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Warianty tytułu
Języki publikacji
Abstrakty
“Human error” is often cited as cause of occupational mishaps and industrial accidents. Human error, however, can also be seen as an effect (rather than the cause) of trouble deeper inside systems. The latter perspective is called the “new view” in ergonomics today. This paper details some of the antecedents and implications of the old and the new view, indicating that human error is a judgment made in hindsight, whereas actual performance makes sense to workers at the time. Support for the new view is drawn from recent research into accidents as emergent phenomena without clear “root causes;” where deviance has become a generally accepted standard of normal operations; and where organizations reveal “messy interiors” no matter whether they are predisposed to an accident or not.
Wydawca
Rocznik
Tom
Strony
211--218
Opis fizyczny
Bibliogr. 14 poz.
Twórcy
autor
- Department of Mechanical Engineering, Linköping Istitute of Technology, Linköping, Sweden
Bibliografia
- 1.Amalberti, R. (2001). The paradoxes of almost totally safe transportation systems. Safety Science, 37, 109-126.
- 2.Batteau, A. W. (2001). The anthropology of aviation and flight safety. Human Organization, 60(3), 201-210.
- 3.Dekker, S.W.A. (2002). The field guide to human error investigations. Aldershot, UK: Ashgate; Bedford, UK: Cranfield University Press.
- 4.Fitts, P.M., & Jones, R.E. (1947). Analysis of factors contributing to 460 “pilot error” experiences in operating aircraft controls (Memorandum Report TSEAA-694-12). Wright-Patterson Air Force Base, Dayton, OH, USA: Aero Medical Laboratory, Air Material Command.
- 5.Galison, P. (2000). An accident of history. In P. Galison & A. Roland (Eds.), Atmospheric flight in the twentieth century (pp. 3-44).Dordrecht, The Netherlands: Kluwer Academic.
- 6.McDonald, N., Corrigan, S., & Ward, M. (2002). Well-intentioned people in dysfunctional systems. Dublin, Ireland: Aerospace Psychology Research Group, Trinity College.
- 7.North, D.M. (2002, February 4). Oil and water, cats and dogs. Aviation Week and Space Technology, p. 70.
- 8.Reason, J. (1997). Managing the risks of organizational accidents. Aldershot, UK: Ashgate.
- 9.Simon, H. (1969). The sciences of the artificial. Cambridge, MA, USA: MIT Press.
- 10.Snook, S.A. (2000). Friendly fire: The accidental shootdown of US Black Hawks over Northern Iraq. Princeton, NJ, USA: Princeton University Press.
- 11.Vaughan, D. (1996). The Challenger launch decision. Chicago, IL, USA: University of Chicago Press.
- 12.Vicente, K. (1999). Cognitive work analysis. Mahwah, NJ, USA: Erlbaum.
- 13.Woods, D.D., & Cook, R.I. (2002). Nine steps to move forward from error. Cognition, Technology & Work, 4, 137-144.
- 14.Woods, D.D., Johannesen, L.J., Cook, R.I., & Sarter, N.B. (1994). Behind human error: Cognitive systems, computers and hindsight. Dayton, OH, USA: Crew System Ergonomics Information Analysis Cente (CSERIAC).
Typ dokumentu
Bibliografia
Identyfikator YADDA
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