In this column, William F. Moroney reports on human factors/ergonomics issues that have appeared in the press. Contributions are invited. Please send electronic copy with references to moroney@udayton.edu.
Whoops! Google Car Hits Bus—First Time It’s at Fault. By Marco Della Cava, USA Today, March 1, 2016, http://usat.ly/1LuSPKY. Over the past 6 years, Google‘s self-driving cars have driven more than 1 million miles and have been involved in 18 minor accidents. Most of the accidents were low-speed rear-enders, attributed to drivers who anticipated that the Google vehicle would accelerate more rapidly. Google’s autonomous vehicle was never at fault in 17 of those accidents, but on February 14, 2016, the autonomous vehicle (moving at ~2 miles an hour) struck a bus, which approached from behind and was moving at ~15 miles an hour. Apparently the autonomous vehicle was trying to avoid sandbags around a storm drain in the right lane and turned left into the bus (http://bit.ly/1UuBbco). According to Google, the autonomous vehicle (and the onboard safety driver) expected the bus to yield and it did not. Also see http://reut.rs/1LQmCsy. This is a good example of the difficulty in implementing the almost covert social interactions (nods, waves, visual contact) that occur between drivers and between drivers and pedestrians. It is also the type of accident that would not have occurred had there been vehicle-to-vehicle (V2V) communication. The lead article in the March 3, 2016, issue of Time magazine provided an interesting discussion on why vehicles should not be driven by people. A second article, “Forget the Distant Future, Smarter Cars Are Already Here,” points out that although automation can accomplish ~85% of the driving task, the last 15% is very difficult because “cars and computers aren’t very good at things that humans take for granted” (p. 58). Rather than wait for fully automated vehicles, Consumer Reports (http://bit.ly/1Lcd4wO) advocates the incorporation of two autonomous safety technologies into all vehicles: forward-looking collision warning and automatic emergency braking. The NPR newscast “What’s Next for Self-Driving Cars” provides relevant links (http://bit.ly/21AFWX8). Also, listen to “Should Self-Driving Cars Have Drivers Ready to Take Over?” at http://bit.ly/1Ql99gj.
Study Suggests Surgical Residents Can Safely Work Longer Shifts. By Jordan Rau, NPR, February 2, 2016, http://n.pr/1oWGnKe. A study published in the New England Journal of Medicine reported that patients did not suffer any additional harm when surgery residents worked longer shifts than those permitted under the 2011 rules. Residency directors were concerned that the new rules interfered with patient care and made it more difficult for the residents to follow their patients. The findings were based on an experiment that compared patient outcomes at 58 surgical residency programs at which restrictions were loosened with outcomes at 59 residency programs using the current constraints. Although the study was more rigorous than previous studies, dissenters to the findings argued that the study was unlikely to show a significant difference given that other (redundant patient safety) factors that determine patient outcome (physicians, other specialists, nurses, etc.) remained unchanged. No differences were reported between the ratings of overall well-being and morale reported by the experimental and control groups. In a related JAMA editorial, one physician wrote that the experiment “effectively debunks concerns that patients will suffer as a result of increased handoffs and breaks in continuity of care.” Rather than roll back the rules on duty hours, he argued that surgeons should find safer ways to treat patients without relying on “overworked residents.” It should be noted that the findings were based on surgical residents only, and the findings may not generalize to other residencies. Also, “the most major restrictions on resident duty hours put into place in 2003, such as a maximum workweek of 80 hours a week and a minimum of one day off every seven, were not tested in the study and are expected to remain in place.”
Improving Doctor–Patient Communications in a Digital World. By Diane Rehm, WAMU, February 9, 2016, http://bit.ly/24zBQxz. Physicians and a health care specialist discussed how to optimize the 10- to 15-min patient–physician meeting during which there are four “people” in the room: the patient, the physician, the computer, and the clock. Currently physicians are often “talking” with the computer because they are rewarded or punished for completeness of medical records, and proper coding is essential for payment. One physician suggested improving communication by sharing the screen with the patient. Another physician recommended use of the “teach-back tool,” in which the physician asks the patient to report and explain what the physician just said. Patient responses often surprised the physicians. The use of e-mail and texting (including attachments) has encouraged distance diagnosis and reduced the need for expensive Emergency Room visits. Communication is confounded by interface design problems: accessing portals, physicians’ use of jargon, acronyms, and unique medical abbreviations. The different reading levels of patients who are referred to Web pages for further information was also mentioned. Physicians discussed the need to rethink the health care model and the use of video chats and smart algorithms that monitor results.
Additional links
Adjustable Airline Seat Widths? http://bbc.in/1Ux7cjX
FDA Issues New Guidance on Human Factors Testing for Medical Devices: http://bit.ly/1REBkr4
Human Factors Needed in These Medical Devices: http://bit.ly/1oWRoeK
Use Systems Thinking in Medical Devices: http://bit.ly/1S0ckNx
Virtual-Reality Evacuation Training at Children’s Hospital: http://bit.ly/1QS3z8G
TSA Misses Explosives and Weapons: http://n.pr/1Ux80Fu
Gesture Control in Autos: http://bit.ly/1QyJeUm
The Future Of Sports: http://bit.ly/1SuOMO5; also see http://usat.ly/1NSF2Z2
Improving Railway Safety by Properly Modeling Sociotechnological Systems: http://bit.ly/1oWJRMV
Virtual Reality in Land Vehicles: http://bit.ly/1pmYIAc
Three Ways Radiologists Can Improve Productivity: http://bit.ly/1oWKje9
Ergonomic High Heels? http://for.tn/1QqGaZL
