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Although precise definitions and models of human error in medicine remain elusive, there is little doubt that adverse events, sometimes involving human error, threaten patient safety and can be addressed by human factors approaches to error. In this chapter, we combine an information-processing framework that identifies perceptual, cognitive, and behavioral requirements of operators involved in health care activities with a system-based perspective that helps define when these needs are met by the health care context. We focus on errors and adverse events related to four broad areas of medical activities: medical device use, medication use, team collaboration, and diagnostic/decision support. For each area, we review evidence for specific error types, operator and system factors that contribute to these errors, and possible mitigating strategies related to design and training interventions that enable health care systems to better meet operators' perceptual, cognitive, and behavioral needs. This review reveals progress in identifying sources of human error and developing mitigating strategies in the areas of medical device and medication use, in part because of tools from human factors engineering that identify user needs and how to design environments to support them. Much less is known about how error emerges from work practices in complex settings, such as collaboration among team members. There is a need for theoretical frameworks to analyze error in the context of routine work practices. Such frameworks will bridge cognitive analyses of individual operators and tasks and more comprehensive theories of organizations, to guide interventions that target medical error at multiple levels.

A new technique for measuring individual differences in basic attention capabilities and the validity of these differences in predicting success in flight training were investigated. The testing system included a digit-processing, reaction-time task and a one-dimensional compensatory tracking task. Comparisons were made between separate and concurrent performances of thesetasks, with both equal and shifting task priorities. Adaptive techniques were employed to obtain maximum performance levels for each subject in the single-task condition and to maintain dual-task difficulty within subjects. Consistent individual differences in basic attention capabilities were observed and several dimensions of attention capabilities are suggested. A preliminary validation study compared scores for flight instructors and student pilots. In addition, the student sample was dichotomized based on performance in training. There were reliable differences for both groups on dual-task performance efficiency.

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Four tasks were tested in single and pairwise combined performances to investigate their mutual interference. The results demonstrate that functionally dissimilar tasks, in terms of the activities required in processing and responding, can be performed together with much less decrement than functionally identical tasks. The short-term memory function, furthermore, is extremely disruptive when required in one or both of two simultaneously performed discrete, reaction-time tasks.