■ The healthcare system:

Building safer systems to enhance clinical care delivery

Reflections on human factors

Type of activity: Narrative

Activity summary

Writing about one's personal experience encourages self-reflection and improves self-awareness. In this activity, learners are invited to reflect, in writing, on their experiences related to human factors. Faculty may choose to have learners personally explore the topic (e.g. keep a journal), or share their narratives as part of an interactive small group session.

Note: Do not use open medico-legal cases. Patient and provider privacy and confidentiality must be maintained at all times. No names or other identifiers should be used.

Activity description

Ask learners to write about an event they observed or were involved in during their medical training or practice that they feel reflects human factors. Alternatively, learners may want to write about an event that occurred to them as recipients of healthcare, or as an observer to a friend’s or a family member’s healthcare experiences. The event may be one that they feel reflects how individual human factors may have compromised care (e.g. fatigue, cognitive bias, affective bias, etc.), or an example of human factors engineering (e.g. a system design that allows for variability in people and their performance).

Suggested content for the narrative:

  • A description of the event
  • An explanation of how this event influenced patient care (for better or for worse)
  • The learner’s reflections on the event including:
    • if and how the event was recognized
    • why and how the event occurred. For example, was the event due to:
      • action or inaction by an individual healthcare provider
      • system failure(s)
      • a combination of systems failure(s) and individual provider performance issues
    • what changes or improvements they would make, if any
    • how they felt at the time
    • how they currently feel about the event

Suggestions to faculty

Faculty may choose to have learners share their narratives, if they feel comfortable doing so, as part of an interactive small group session.

Examples of questions that may be used to debrief their experience:

  • Were you personally involved in the event? Discuss.
  • What, if any, workplace factors contributed to the event? (e.g. Was it during a handover? Did it involve a medication?)
  • How aware were the healthcare providers of what was going on around them? (situational awareness)
  • How well was any equipment or technology designed to make the associated tasks easier or more efficient?
  • How did this event affect you?
  • What did you take away that you will use in the future?
  • I would do something differently next time because…

Additional resources

CanMEDS: Medical Expert, Professional

DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.