Human Error - PowerPoint
5 important questions on Human Error - PowerPoint
What is the history of human error?
- Being hurt was a personality trait: accident proneness
- Change after horse kick research by Russian statistician
- Poisson distribution
- Freud explored idea of unconscious drivers of behavior "you don't want to montage your Ikea closet"
What is the model of Kahneman?
System 2 (Schildpad): Slow, conscious reasoning, evaluate, sensitive for information
What are psychological factors of this system 1 and 2 model?
- System 1 is always an immediate reaction, this is uncontrollable.
- System 2 has to be activated
- This reaction is not always goodEstimates of probability and impacts are strongly influenced by saliency and availability
- Higher grades + faster learning
- Never study anything twice
- 100% sure, 100% understanding
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What did James Reason and Rasmussen do?
Non-intentional behavior
- Skill-based slip (error of comission, typo)
- Skill-based lapse (error of omission, forget the original on the glass plate)
- Warning people about this doesn't work
- Rule- or knowledge-based mistake (fire on the first floor in Finland)
- Violation (think about a problem, but incompetent to come to the right diagnosis, starting the car in the winter and try again till the battery is down)
What is barrier based management
Prevention: stop the shit hitting the fan
Top event: the shit has hit the fan
Mitigation: what can you do about it
The question on the page originate from the summary of the following study material:
- A unique study and practice tool
- Never study anything twice again
- Get the grades you hope for
- 100% sure, 100% understanding
