as a professional (by definition), then the next question is whether Human Factors/Ergonomics should be included in this list of professions. Is HF/E a profession that requires suitably qualified and experienced people?

Whatever our view on this, HF/E is already a profession that requires appropriate qualifications and experience. This is evidenced by professional registration in many countries (including Chartership in the UK, as per Chartered Accountants, Chartered Psychologists and Chartered Architects). If one still rejects the idea that one needs to be suitably qualified and experienced, then one risks saying that professional standards in Human Factors/Ergonomics are unimportant and that the quality of Human Factors/Ergonomics professional services, including ethical considerations, is unimportant. This devalues HF/E to such an extent that to offer professional services becomes illogical. One cannot offer professional services (e.g., consultancy, training, expert witness) in something that one does not consider to be a profession. QED.

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NATS employs 25-30 Qualified Human Factors/Ergonomics Specialists. Photo: NATS.- UK Air Traffic Control CC BY-NC-ND 2.0 https://flic.kr/p/gmWeLo

Risk

From the client’s point of view, the above may not seen terribly relevant. What matters more to clients is risk management. What is the risk of professional appropriation? The ‘risk’ concerns problems or opportunities that may not be properly recognised or managed. The risks could be risks to process safety, occupational safety, health, wellbeing, productivity, efficiency, quality, morale, etc,  By hiring someone who is not suitably qualified and experienced, you are hiring someone who is lacks the required competency to help recognise, understand and manage problems and opportunities relating to system performance and human wellbeing. And someone who is not suitably qualified and experienced may be unaware of this. The Dunning-Kruger effect shields us from the limits of our knowledge and skills.

The risks of professional appropriation are quite obvious and immediate for some professions (e.g., surgery, dentistry, anaesthesia), while for others the risks are obvious to some but usually emerge after some time as a project develops (e.g., civil and structural engineering, safety engineering). For still others, the risks are less obvious and may take longer to come to light. HF/E tends to fall into the latter two categories.

One particular risk of hiring someone who is not suitably qualified and experienced is second order problems. With relatively little knowledge and skill in a profession, we tend to be more focused on first order problems – immediate issues. With more knowledge and skill, we are more focused also on second order problems – possible unintended consequences. This requires systems thinking, which happens to be the foundation of HF/E. For instance, focusing only on non-technical skills training and labelling this as ‘human factors training’, without addressing underlying system and design problems to an appropriate degree, can consume an organisation’s ‘Human Factors budget’ and leave people (usually a small and diminishing proportion of the total number of people) to cope with systemic and design problems using their non-technical skills: an ethical dilemma.

And there are very specific risks to professional appropriation. The SMH article recounts a case where a worker was awarded tribunal-ordered compensation – after she suffered an injury caused by a so-called ‘ergonomics intervention’. 

Cakir was working as a web publishing officer with the Department of Employment and Workplace Relations when she was given an “ergonomic assessment of [her] workstation” by an injury management consultant, according to tribunal papers.

The ‘ergonomics intervention’ was apparently not prescribed by a SQE ergonomist, but by an exercise physiologist (the article does not question the validity of exercise physiology).

The risks of professional appropriation are real but hard for clients to see. Clients can, however, ask if those who use the title ‘ergonomist’, ‘human factors expert’ are suitably qualified and experienced. (Note that ‘expert’ is a term that most bona fide experts seem to avoid. I’ve met a handful of people in HF/E who I would truly consider experts. I am not one of them. Though just to confuse matters, note that in some countries, especially in mainland Europe, the term ‘expert’ simply refers to a specialist or someone occupying a particular job role.)

Professional desertification

If anyone can simply adopt any professional title, then one particular system-wide risk is the illusion that the market for associated services is already well-served. For instance, if everyone with a few days of life coaching or NLP training (or even no training at all) adopts the title ‘psychotherapist’, and if employers and clients are none the wiser, then why the need for suitably qualified and experienced psychotherapists (e.g., meeting the standards laid down for full membership by BACP and UKCP, in the UK, requiring many years of formal study, and supervised [often unpaid] practice)? The same goes for any profession.

I wonder if this has become a hidden reality in some sectors when it comes to Human Factors and Ergonomics. As Associate Professor Jodi Oakman, head of the Centre for Ergonomics and Human Factors at La Trobe University, pointed out, “there are thousands of people calling themselves ergonomists who aren’t.” In the National Health Service (NHS) in England, there was, at the time of writing this post, just one Chartered Ergonomist and Human Factors Specialist formally practicing in the role of an HF/E specialist.

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The National Health Service in the UK has a focus on Human Factors, but only a few qualified Human Factors and Ergonomics Specialists, out of 1.5 million staff. Photo: Lydia CC BY 2.0 https://flic.kr/p/9YP29k

And yet, ‘human factors’ is a huge buzzword in the NHS. There are many courses, and many external consultants (often from aviation) describe themselves as human factors specialists or ‘experts’. The training provided is typically in behavioural (non-technical skills). Non-technical skills are vitally important but NTS training is – I would estimate – somewhere between 1/100th or 1/1000th of the whole scope of discipline of HF/E, if one were to count the pages of text books or journal articles, or hours of teaching on HF/E degrees. In fact, NTS training is more properly aligned with Applied Psychology, because its principles are behavioural, not design-led. (HF/E is primarily about fitting the task to the person, not vice versa.)

This is not to de-emphasise the importance of this training. I have supported such training in healthcare and aviation, and strongly encourage it. But the effect of labeling this ‘Human Factors Training’ – something that has been inherited from airlines – seems to have had unintended consequences. The most obvious of these is the widespread lack of understanding (including at Board level) about

  • the true focus of HF/E (socio-technical systems)
  • its primary means of gaining insight (understanding system interactions, which we might call ‘work’ for our purposes), and
  • its primary means of intervention (design).

In Frank Hawkins’ 1987 book ‘Human Factors in Flight’, he remarked that “There seems to be little justification for any large organisation not employing, in house, one or more degree-qualified Human Factors specialists. In fact, without some level of in-house expertise, Human Factors problems are unlikely to be recognised adequately to generate a call for reference to an external consultant” (p. 328-329).

It may be the case that the professional appropriation of HF/E is somehow associated with the professional desertification of HF/E. The same would likely happen, to varying degrees, with dietetics, architecture, nursing. and psychology.

Involvement and inclusion

At this point, having described some of the problematic aspects of professional appropriation, I find myself dissatisfied and conflicted. On the one hand, professional services, including those done by people who identify themselves as ‘Human Factors Specialists’ and ‘Ergonomists’, should obviously abide by professional standards, including ethical standards. But there are a few problems (see also Human Factors and Ergonomics: Looking Back to Look Forward).

First, there are not sufficient numbers of SQE HF/E specialists (internal or external) to meet demand for HF/E, let alone get involved in solving problems that could benefit from a professional HF/E approach. (This is similar, however, to clinical and counselling psychology in the NHS, for which there are long waiting lists.)

Second, there are relatively few HF/E courses, and little funding, for those who wish to become suitably qualified in HF/E. This applies more, to degree-level courses, which are also a significant investment in time and money. Still, an increasing number of people, for instance front line professionals and other those coming from other allied professions, are signing up for diploma and degree level courses in order to apply HF/E theory and method to their work. (See here for a discussion of becoming an HF/E practitioner.)

Third, it is crucial that HF/E is not merely a discipline and profession, but a broader endeavour aimed at improving system performance and human wellbeing. This is similar to psychology and psychotherapy (regarding mind, behaviour and mental health) and dietetics (regarding diet). This seems to apply various disciplines and professions that centre on human needs. HF/E theory and methods can be applied by many professions with various qualifications and experience as part of their professional work, given appropriate competency. It is not necessary that everyone undertakes a degree in HF/E, but neither is it sufficient to undertake a one- or two-day training course alone to be considered a specialist of any aspect of HF/E. There are, however, training courses in aspects of HF/E that are recognised by professional bodies affiliated with the International Ergonomics Association. There are also specific membership grades such as CIEHF’s ‘Technical Membership’ that apply to specific aspects of HF/E, as relevant to one’s own professional work. Ultimately, I consider HF/E expertise as emergent, from interaction between those with expertise in theory, findings and methods, and those with expertise in work and the context of work.

We can take some practical steps. It is helpful, for instance, when offering HF/E-related training courses or services, to indicate the scope of HF/E covered, relative to the scope of the discipline as a whole. This can be made more obvious in the title of the course, For example, a course entitled ‘Human Factors in <Operating Theatres>’ might cover human factors issues in operating theatres, including the interactions between people, activities, context and tools, and methods for improving these by design (of artefacts, tools, work, etc). Alternatively, a course could be titled, ‘Human Factors for <Surgeons/Pilots/etc>’. Such a course would be more adapted to the needs of a particular stakeholder group. This night be a blend of NTS training and training related to the design of various aspects of work (routines, checklists, equipment, etc), with an aim to help improve work design or at least compensate or mitigate unwanted effects.

And of course, in providing consultancy and training we must be clear about our own qualifications and experience. I ultimately consider my practice cross-disciplinary, and dip into several other disciplines that I find especially helpful in helping to improve system performance and human wellbeing (e.g., philosophy, anthropology, practice theory, community organising, counselling and psychotherapy, graphic design). My approach is to integrate aspects of these into an eclectic, cross-discplinary practice, but of course I stop short of describing myself as a professional or specialist in any of them. I know that my interpretation and implementation of these disciplines is narrow, often shallow, and selective. So I simply indicate the cross-disciplinary influences on my practice. Even within a discipline, our competency soon reaches its limits, and understanding these is a critical aspect of ethical practice. Physical ergonomics, for instance (the topic of the SMH news report) is not an area of competency for me. My last experience was part of my ergonomics post-graduate degree and I have not practised this, outside of basic anthropometry, for 21 years. I am simply not competent to practise it.

Summing up

As with may human-centred professions, there is a balance between professional standards and inclusion. The way to address this balance is by total honesty and clarity, abiding by ethical standards of professional practice, collaborating between different areas of knowledge and practice, carefully drawing from useful theory and applicable methods, but avoiding appropriating professional titles, which can have significant unintended consequences for professional standards, system performance and human wellbeing.


Afterword

From my previous post on this topic (Suitably Qualified and Experienced? Five Questions to ask before buying Human Factors training or consultancy), here are the five criteria and questions that apply to paid-for human factors and ergonomics (HF/E) consultancy and training support and employment, that may help with reflection and discussion.

1. Qualification – Do they have a recognised qualification in HF/E?

2. Accreditation – Do they have an appropriate level of membership of an HF/E related professional organisation?

3. Code of Ethics – Do they abide by a code of ethical conduct from an HF/E related society or association?

4. Experience – Do they have experience in the HF/E work and the domain of interest?

5. Social recognition – Is the person recognised as an HF/E specialist by other qualified HF/E specialists?

The aim of these criteria and questions is to ensure that professional standards – including ethical standards – are met. The criteria and questions are framed above in the context of HF/E, but in fact they apply to any professions, such as psychology, dietetics, or physiotherapy. Proper consideration of the criteria and questions should help to protect organisations, individuals, and the integrity of the profession.


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About stevenshorrock

I am a systems ergonomist/human factors specialist and work psychologist with a background in practice and research in safety-critical industries. My main interest is human and system behaviour in the context of safety-related organisations. I seek to enable improvement via a combination of systems thinking, design thinking and humanistic thinking. I am a Chartered Ergonomist and Human Factors Specialist with the CIEHF and a Chartered Psychologist with the British Psychological Society. I currently work as a human factors and safety specialist in air traffic control in Europe. I am also Adjunct Associate Professor at University of the Sunshine Coast, Centre for Human Factors & Sociotechnical Systems. I blog in a personal capacity. Views expressed here are mine and not those of any affiliated organisation, unless stated otherwise. You can find me on twitter at @stevenshorrock or email contact[at]humanisticsystems[dot]com.
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