Research into Medical Human Factors and Human Error in Medicine

Project Background

Beginning in the mid 1990's, our research group became active in studying human factors and human error in medicine and surgery. Our first work in this area was through a collaboration with the department of anesthesia at the University of Basel in Switzerland. We were also involved in a number of projects that can loosely be grouped under the term, medical human factors. We extended previous research into attitudes in the cockpit into the world of medicine, particularly attitudes in intensive care units both here in the United States as well as in the United Kingdom. In another project, we participated in a collaboration with Dr. Eric Thomas of The University of Texas Health Science Center in Houston that examined teamwork in neonatal resuscitation. Finally, we continued efforts to accurately model human error and error management in medical settings - also an extension of our work in aviation. In general, we became interested in team behaviour, attitudes towards safety, and the impact of professional culture on human performance in medicine.

For more information on our work in this area, please contact Dr. Dave Musson, Director, Centre for Simulation-Based Learning, Department of Anesthesia, McMaster University at musson@mcmaster.ca

Selected Publications

Below are selected publications related to our work in medical human factors and medical error. For a full list of all project publications, click here.

2004

Helmreich, RL, Musson, DM and Sexton, JB (2004). Human Factors and Safety in Surgery. In Nora, PF (Ed) Surgical Patient Safety: Essential Information for Surgeons in Today's Environment. American College of Surgeons; Chicago, IL.

Musson, DM & Helmreich, RL. (2004). Team training and resource management in healthcare: Current issues and future directions. Harvard Health Policy Review, 5, 1, 25-35. (link to HHPR) (pdf of paper)

2003

Thomas, E.J., Sexton, J.B., & Helmreich, R.L. (2003). Discrepant attitudes about teamwork among critical care nurses and physicians. Critical Care Medicine, 31(3), 956-959.

Helmreich, R.L., & Sexton, J.B. (2003). Chapter 2. Group interaction under threat and high workload. In R. Dietrich & T.M. Childress (Eds.), GroupInteraction in High Risk Environments (pp. 8-9). Berlin: Humboldt Universitat zu Berlin.

2002

Thomas, E.J., & Helmreich, R.L. (2002). Will airline safety models work in medicine? In M.M. Rosenthal & K.M. Sutcliffe (Eds.), Medical Error: What do we know? What do we do? (pp. 217-234). San Francisco: Jossey-Bass.

Helmreich, R.L. (2002). Managing threat and error in aviation and medicine. In Proceedings of the Third LOSA Week (ICAO) (pp. 15-22). , Dubai, United Arab Emirates, October 14-16, 2002.

2001

2000

Sexton, J.B., Thomas, E.J., & Helmreich, R.L. (2000). Error, stress, and teamwork in medicine and aviation: Cross sectional surveys. British Medical Journal, 320, 745-749. (UTHFRP Pub245) (Download pdf)

Helmreich, R.L. (2000). On error management: Lessons from aviation. British Medical Journal, 320, 781-785. (UTHFRP Pub246) (Download pdf)

Helmreich, R.L., & Musson, D.M. (2000). Surgery as a team endeavor [Editorial]. Canadian Journal of Anesthesia, 47:5, 391-392. (UTHFRP Pub247) (Download pdf)

Helmreich, R.L., & Musson, D.M. (2000). The University of Texas Threat and Error Model [On-line]. British Medical Journal web site. http://www.bmj.com/misc/bmj.320.7237.781/sld001.htm (UTHFRP Pub 248) (view on line or download the pdf)

1999 and earlier

Helmreich, R.L. (1999). The individual as a member of a working group: Evaluating team performance in aviation and medicine. In A. Tekian, C.H. McGuire, W.C. McGaghie, & Assoc. (Eds.), Innovative simulations for assessing professional competence: From paper-and-pencil to virtual reality (pp. 147-156). Chicago, IL: University of Illinois at Chicago.

Helmreich, R.L., & Merritt, A.C. (1998). Culture at work in aviation and medicine: National, organizational, and professional influences. Aldershot, U.K: Ashgate. (Book - click here for information)

Helmreich, R.L., & Davies, J.M. (1997). Anaesthetic simulation and lessons to be learned from aviation. [Editorial]. Canadian Journal of Anaesthesia, 44(9), 907-912.

Helmreich, R.L., & Schaefer, H-G. (1997). Turning silk purses into sows’ ears: Human factors in medicine. In L. Henson, A. Lee, & A. Basford (Eds.), Simulators in Anesthesiology Education (pp. 1-8). New York: Plenum.

Helmreich, R.L., & Davies, J. (1996). Human factors in the operating room: Interpersonal determinants of safety, efficiency, and morale (pp. 277-296). In A.A. Aitkenhead (Ed.), Balliere’s Clinical Anaesthesiology: Safety and Risk Management in Anaesthesia. London: Balliere Tindall.

Davies, J.M., & Helmreich, R.L. (1996). Simulation: It’s a start. [Editorial]. Canadian Journal of Anaesthesia, 43(5), 425-429.

Schaefer, H.G., Helmreich, R.L., & Scheidegger, D. (1995). Safety in the operating theatre - Part 1: Interpersonal relationships and team performance. Current Anaesthesia and Critical Care, 6, 48-53.

Helmreich, R. L., & Schaefer, H.-G. (1994). Team performance in the operating room. In M.S. Bogner (Ed.), Human Error in Medicine (pp. 225-253). Hillside, NJ: Lawrence Erlbaum and Associates.

Schaefer, H.-G., Scheidegger, D., & Helmreich, R.L. (1993). Human Factors im Operationssaal: Grundlangen und voraussetzunger fur ein multidisziplinares project. Swiss Medical Journal, 74, 1882-1885.