AEM Early Access 11: Human Factors and Simulation in EM

Welcome to the eleventh episode of AEM Early Access, a FOAMed podcast collaboration between the Academic Emergency Medicine Journal and Brown Emergency Medicine. Each month, we'll give you digital open access to an recent AEM Article or Article in Press, with an author interview podcast and suggested supportive educational materials for EM learners.

Find this podcast series on iTunes here.

A FOAM Collaboration: Academic Emergency Medicine Journal and Brown EM

A FOAM Collaboration: Academic Emergency Medicine Journal and Brown EM

Discussing: (click title for full text; open access through February 28, 2018.)

Human Factors and Simulation in Emergency Medicine. Emily Hayden MD, MHPE,
Ambrose H. Wong MD, MSHPEd, Jeremy Ackerman MD, PhD, Margaret K. Sande MD, MS,MSHPEd, Charles Lei MD,Leo Kobayashi MD, Michael Cassara DO, MSED, Dylan D. Cooper MD, Kimberly Perry,William E. Lewandowski MS, Mark W. Scerbo PhD; Academic Emergency Medicine 2017.



MGH Hayden photo.jpg

Emily Hayden, MD, MHPE

Director of Telemedicine

Department of Emergency Medicine

Massachusetts General Hospital


Human Factors (HF) is the scientific discipline concerned with the understanding of the interactions among humans and the other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance. During the 2017 Academic Emergency Medicine Consensus Conference, the Human Factors and Simulation in Emergency Medicine breakout group presented their findings of the current state of the topic as well as gaps in research and understanding. This article serves to document the breakout group’s findings.

The field of human factors (HF) examines the physical demands, mental workload, team dynamics, work environments, and device design required to complete a task optimally and improve safety and effectiveness. HF methods have been used to examine aspects of individual performance, such as task switching exhibited by EM residents, clinical decision-making, EM team performance in traumas and codes, and task saturation for those involved in rapid response and critical care transport. 

The authors put forth three main positions regarding the future of HF research in Simulation and Emergency Medicine: 1) Emergency medicine simulation should promote the use of HF approaches to address emergency care by educating their stakeholders and col- leagues as well as leading successful collaborations that lead to improved safety and outcomes; 2) Application of HF in EM should focus on demonstrable outcomes in patient safety and clinical outcomes that should be disseminated widely to all stakeholders (e.g., the public, policy makers, payers); and 3) Collaborative and structured relationships should be fostered and established between EM simulation and HF professionals using existing academic structures at the local, regional, and national levels. 


Fidler R, Johnson M. Human Factors Approach to Comparative Usability of Hospital Manual Defibrillators. Resuscitation. 2016;101:71-76. 

Cvach M, Rothwell KJ, Cullen AM, Nayden MG, Cvach N, Pham JC. Effect of altering alarm settings: a randomized controlled study. Biomed Instrum Technol. 2015;49(3):214-222. 

Kobayashi L, Dunbar-Viveiros JA, Sheahan BA, et al. In Situ Simulation Comparing In-Hospital First Responder Sudden Cardiac Arrest Resuscitation Using Semiautomated Defibrillators and Automated External Defibrillators. Simul Healthc. 2010;5(2):82-90. 

Zhang XC, Bermudez AM, Reddy PM, et al. Interdisciplinary Development of an Improved Emergency Department Procedural Work Surface Through Iterative Design and Use Testing in Simulated and Clinical Environments. Ann Emerg Med. November 2016.