State of science: evolving perspectives on ‘human error’

Abstract

This paper reviews the key perspectives on human error and analyses the core theories and methods developed and applied over the last 60 years. These theories and methods have sought to improve our understanding of what human error is, and how and why it occurs, to facilitate the prediction of errors and use these insights to support safer work and societal systems. Yet, while this area of Ergonomics and Human Factors (EHF) has been influential and long-standing, the benefits of the ‘human error approach’ to understanding accidents and optimising system performance have been questioned. This state of science review analyses the construct of human error within EHF. It then discusses the key conceptual difficulties the construct faces in an era of systems EHF. Finally, a way forward is proposed to prompt further discussion within the EHF community.

Practitioner statement This state-of-science review discusses the evolution of perspectives on human error as well as trends in the theories and methods applied to understand, prevent and mitigate error. It concludes that, although a useful contribution has been made, we must move beyond a focus on an individual error to systems failure to understand and optimise whole systems.

Keywords:

• Human error
• accident analysis
• systems thinking
• complex systems
• future of ergonomics

Acknowledgements

We sincerely thank Rhona Flin for her insightful comments on a draft version of this paper. We also thank Alison O’Brien and Nicole Liddell for their assistance with proofreading and literature searching. Finally, we are immensely grateful to the anonymous peer reviewers for their valuable comments which have strengthened the paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Note, the terms ergonomics and human factors can be used interchangeably, and the discipline is also known by HFE.

2 From https://www.etymonline.com/word/error [accessed 6 June 2020]

3 From https://www.etymonline.com/word/accident

4 From https://www.encyclopedia.com/social-sciences-and-law/law/law/judgment [accessed 6 June 2020].

5 Contemporary metrics such as social media engagements and mentions in news articles or blog posts were not available for these publications given most were released some time ago.

6 No seminal paper could be identified for human error HAZOP.

7 The citation search was refined to papers also including the words ‘HEIST’ OR ‘Human error identification in systems tool’, given that the seminal publication contains broader content beyond describing the HEIST method.

8 The citation search was refined to papers also including the words ‘SPEAR’ OR ‘Systems for Predicting Human Error and Recovery’, given that the seminal publication contains broader content beyond describing the SPEAR method.

Additional information

Funding

Gemma Read’s contribution to this work was funded through her Australian Research Council (ARC) Discovery Early Career Research Award [DE180101449]. Guy Walker’s contribution to this work was funded through the UK Engineering and Physical Sciences Research Council project Centre for Sustainable Road Freight [EP/R035199/1]