What Human Factors Isn’t: 3. Off-The-Shelf Behaviour Modification Training

‘Human Factors’ (or Ergonomics) is often presented as something that it’s not, or as something that is only a small part of the whole. Rather than just explain what Human Factors is, in this sporadic series of short posts I will explain what it isn’t. The posts outline a number of myths, misunderstandings, and false equivalencies.

In this series:

1. What Human Factors isn’t: 1. Common Sense
2. What Human Factors isn’t: 2. Courtesy and Civility at Work
3. What Human Factors isn’t: 3. Off-the-shelf Behaviour Modification Training (this post)
4. What Human Factors isn’t: 4. A Cause of Accidents

Human Factors Isn’t Off-the-shelf Behaviour Modification Training

Human Factors and behaviour modification training have a somewhat complicated relationship. It is not easy to explain, especially in a way that everyone would agree. I will start by saying that one thing is certain: Human Factors and training-based behaviour modification are not equivalent. But, in my view, training-based behaviour modification can be an application of Human Factors. In other words, the two are not equivalent, but one can be an application of the other. I’ll try to explain.

Human Factors has a core focus that can be described in a few words as ‘fitting the work to the people’ or ‘designing for human use’. It does this in the context of the system as a whole. More formally, there are a number of definitions that help to make the point, but they tend include two foci: understanding system interactions as the method of understanding and design as the method of intervention. These foci are not contentious: they are core to many definitions and are the foci of Human Factors textbooks and degrees. My preferred definition was offered by my late PhD supervisor, Prof. John Wilson:

“Understanding the interactions between people and all other elements within a system, and design in light of this understanding.” (Wilson, 2014, p.12)

The word that is sometimes subject to discussion is the word ‘design’. In the context of Human Factors, it can be described as a process for solving problems and realising opportunities relating to interactions between people and all other elements within a system. Some definitions flesh this out a little more, including also the goals of Human Factors, e.g.:

“Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance.” (International Ergonomics Association)

(Note that the terms ‘Human Factors’ and ‘Ergonomics’, which originate in the US and Europe respectively, are usually treated as synonymous within the discipline, but often one is chosen over the other in the profession, and in practice more generally, depending also on the country.)

Going back to the origins of Human Factors in WWII aviation, it began with observations around the lack of fit or compatibility between designed artefacts on the one hand, and human capabilities, limitations and needs on the other. While the intention of early researchers was not to create a new discipline, that is effectively what happened, as is the case, I suspect, with many disciplines.

In 1977, the Tenerife runway accident occurred. This led a renewed focus on behaviour, especially communication and teamwork, and ultimately the development of crew resource management (CRM). The term CRM was invented by American aviation psychologist John Lauber, who defined it as “using all the available resources – information, equipment, and people – to achieve safe and efficient flight operations”. The concept was further developed and tested by other applied psychologists, such as psychologist Bob Helmreich, drawing especially from social psychology.

It is worth saying here that Human Factors and Applied Psychology are closely related, sometimes indistinguishably so in practice. Applied Psychology is one of several core disciplines of HF, and a large proportion HF specialists, including those involved in the initial development of CRM and TEM, are psychologists. But the fields are also distinct disciplines and professions. Going back to the ICAO SHELL model, psychology tends to focus on the ‘liveware’ and ‘liveware-liveware’ interactions – people, individually and collectively. Human Factors tends to focus on the patterns of interactions between ‘liveware’, ‘software’ (including policies and procedures), ‘hardware’ and the ‘environment’ – the relationships between elements are more interesting and relevant than the elements themselves. Psychology is a human science focused on mind and behaviour. Human Factors is a design discipline focused on system interactions.

Since ‘Human Factors’ was better embedded as a term in aviation, CRM was soon associated with Human Factors in a cockpit and crew context. In an sense, it is an aspect of ‘Human Factors in Operations‘, though even then, it is only one aspect – one application. CRM training typically comprises a training course and subsequent monitoring of CRM skills during simulator flights (line-oriented flight training, or LOFT). CRM training is now a regulatory requirement for commercial pilots under most regulatory bodies.

Threat and error management (TEM) also emerged, which is often seen as another application of HF, used alongside with normal operations safety survey (NOSS) in aviation. Interestingly, ICAO notes in a circular on TEM that,

It must be made clear from the outset that TEM and NOSS are neither human performance/Human Factors research tools, nor human performance evaluation/assessment tools. TEM and NOSS are operational tools designed to be primarily, but not exclusively, used by safety managers in their endeavours to identify and manage safety issues as they may affect safety and efficiency of aviation operations.

CRM, and to a lesser extent TEM, has since become widespread not only in aviation, but also in rail, shipping, healthcare, and other sectors.

The downside of this success is the perceived (but false) equivalence of ‘Human Factors’ and ‘training-based behaviour modification’. This perception is more prevalent among those who have received such training (e.g., pilots and clinicians), and where there are no or few Human Factors practitioners working more systemically. Unfortunately, the perception has spread to managers, who have come to see Human Factors as ‘done’ once training has been delivered. This creates a moral hazard. If there are now inadequate funds available to address wider systems problems, and if failure is seen as focused on individual and team performance, then failure is both more likely and more punishable.

So it is fair to say that Human Factors researchers and practitioners are uncomfortable with training as an intervention for problems that are not fundamentally associated with competency, at least in the first instance. Since training is about modifying people – fitting people to tasks – it seems to go against the philosophy of Human Factors. If interaction problems are rooted more in the design of activities, tools, and contexts of work, then those are the first ports of call when it comes to modification. “It’s easier to bend metal than twist arms”, wrote Sanders and McCormick (1993), while James Reason wrote “You cannot change the human condition, but you can change the conditions in which humans work” (2000).

From a practical point of view, training to modify behaviour is expensive and often ineffective in the short or long term, unless done in a way that integrates a thorough understanding of Human Factors. More is said on this by Russ et al‘s The science of human factors: separating fact from fiction, an excellent paper written by Human Factors specialists from psychological, engineering and clinical backgrounds.

But to put it into perspective, consider the National Health Service in England, which employs around 1.5 million people (1.1 FTE). Around half a million of these are doctors, nurses, midwives and ambulance staff. Training is essential for all staff, in order to do their jobs. But imagine training 500,000 staff to modify their behaviour in order to address problems. You’d still be left with inadequate staffing, poor rosters, confusing medicine packaging, badly designed equipment and facilities, too many policies and guidelines, shallow investigations, and stressful jobs and tasks, to pick just a few remaining problems. (And you’d still have to train the 140,000 or so pharmacists, radiographers, operating theatre practitioners and other scientific, therapeutic and technical staff.) During this training process, many staff would also have left, and new staff would have joined. And after a year or so, training would need to be refreshed. Training staff in behaviour modification can make painting the Forth bridge look easy.

Ultimately, all training aims to modify behaviour or practice, but it would be nonsensical to call all training ‘Human Factors’. ‘Human Factors’ is often invoked for so-called ‘non-technical’ skills rather than ‘technical skills’ – a false dichotomy on both theoretical and practical grounds, with unfortunate unintended consequences.

Still, I would argue that, if done well, behaviour modification training can be an application of Human Factors. If you’ve read this far, then you might be wondering how. One argument can be seen in in the example of CRM, which can be found in Human Factors journals and in some textbooks. However, to reinforce the point about non-equivalence, training-based behaviour modification approaches are indeed a minority of articles. Given the number of pages of journals and textbooks on Human Factors, I would estimate that training-based behaviour modification solutions are mentioned in fewer than 1 in every 100 pages.

So what might make training-based behaviour modification a ‘Human Factors’ intervention, since all training aims to modify behaviour? The conditions might involve the following sorts of activities, laid out below in a process.

1. A problem or opportunity relating to the interaction between humans and other elements of a system has been identified and investigated.
2. The interactions between people, activities, contexts and tools/technologies are analysed and understood using Human Factors methods.
3. Needs arriving from 1 and 2 above are analysed and understood, considering both system performance and human wellbeing criteria.
4. A range of solutions is considered, as ways of meeting these needs.
5. Training is identified as an appropriate solution (typically, along with others).
6. Training requirements are defined.
7. A prototype training solution is developed (typically in conjunction with other prototype solutions).
8. The prototype training solution is implemented and evaluated, ideally in conditions that are reasonably reflective of real working conditions.
9. If the needs are not met, then the process returns to any of the steps 1 to 7 (the activities may need to be done more thoroughly, perhaps, or the problem or context may have changed).
10. If the needs are met, then the training solution is implemented and sustained.

With such a process, we can say that training is a well-designed solution to a well-understood problem or opportunity. Training, in this context, is part of the work context, and must be designed. Where training is simply provided en masse without these steps (accepting that there will be compromises – the above is intended as a fairly robust process), then we would have to question whether training is a well-designed solution to a well-understood problem or opportunity.

What about simply teaching people about ‘factors of humans‘ – memory, attention, decision making, fatigue, and the like? Again, if something like the process above is followed, then one can be confident that this is a ‘Human Factors solution’. If the process is heavily compromised, or not followed at all, then there may well be too many assumptions about:

• the problem or opportunity
• the people, activities, contexts and tools (PACT) that are exposed to the problem or opportunity
• the suitability of training as a solution
• the adequacy of the development, evaluation and implementation of training
• competing systems and behaviours that affect the behaviour targeted by training, and
• the sustainability of training as a solution.

So how can you know training-based behaviour modification is a Human Factors intervention, or…just training? If a training-based behaviour modification solution is offered off the shelf, without following something like the 10 steps above, then it is probably fair to say that it isn’t a Human Factors intervention. One quick test is to check how soon training is proposed in response to an identified problem or opportunity. If any of steps 1 to 4 have been missed in any significant way (regarding the understanding of the problem/opportunity, context and possible solutions), then it’s probably not a Human Factors intervention, and it would be more appropriate (and helpful) to describe such training as something else (much ‘Human Factors Training’ would be better described as something more contextual and specific). If any of steps 6 to 9 have been missed (regarding the development, evaluation and implementation of training), then the training solution may not be well-designed, no matter how it is branded.