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July 29, 2022

International Symposium on Human Factors and Ergonomics in Healthcare 2022 Recap | #HCS2022 | Bonus Episode

This week on the show we sit down with Joe Keebler to discuss the International Symposium on Human Factors and Ergonomics in Healthcare (#HCS2022) put on by the Human Factors and Ergonomics Society.

Recorded in July, 2022, hosted by Nick Roome with guest Joe Keebler.

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Welcome to Human Factors Cast, your weekly podcast for human factors psychology and design.

Hi, everyone. Welcome to a special conference reference coverage episode of Human Factors Cast. We're recording this on July 20, 2022. I'm your host, Nick Rome. On this episode, we're going to be recapping the International Symposium on Human Factors and Ergonomics in Healthcare 2022 across the Internet. From me is our guest, Mr. Joe Keebler, chair of the Human Factors Healthcare Symposium. Joe, welcome back to the show. It's funny that you've been on, but we have never actually communicated on this medium before. It's true. Thank you so much for having me, Nick, and for covering the events, I should say. Yeah, well, thank you for being here. So I guess we can kind of just jump right into the health care symposium. I know we've done coverage about this event in the past, but really, can you walk us through a little bit of the history on how this event started and how we got to where we are today? Sure. And Tony Andre can fill in some of the earlier details. I believe it came out of when he was president of Team Back for Society was when the idea and the original conference was kind of started. I didn't get involved until 2013 or so, but I believe the symposium was started because there's a need both from the medical side needing more safety and HF science in their world for a variety of reasons and career paths for our folks. So I think there's just a need there. There's a variety of research that came out in the late nineties, early 2000s making a call for improvements in patient safety and a lot of that looked towards our science for that. And so the conference obviously was needed because it's been growing ever since and we're larger now than we've ever been. The pandemic obviously caused some lower numbers, some of the conference attendance, because we had to cancel an event and shifted to an online event. But I think we're doing very well. And as a side, I think we're more involved in medicine now than we've ever been, which is exciting. Yeah. And thinking about the pandemic, I can imagine that opened a lot of doors for some Human Factors healthcare research. And so this is just kind of satisfying my own curiosity. Sorry, everyone, this isn't in the notes, but how is the content a little bit different from years past with so much I guess I want to say focus on the pandemic. But having that being sort of more prevalent in our lives, how does that change everything? First off, I think that a lot of research got stalled. A lot of folks that had access to hospitals were doing research in live medical settings that had to cease for maybe a year or two years until the pandemic kind of cooled down. So I think a lot of people got stuck not being able to collect their data or had a project. And this happened to me too, where I just wait for months because we couldn't do Irv approvals, we couldn't do the things we need to do to do our research. And hospitals, last thing I think about is research or thinking about dealing with pandemic. All the fallout from that. But we did see, as the year pass, the next conference came up, lots of folks submitting research around Kobe and the interventions they used and how human factors help with things like personal protective equipment. I don't really do research on this, but there's been a variety of papers and submissions surrounding hire applications for pandemic safety, in a sense. I don't know what else to frame it but how to prepare hospitals teams and hospitals to deal with lots of sick patients. So our field, I think in some ways it's probably really helping grain folks doing this kind of work that we're already there and help them kind of show that the science can be really useful for a variety of things that probably people weren't thinking about when the pandemic started. But I think it probably also led to a slowdown of certain types of research projects and a lot of folks probably waiting months to years to get their research program started back up. Yeah. And now that we're kind of quote unquote out of this thing, right. I'd imagine there's kind of a surge now of all this research that's coming in as they catch up. I think so. And we have the new journal, the Human Factors and Healthcare Journal now with a cellular and from my perspective, it's brand new journal. It's not even a year and we have so many articles already and they're offered the public. So that's really a great resource. But you're seeing that picked up a lot. And then this year in New Orleans was almost back to normal. We're a little bit shy in regards to the size of attendance compared to Chicago of 2019, I believe. I don't remember which year the pandemic started. It was 2020 when we had to stop the trip to Toronto and Pivoted online. But the Chicago event was a little bit larger. But we're kind of back normal now. So the research is back, I think, in full swing. And people are getting back to working with hospitals again, I know I am, where some of our work is totally ceased because hospitals, we're not letting anyone in that's not a patient or a provider. Right? Yeah. Well, that's awesome. I'm glad we're kind of getting back there now. Could you kind of just give us a little bit of overview about what the conference is? I know we've been kind of hinting at it, talking about it, just for those who haven't attended, have never heard about it, new to the show, something like that. Give us a little bit about what this conference is. Sure. So HFS sponsoring conference. So the impact of Ergonomic society is kind of running it, and I work as the chair of it through HFPS. It's very outward facing towards medical providers, administrators, medical device design companies, consultancies. And so when I'm outward facing, half of our attendees are not HFDs folks per se are not necessarily HF trained individuals or students or whatever. So we have a lot of medical providers, nurses and doctors. We have a lot of hostile admin folks that come to learn about what people are doing with human factors in a variety of settings. So we have five tracks and it's a conference. So it is a two and a half day conference, and it's mainly based around lectures, panels and poster presentation. So it's people coming and showing their scientific work. So fundamentally, it's just like any other conference. But because of the outward facing nature of it, we have a lot of applied the tracks are very applied. So the way it's broken up is into five tracks. We have one on digital health, which is all about the medical technologies, especially digital technologies like medical records and health records. We have education Simulation, which is about how we're using cutting edge technologies to train medical providers and medical students, hospital Environments, which focuses on applying human factors in economics to studying and implementing changes within hospitals, kind of at maybe a macroeconomic scale. But it could also be something like redesigning hospital room, or it could be more safety initiatives, which ties to the other track, which is patient safety, which is very focused on patient safety changes, things that lead to safer care, reducing errors, things like that. And then medical Devices and drug Delivery, which is probably our most popular track, which is all about usability and creation and FDA validation of medical devices. And so a lot of those talks are we have workshops from that day, we have talks about various devices and interfaces being designed by all kinds of companies across the world that talk to the audience about what they're doing with their technologies and how they got them approved by the FDA or whatever governing body overseas those technologies. And even our keynote speaker this year was Matt Wenger, and his whole keynote was about medical device that he had been working on for decades. So that's a big part of the conference because we have really good attendance throughout. But whenever you go to the face space conference, the medical device room is always full to the doors, pretty much. Not to say that any other tracks are less important, but that's where a lot of the jobs are. I think a lot of the folks getting hired in this environment, getting hired to design medical devices and working in those domains,

I was going to say it feels like so, full disclosure, I've never actually been to this event in person. I've been meaning to go, and it's on my bucket list of things to do. Almost went in this year in person, but things didn't quite line up. But I really appreciate the sort of picture that you're painting here of the physical conference and sort of what I wouldn't say the popularity of necessarily each track, but sort of

I'm going to say the level of commitment to each track and sort of the attendance about each track. It really gives a good sense of kind of where the industry's at. And we can talk a little bit towards the end about trends in human factors, healthcare and what the future might hold. But can you elaborate just a little bit more on sort of the physical event? Or I guess let's actually back up a minute and talk about the venue overall. Right? We talked about the conference. Let's talk a little bit about the venue this year because it's a little bit different. This is New Orleans. You mean well, because there were two components to it. Oh, sure. Well, it's funny because you said yes, it was kind of like two separate events in the way. But I see what you're saying. Right. Really? The face to face conference. So maybe we stuck a little history here. So we have the first decade of the conference is always face to face, and we've been in a variety of cities, like Chicago, Baltimore. We had it in New Orleans a couple of times, and slowly that was growing over time. Then the Pandamic Captain, we were supposed to be in Toronto that year, and it got canceled because the Pandemic was the event was like a week out, and we just had a lot of people emailing and worried and panicking, and I don't blame them. I probably was myself. It's just like no one wants to get on a plane. No one to be stuck in another country coming from us to Canada or vice versa and get stuck because they caught Kobe, and now it'd be quarantined for 18 days or whatever. So it's all brand new. Canceling just made sense. It's a healthcare conference. We should be conscientious about who we serve and our job, the safety professionals. It's kind of a smart thing to cancel a conference in Milk Pandemic. So we pivoted to an online conference a couple of months later. So we went from the face to face and canceled entirely. And then we went to an online format and basically ported the entire thing online as best we could. Obviously has nutrition, but the conference was very well tended. I mean, we were probably face to face gang, 500 attendees. And for that first online event, we had like 800 or something like that, because so many people could attend that wouldn't have been able to for other reasons. So we be online, we found out, okay, wow, this opens up to a variety of professionals. Maybe younger folks who can't afford to go to a conference. Maybe people are international, can't afford worked out the time to come across to the United States or to Canada. So then we did the virtual one again the following year because the pendant was still full force. And then this year things are cooling down and we decided to go face to face. But then the question remained, well, are we still providing content for these folks online? And that's why we did two events, because we assume that some people are still going to come to face to face. We'll get that normal tenants we're getting for this first eight or nine years. But there's probably some set of people, students and international people and folks who couldn't travel to a Face based conference because they still couldn't risk a good for a variety of reasons that we're still serving. And I think it ended up being we had a pretty good attendance for both considering, so we figured that it's filling a need there, Nick, that the online component would serve different folks. Maybe some people would be the same both, but most people would probably be the online one because whatever circumstances are and it was easier for them to attend that face to face. New Orleans? Yeah. Is that what you found? Is that the online one this year? Was it more attended? Is that something you could talk about it? So we canceled and then we had a pretty big attendance. But then if you look at it, it wasn't quite added up to splitting. And I don't know the exact numbers, but I believe we had around 400 or so attendees in New Orleans. I think we had around 200 in the online, which in my mind is not bad. I think we're okay and we're nonprofit. I think it's smart that we make money where we can to keep our society alive and have funding. But at the end of the day, as long as we're getting our content out there, I believe that having the conference and as long as it pays for itself, then it's worth it, right? So I think it was a win for both and it's a lot of work. I don't know if we'll be doing it every year. We now have three kind of healthcare events because we have the main HFS conference, which has its own track that's Httg healthcare TG, and they have their own content. And then we have healthcare symposium that's Face to Face. And then maybe this virtual event that's maybe every year, every two years. That's not up to me, that's up to the executive council and other folks to decide that. But I think this is our kind of proof of concept of it worked and it might have been worth it, and maybe it's worth it to have it at some interval every year or every two years or something. So I think it was a win for both and the Face conference was a success. And we didn't have I believe there was one person reported coba after the conference is over. So it's like, who knows where they caught up. I've heard of other conferences where there's like outbreaks and stuff, so we didn't there was vaccination cards required and masking. So we played it very safe because half the attendees are medical providers. We can't be having MDS coming to our conference and catching Covet. I think it just looks really strange to be a safe design and not be as safe as possible. But I do think having a face to face event as someone who hadn't been to anything like that in years because of the pandemic, it was really nice to just be back face to face with people. So I really enjoyed it. Yeah, I mean, nothing beats that face to face networking that you pull somebody aside into a corner and just say, hey, yeah, exactly. That for meeting new people. Yeah, go ahead, layout. So I'm happy to talk about that. You had said that was your original question. Then we have back. Yeah, tell me about sort of New Orleans. Just tell me about how it was this year. It was great and it was really nice weather. The conference is in Hilton, I believe, and I think so. I apologize if I'm wrong about that. But we use the conference center and we usually have four rooms that each track is a room. And then in between the rooms there's coffee and water and snacks and and cut. The vendors get various desks to show off for jobs or advertise. It went very well and we had two and a half days of content. I think it went out without a hitch, really. And then at night we have poster sessions. There was a tornado that hit New Orleans the second night. That was unfortunate because there was a fundraising event that a lot of people end up not going to because there's this tornado in the city. But really the conference went very well and really interesting talks about Cove. And I saw a couple of talks that are really compelling. So it's nice because it's really intimate, it's small, only 400 people, which is relatively small conference. And so everyone convenes after each session ends and can kind of meet with each other in the middle hallway. And the poster event is everyone goes to the poster events for the most part. So you get the whole conference there. So if there's someone you want to talk to you, I'll talk like you were saying, it's very easy to find them, which I find really nice. Been a much larger conference that's basically impossible. So it's a nice event that if you really want to learn about the stuff and meet some of the top people doing human factors, medical research and application, this is like the place to be, I think. Yeah, that sounds awesome. And like you said, there's the physical component, but then there's also this virtual event that in a lot of ways you said is completely different or separate event, and can you kind of talk a little bit through that? Like, what does it look like? I've seen it, but for others who haven't, what does it look like? So the original virtual so there's kind of like two virtual events because the first two years were in lieu of the face to face, those events had a lot more kind of there was like a whole almost like virtual conference software using to go through rooms and stuff. But the smaller event that we had this year, which was kind of like not secondary at all, but almost like its own separate event was smaller because we weren't hosting the whole group from the earlier years. So I think about 200 people showed up. But there was just sets of talks, I think, for two days about and people are delivering talks throughout the day, lectures, usually in small groups. Three lecture sets, 20 minutes each. And again, same tracks and everything. And some of it was work that people submitted to the face to face, but then, for whatever reason, they couldn't go. They got sick or so they postponed or they couldn't make it to New Orleans, so they were able to kick it over to the virtual. And then there was other we had like a little brief window where some student work would be submitted. And so we just kind of gathered together work that was not able to present the main conference and kind of put together this kind of separate event with those talks and lectures for this year. Now I don't know what will happen in the future. So that that was kind of very different this year than the last two ones, if that makes sense. I don't know if it makes sense there

in terms of the difference between sort of the physical event this year and the virtual event this year, it sounds like there wasn't a whole lot of overlap. Unless you're counting the cases in which somebody couldn't present in person. It sounds like its own whole thing, right? Correct. It was new. It was separate research. I think a couple of people got invited to either submit an extension or if there's a good talk, I think we might have had a couple of folks that present New Orleans present. But yeah, no, it was all novel work. So it was all different for the most part, probably 90% from the face to face conference. So there was some, I guess, appeal. If you really want to hear about everything that happened this year and human Factors in Healthcare that anyone submitted for presentations or lectures, going to both events was maybe something you'd want to do. Definitely. But I guess it depends on what your research areas are. You could look at the program ahead of time. So I think it just depends on what you're trying to find and get out of the conference. Right. So I think people are very appeased, but with the social aspect going to the Face to Face conference, that wouldn't happen with virtual. So those people all dropped out because they got their fill from New Orleans maybe. Right. So I saw a little bit of overlap, people who were very hungry for more content, plus folks who just couldn't make Face to Face event. Yeah. I'd be curious to see what that Venn diagram looks like of attendees. Yeah, it's kind of hard because a lot of folks aren't members. They just come to the conference. They're outside, and we have their names and emails and stuff, some of the MDS and nurses that come, but they're not necessarily human factors HFS members. And so it's not the same as knowing who attends. What if they're an HFS member?

Yeah. So were there any sort of key takeaways from either the physical event or the virtual event that, I don't know, resonated with you, you want to take forward in your own research? Yeah, there's a couple of things. During the conference, everyone was talking about the Redondo Bot case that happened back. Well, it's four years old now, but it's this nurse case where this nurse was involved in a medication error and lost a patient. And I feel like everyone was talking about it because some of the testimony had come out and she's about to be convicted and she got charged with homicide. So that was a kind of hot topic during that. And I'm actually writing a paper about it right now. And that was just something that was kind of I heard about at the conference, but it happened years ago, and I was just floored by that because it kind of sets the packet a couple of decades. Honestly, there was a lot of good, very positive things, Nick, were that the jobs for students and new professionals were everywhere. I felt like there were so many internships and jobs, and our students, many of our students landed internships at the conference, which is really awesome. What a good place for the young folks trying to find their career path to go to this conference. It's exactly what the conference should do, is provide scientific content and networking. The network opportunities for jobs was just really compelling. And then I guess it was good just to see folks I hadn't seen a couple of years and like, everyone's doing their thing still and like the research to pick back up. So it was exciting to be there. But we all still masked on and people vaccinated vaccine. It was still that shadow. The pandemic was there, and it was smaller than it's been in the previous Face to Face year, obviously. So I'm hoping it grows even more next year, which is Norlando. So anyway yeah, that sounds awesome. Question for you, is there an on site career center like there is at HSEs or is it just like through connections that they got these jobs. No, I believe we started the online career center maybe the year before the Pandemic started. And I believe there is, Nick, and I do not remember. It was like a specific room. We also have like there's like a board where you can post jobs and then you can go and drop your resume into an envelope and then the person posting the job can look through them and schedule interviews with you. I believe we had something like that, but I don't remember me. I apologize for that. I don't remember if we had a separate room this year. If we don't, we definitely need one, but I cannot remember. Yes, well, I mean, it's still really encouraging that with or without, there's still so many success stories from new grads or even students that are getting internships and jobs in the field. That's awesome. I think it's exciting that companies know that they can come there to get competent HF workers. And that's really exciting in the sense of these medical device companies and a variety of medical companies and organizations and hospitals. They hired our folks. We probably have more embedded HF folks now than we've ever had in regards to working in hospitals. And they very well likely got connected to that through HFS. I would imagine a lot of them met people that had impacts on their career at this conference, which is really exciting.

Yeah. So let's pivot away from the conference a little bit because I want to talk to you about sort of the current state of human factors, healthcare, and then kind of where we're going in the future. Right. Health care covers so much, and so I don't even know where to start with this. We've covered topics on the show where paramedics have jetpacks and they're going to help people in the UK. And then there's also stories where I guess just a couple of weeks ago we talked about putting quote unquote robots in seniors homes to help with some of that loneliness that they experience. And so those kind of are wrapped up in healthcare. But from your perspective, I'm really curious on where you see the field right now and kind of where we're going in the next few years. That's a really great question. It's a very difficult question to answer, Nick. I actually recently wrote a paper and the journalism factors about some industry demands and future paths. I guess coming from my background, I'm kind of a teams guy and a simulation based training guy. So I kind of look at the world status and also got into kind of error and error management stuff in the last decade or so. And my main area I studied mainly hand offs, which is care transitions. So let me back up a bit instead of like what I do, maybe more broadly, I think HF can kind of be involved in medicine in a variety of ways. You brought up a couple of examples of technology. So a lot of students end up in jobs, and I always think of students as a professor, but working with either companies on one side, like working with the FDA, or working for the companies to get FDA approvals, there's a human factor's needs there's almost. The FDA requires a human factors testing for risks for medical devices. So if you're making a new medical device, you need an aging person in your loop, in your group routine to help you test for risk. There's some of us who have made entire careers doing this, and there's a variety of companies that do this. So that's kind of like what I would call the industry FDA and medical device path. Then there's kind of like the embedded human factors path, which I don't even feel like existed. When I was graduating in 2011 for my PhD. I didn't even know this was a job you could get. And I think that the amount of people doing this has probably grown exponentially in the last decade or so. But this is where you're an HF person who is embedded in a hospital, and you work alongside their patient safety office and risk management folks and provide knowledge and scientific stuff to their safety folks. And so you do patient age research. You help run RCA, which are root cause analyses. You help investigate errors in hospital. Maybe you help with device design or device acquisition. Then there's kind of like government jobs. Obviously, you can go work for the CDC. I don't know how many people do that, but I'm sure there's some work there. You can probably work for National Cancer Institute or National Institute of Health. And then there's kind of like the academic medical center or the full academic, like I am like, where you're either an HF person doing research with an academic medical center, kind of like folks that work at Johns Hopkins. There's a bunch of us at the Armstrong Institute that do HF research alongside the doctors at Johns Hopkins, which is similar to the embedded, but it's different because it's an academic appointment and usually got some kind of bent to you to get grants and publish and then kind of what I do, which is similar to that. But I'm in a chef department, not a medical. All of our medical work is, like, outside of the partnerships, not directly at my university, for instance, but some of us might be. So I see, like, those are some of the places where HF intervenes with medicine. So it's kind of in, like, designing devices, developing simulation based training, and evaluating those things, evaluating teams, medicine safety management, error management, in hospital ergonomics and improvement. I feel like a rattle off here for a long time. There's also the whole at home health thing, which is way outside of what I do, but then there's the whole kind of what. You're mentioning within Home Robot, there's a lot of folks that do at home health and research on how to improve older adults, people who can't leave their homes, people with disabilities. There's probably an endless variety of applications in those domains as well. Just kind of haphazardly going through this. But those seem to be the major areas and it kind of aligns with our tracks to a degree. Not quite, but it's like kind of medical devices, patient safety to some degree, hospital designs and environment, clinical decision making, at home health, telehealth, these are the major areas. I see HF really intervening, at least on the very applied side. Like this is where maybe someone gets a PhD or Masters in HF. They go work for company helping design robotic surgery units or help design simulation based training for medical school. I don't know if I answered your question. No, you did. And it's totally okay that you're answering. It kind of haphazardly as you said, because I think you just illustrated the entire reason why there's a need for an entirely separate conference because it is its own subdomain of human factors and almost everything that you can do in human factors can apply to healthcare and in some way, shape or form, even stuff that is being applied in other domains. I'd imagine there's some things in surface transportation, the design of ambulance could learn from anything like that. And so the fact that you've kind of addressed all that in just one comment is enough to say, yes, there is a need for this entire conference based on the subdomain and especially when people's lives are at stake here. That's also something to consider. One sort of follow up question I have for you a lot of the stuff that you were talking about and it sounded more centered towards American lot of three letter agencies. And it is an international symposium and it's just to answer my curiosity and because I know Barry traditional co host would ask about what international brings to the table, like what types of things do you see from the international presenters at this conference? Sure, our international presence could probably be larger. It's probably tough for people to come for two day conference short, right? So I don't know if that limits us, but we do have a couple of international researchers like Sq comes to mind, who is a patient safety researcher and one of these embedded HF folks. He's one of the first ones I met in regards to being like HF in a hospital system. He's in a pediatric system in Southeast Asia. So he does hospital safety, HF research and application in a live hospital environment. Every day he's being faced with different challenges. So I think of sq. He doesn't come to our conference, but a pretty impactful writer in our areas. Like Sydney Decker, he's in Australia, so I believe he's actually Swedish, but he's a former graduate of the Ohio state HF cognitive engineering program and is a pretty prolific writer. And I think a lot of his safety ideas have kind of made their way to non HF folks that read about safety and HF. And so he's got a couple of books that I believe might be one of the first things, like an MD that's learning about HF reads. And so I think it's a really important international contributor. But Nick, I think we probably do a little bit better of a job of having more international folks attend and kind of collaborate with it's probably tough. Again, I think the conference might be a little short for someone to fly across the world to come for two days. And maybe that's one of the things that's limiting. I do believe our international presence boosted quite a bit when we had the online conference in 2020. We do have a lot of Canadian folks that come because they're right next door. And we have quite a few Canadian researchers that have both been track chairs and have sponsored the conference in the past. So that's another international group that's pretty prevalent. But outside of that, I can't really think of too many. And I apologize. Tony, I bet you Tony Andre could probably think of more than I can. That guy is an encyclopedia. I want to touch on sort of the future of health care because we talked a lot about, at least on the show, some of these very I don't know, they seem far fetched in some ways, but are not so far fetched in a lot of ways too, right. Being able to identify, I don't know, certain diagnoses through the use of AI or anything like that. And I know we're kind of working secretly behind the scenes here on AI in healthcare and what the human factor's connection to that is. Stay tuned for that, I guess, teaser. But we're working on things. And I find it interesting that you have sort of this digital assistant. You have all the traditional issues of trust with an automated agent or automated system that you're going to have to not only figure out for the doctor, but also for the patient. And how does all that trust play into this, all that stuff? I don't know. I really like the AI aspect, but that's one slice of the future and where the domain can go. What is the most out there thing that you've heard of that's like, oh, that's going to be a game changer someday when we figure that out? I mean, out there, I'm thinking like robotic surgery and a lot of space flight or something like that. Hopefully that never has to happen. That's something that's like really crazy out there, but not really practical, right? So I think kind of future, 10, 15, 20 years out, I think about well, I think about how so much still needs to change right now and we're going to keep back up. We like to throw technology of problems. It's common to do that. And I think oftentimes we don't know what the problem is well enough to put the right technology in the right place and have it designed correctly for the issues that are at hand. And so I see both great benefits and major issues arising with things like telemedicine and used to telemedicine. I think that with and this is related to the paper I told you about earlier, which I'm happy to send you that I wrote earlier this year that as our population ages, we're going to have a lot more people using telemedicine because they don't leave their home or they can't drive anymore. And the geriatric population in the United States is going to grow very large by 2050. I don't have the exact numbers off my head, but it's going to be a huge strain on our medical systems. We have to rely on things like maybe robotic ambulances, telemedical consulting instead of going to a doctor again, you're doing everything online. More advanced robotic surgeries and advanced robotic procedures and use of robots and other ways. Robotic nurses and robotic assistance, those already exist, are already hospitals using robots in pretty complex ways. So how are those going to change? And I used to study human robot teaming for the military, human robot teaming for medicine. I think it's kind of just starting to be looked at. Obviously there has been a lot of robotic surgeries over the last two decades, but I mean in a more complex way when we have maybe AI or more intelligent robotics that do decision making and maybe intervene or do things that are unexpected. And so what does that kind of team look like? How do you train people to prepare to deal with the complex robotic system that's making decisions alongside them and doing things that maybe they don't quite understand? So it gets back to automation and mode awareness stuff, right? Kind of core human factors ideas. So I think those are couple of things. I think error management and error mitigation is a big one. There's a kind of philosophy like safety one and Safety Two. Philosophy I've even heard now is safety Three. And these are just different kinds of ways of approaching errors. Kind of safety one. And I'm really short handing this, but it's very much about like finding out what errors are existing and kind of counting them and trying to figure out where the errors are happening. Safety two is much more being proactive and building systems that are kind of designed to be resilient to error and so that they have a catch factors of safety built in ahead of time so errors can't be as damaging. And now people are saying safety three which is kind of like a socio technical approach and considers both. I don't know these ideas. To me it really comes down to like how many resources do these houses have. But my point being is that error management is in fluctuation. Like the Redondoval case I was talking about. She reported the medical error voluntarily and now she got convicted of homicide. I think that set us back two decades in some ways. I think there's a lot of nurses and medical providers out there scared of death to reporting. Reporting errors is how we understand where there's potential flaws in the system, where there's potential devices that aren't useful or there's potential processes that are problematic or unsafe. So I think that there's a lot of work to be done there. And unfortunately, I feel like this recent event and it's only one event, but it was really widely popular, just like pushed us back so far because we feel like part of it's convincing people it's okay to talk about errors. It's okay you're not a bad provider because your patient died on you. That could be for a variety of reasons. You're working with sick people and in a complex system that's not necessarily safe. And so I feel like kind of changing the mindset of medicine in a way to be more like us is something that I see happening and it's going to take decades probably. But I would love every medical provider to get a bit of a human factors education along their path to go errors happen not because I'm bad at my job. But because I'm in a complex socio technical system that's loosely coupled and there's all these things that go wrong because people are sick and hurt when they come to a hospital so I could keep going. You've certainly given us a lot to think about. I mean, I do want to comment on just a couple of things. One, this is exactly why we're human factors people is because we look at these technical approaches or technical solutions to some of these problems and we immediately step back and say, okay, well, what does it take to get the human on board with these technical advances? What does it mean for somebody to use this in conjunction with how they're doing the processes today? And then also there's kind of the other approach of like, well, there's going to be a robot conducting surgery on you. What happens if they make a mistake or AI makes a mistake? Is it the person who wrote the AI? Is it a collective sort of finger pointing at a company that has developed it? Or is it the individual developer that's made that coding error in there? So there's all these other not just process procedure, but policy and really just understanding about how we're going to approach these problems in the future. And the second point I'll make is all that means that we have some job security. So that's also kind of comforting in some ways, I agree. Well, yes, it's comforting, but it's also like there's so much work to do and there's not enough of us we need more HF people, more now than ever maybe. And we're so important to a variety of domains, but I think medicine is hungry for our work. I feel like this is just like starting to me again, I'm referring to this paper, I did this Google Dimensions Analytics on HF publications with healthcare, so HF plus healthcare and it went from nothing in the last year or something. So we just had this exponential rise, starting the rise. If you look at around 2000, 2001 mark, it starts to kind of skyrocket. Clearly there's something right here and so I'm just very hopeful but it's just hard to kind of, I don't want to say, sell our signs to convince people that this is valid and valuable. And I feel like most people get a concept of what we do and don't even understand it well enough to know how valuable it is. So trying a little bit of a marketing and branding thing there, but I spoke to my friend Mike Rosen who's at Johns Hopkins probably about a year ago, we talked about this very problem of how we brand ourselves because most of us are trained in such diverse areas. You have one guy or gal who's an expert in automation, another one who's an expert in error management, another one who is driving and another one who's robotics. And we all these different backgrounds in HF. And so when you then outward face to a hospital, it's like, how does this guy does robotics and this gal that does automation? Like they're very different people in my mind. And it's not necessarily a branding problem for HF, but it's just that we have such diverse backgrounds that it's not always the same degree, does not always equal the same skill set. And I think that in some ways is probably difficult for hospitals organizations to understand in the medical community perhaps speculate yeah, I do understand a lot of that. There's a lot of work to be done not only in the field, but with explaining the importance of the field. And I feel like that is a battle that we are continuously fighting. And so with that, do you have any other closing thoughts about the healthcare symposium? Future of health care, human factors, anything? I think the future is pretty bright. I think that the conference is going to keep growing. We don't want to get huge because we like how it's small and intimate and easy to meet people. So I think that if we ended up being a conference that sits around 600 people, 700 people each year, that'd be awesome, but we are fine with 400 if that's what it ends up being. I think that there's a community of people that always show up. So conference is great. And we have now brought Dr. Tara Cohen in from Cedar Sinai who is going to be assisting me and Tony and eventually taking conference over down the road. I'm still on board for a few more years. And Tara is great, so she's already worked with me and Tony, so it's going to be in good hands, at least for the foreseeable future. And then the field itself and HF, I just feel like the jobs and the opportunities are just the best. So I see so much opportunity and potential for growth for our field and for students in this field to get amazing careers and do really amazing, critically important work to save people's lives in some instances. So couldn't be more excited than that for an HF engineer psychologist. Yeah. Well, you know what you could always do is if the conference does blow up, you could always split it off again. There you go. Maybe one day. True. Nick already there's already large things happening within the conference. I see that certain areas are really popular, so you might be on something there. Yeah. All right, well, that's it for today, everyone. If you like this coverage, want to hear more from Joe? Go check out our interview with him from 2019 so you can see how the conference has grown and some of his research interests he talks about in that interview as well. Comment wherever you're listening with what you think of the coverage. For more in depth discussion, you can always join us on our Discord community. Visit our official website, sign up for our newsletter. Stay up to date with all the latest Human Factors news. If you like what you hear, you want to support the show, there's a couple of things you can do. One, you can leave us a five star review wherever you're watching or listening right now. Two, you can tell your friends about us. Word of mouth really helps us grow. And three, if you're financially able to consider supporting us on Patreon, that really helps for contributing to some of the show costs and making sure that we stay afloat. And my pocketbook empty. And as always, links to all of our socials and our website are in the description of this episode. I want to thank Joe Kebler for being on the show today. Where can our listeners go and find you if they want to talk more about the healthcare symposium? You can find my link page under Joseph Gaiel. You can find me at Embryo Aeronautical University's webpage on the Department of Human Factors in Daytona Beach. I also have Google Scholar if you want to look up any of my publications and easy to find on there. My profile has everything I've ever published on there. Awesome. As for me, I've been to host Nick Rome. You can find me on our Discord and across social media at nickrome. Thanks again for tuning in to Human Factors cast. Until next time, joe, you've been on the show before. You know we say it depends at the end. Ready? One, two, three. It depends. Thanks, Nick. Thank you.


Joseph KeeblerProfile Photo

Joseph Keebler

Associate Professor of Human Factors, Embry-Riddle Aeronautical University

I have over 15 years of experience conducting experimental and applied research in human factors, with a specific focus on training and teamwork in medical, military, and consumer domains. I have partnered with multiple agencies and have led projects aimed at the implementation of HF/E in complex, high-risk systems to increase safety and human performance. This work includes command and control of tele-operated unmanned systems, communication and teamwork in medical systems, and simulation-/game- based training for advanced skills including playing guitar and identifying combat vehicles. My work includes over 50 publications and over 60 presentations at national and international conferences. I am currently co-director of the Research Engineering and Applied Collaborations in Healthcare (REACH) Laboratory where I work with a team of faculty and students to solve real world medical issues at the intersection of teamwork and technology.