2a-Human Performance Fundamentals: Lesson Plan Perfor… · Web viewInstruct students to review the Student Handout, page three. The Department of Energy identified Human Performance

Human Performance Fundamentals

LESSON PLAN

© 2012 Arizona Public Service Company. Energy Delivery Training. All rights Reserved.

HP101 HPGG001C Revision Date: December 17, 2012

Prerequisites: N/A

Duration: 4 Hours

Class Size: Minimum: 1 Maximum: 12

Audience: All YOUR COMPANY NAME and contractor personnel

Student Materials: Latest handout revision (12/17/12 ) Feedback Form Knowledge Check

InstructorMaterials:

Lesson Plan Latest handout revision (12/17/12 ) Projector Computer DVDs/Videos

Notes: The following graphic signifies a concept included on the Knowledge Check.♥

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Review INSTRUCTIONS: Distribute the student handout.Typeequationhere . OVERVIEW

MAIN OBJECTIVE:Participants will discuss and review introductory Human Performance principles and tools and apply them by working in groups to analyze accident situations.ENABLING OBJECTIVES:

EO01 - DESCRIBE THE TYPES AND CAUSES OF HUMAN ERROREO02- DESCRIBE BASIC HUMAN PERFORMANCE CONCEPTS AND PRINCIPLESEO03 - APPLY THE PRINCIPLES OF HUMAN PERFORMANCE IN A CASE STUDYEO04 - IDENTIFY THE HUMAN PERFORMANCE TOOLS.EO05 - APPLY THE APPROPRIATE HUMAN PERFORMANCE TOOLS IN WORK SITUATIONS.

Regulatory References: APM



PRESENTATIONTitle Slide Welcome and Introduction

Welcome and indicate that the purpose of the course is both to reduce the frequency and severity of events and improve operational performance.

Introductions should include: Name Position Location Time on job Expectations – chart this

Housekeeping – chart Restrooms Exits (fire assembly area) Breaks Cell phones off Parking Lot

Note taking is encouraged.There will be an “open-note” Knowledge Check at the end of the course.80% accuracy is a passing score.

Related Safety Alerts/Information

Share an example of a current event alert



DESCRIBE BASIC HUMAN PERFORMANCECONCEPTS AND PRINCIPLES

Slides 1-3 Introductions, Housekeeping, Safety note

Slide 4 Purpose of the Training

SH 2

Have a volunteer read the quote on the slide. Invite participants to discuss what that quotes could mean.

Quotes from your company

Slide 5 At YOUR COMPANY NAME, we value safety

Introduce Event ClockSay: Safety is the Core Value of YOUR COMPANY NAME. We are all well aware of how YOUR COMPANY NAME has established a culture, an environment and an attitude of safe work practices in all we do.

With Human Performance concepts, we can take safety to a higher level, and help eliminate unsafe acts or conditions using error prevention tools.

Improved human performance increases benefits to customers and shareholders.We also experience zero event-clock resets.

SAY: There are multiple benefits for the company. These help support our values and build our culture. We are all expected to apply these, on the job, immediately and use them 100% of the time. We have a number of safety goals, including tracking by an Error-Free Event Clock. (Discuss this.)

?Ask: What is the ultimate performance goal we are targeting?Answer: event-free performance / no clock resets.

Slide 6Why learn this at YOUR COMPANY NAME

Values: Each individual’s mind-set toward quality of effort. Concern of self and others.

Culture: The combined values of all active participants. This is a major factor in the degree of success in efforts of the group or organization.



Performance Improvement: A positive safety culture is evident in the self-evaluation that promotes safer individuals and organizations.

Slide 7 TRAINING OBJECTIVES

SH 2 At the conclusion of this course you will be able to: Describe basic human performance concepts and

principles Apply the principles of human performance in a case

study Identify the human performance tools. Apply the appropriate human performance tools in

work situations. The participant will apply Human Performance

principles in a scenario as a group. Mastery will include 80% or better on a written exam.



MODULE ONE

SH 3 The Science of Human Performance

Slide 9

Instruct students to review the Student Handout, page three.The Department of Energy identified Human Performance Improvement as a system of behaviors, concepts and principals.This is not a step-by-step program that addresses one action or process, but an identification that a system of components can come together to create events and failures.SAY: Human Performance is a study of behaviors we exhibit in order to achieve results. These behaviors can be identified and measured by observations.Because they can be observed they can be changed.H.P. looks more at what has caused a given behavior than the behavior or its result. We will attempt to identify how errors occur and then address how to prevent them.

Slide 10 Event Pyramid

SAY: In a study of reported events, patterns related to severity of consequences emerged.This “Pyramid” shows the numerical relationship of “minor” error-consequences leading to more serious consequences.It’s important to understand that this pattern can be broken. More severe consequences can happen well before the number of less severe is reached.Understand that when you take care of the little things, “At-Risk Behaviors” the big things, “Fatalities”, go away.

SH page 3

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ErrorsASK - What is the difference between an error and an

event?ANSWER: Consequence. The error that caused a major

accident and the error that is one of hundreds /tt/file_convert/5eceb81dac8f391609197ea6/document.docx Page 7 of 23


?

with no consequence can be the same error.ASK - Statistically how many errors does an average

person commit and hour?ANSWER: 4-6ASK - Why does it make sense to report and investigate

non-consequential errors?ANSWER: To eliminate the likely hood of those errors

so that we do not have a more significant event.The lower your number of non-consequential errors, the longer it will take your department to reach the higher levels of the pyramid.

?

SAY: Errors are actions that result in unintentional results. When we commit an error we have no control over the result because we didn’t expect “things to go that way” in the first place.

ASK: Is it possible to commit the same error under different conditions and have different or no consequences?

Answer: Yes. There may be no consequence or there may be catastrophic consequences. We can’t control consequences!

Slide 11 Layers of Responsibility Contributing to Human Performance

SH page 4

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Discusses the various parties involved in human performance:

individual leader organizational values & processes

Ask: How does each of these contribute to performance? Give an example.

Slide 12 ♥Elements that Impact Human Performance

A System of Interdependencies

SH pages 4-5 Organizational Processes and Values

Processes are a result of mission and planning. Values indicate priorities. Together, these establish how to do a job and expected

Job Results When compared against expectations these will initiate changes and /or corrective actions to



equipment, materials or personnel. Work Conditions

Shape worker performance. If worker abilities or motivations don’t match the tasks, error tryour company name begin to emerge.

Worker Behavior Actions or inactions a worker uses in the performance of tasks. These can include fitness for duty, tool use, hazard recognition and error prevention efforts.

Leadership For good, or bad, leaders influence others’ behavior toward the group’s goals. Aggressive leadership will balance production with error prevention. Anyone can be a leader.

Define leader: Anyone, who, at any time influences another person’s behavior, attitude, belief or values

?SAY: Production is goal directed while prevention is

value directed.ASK: What would be the result of a balance of

production and prevention?Answer: A safe, highly performing, productive

workplace.

Slide 13 - 15 Counting Exercise

SAY: On the next slide is a sentence. Please read in silently and count the “F’s”.This could be a simple task if you can read, count and identify an “F”.By the way, you’ll have 15 seconds to complete this task.

?ASK: Who counted at least three “F’s”; four; five; six?

There are six. CLICK MOUSE - “F” is highlighted.Because of pre-conceptions of what the “F” will sound like in our minds most people fail to count those that sound like a “V”.Pre-conceptions can lead to errors.

Slide 16-17 Reading Exercise

Have a class member read the slide. He/she should be able to read the text despite the fact that most of the words are spelled incorrectly.



SAY: These two exercises illustrates that Humans sometime don’t see what’s right in front of them and at other times think they see things that really don’t exist.We look for letters based on sound in the first exercise and our mind’s pattern is to match to words it is familiar with, to read the paragraph in the second exercise.We can see the fallibility and ability of the human mind.

We know that even the best of us will make errors.

Slide 18Types of ErrorsSAY: There are two types of errors – Active and Latent

SH page 6

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Active An error having an immediate, unfavorable

result to personnel, service or equipment.

Latent Actions, directives or decisions that either create

the conditions for error or fail to prevent, expose, or mitigate an error’s effects. These are hidden and dormant until conditions allow consequences to occur.

SH page 7

Slide 19How We Commit Errors

SAY: We won’t discuss violations. Violations are based on a conscious decision to deviate from acceptable or permitted behavior.Mistakes:

Misapplying a good rule Application of a bad or incorrect rule Consciously deciding against enough planning

or preparation to avoid errors (Fail to plan – use misdialing phone number as an example)

?

Your company name: Memory failure Forgetting intentions Lost place Omitting a planned item

ASK: What might we do to compensate for memory concerns? Allow time for 2–3 answers.

SAY: Old proverb say – Sometimes dull pencil is better than sharp mind.



Slip: Attention failure Distraction Stressors Time issues

Slide 20

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Information Processing

ASK: Are there limits to the amount of information on individual can process? YES

ASK: If so, how much information can you process at a time.

Sensing - visual, audible, and other senses used to detect and recognize.

Thinking - mental activities to decide what to do with the information; interaction between one’s working memory and long-term memory.

Acting - physical response based on mental processing of information.

Shared Attention Resources - a pool of resources available for various mental activities to function effectively; defines workload.

Fact: Most error is associated with our limitations in processing information

Ask group to memorize, without writing it, the number: “19410071776” stated one digit at a time quickly.

Fact: Humans tend to look for patterns. This can be especially error-provoking when we talk about the knowledge-based mode of information processing. We’ll discuss that next



Slide 21 Performance Modes

SH page 8

SAY: Workers lacking familiarity in a task or position need to pay more attention.Workers with more familiarity must avoid inattention.At any time we could be anywhere on the scale.

♥Knowledge Based Lack of understanding, knowledge, experience Worker is unable to think his/her way out Possibility of error: 1:2 to 1:10 decisions/actions

Rule Based Written or verbal expectation is available for use I know the rule exists and where to find it Possibility of error: 1:100 decisions/actions

Skill Based I don’t have to think during a task Actions are based on habit Task is routine Possibility of error: 1:1,000 decisions/actions

? ASK: When have you been in these performance modes? What, if any consequences, occurred.

Allow time for 3 to 4 responses.SH page 9

Slide 22Error Traps

♥

Task Demands (mental/physical requirements) Unclear roles/responsibilities Time pressures High workload Simultaneous or Multi-tasks

Human Nature Stress Habit patterns Mind set

Individual Capabilities Knowledge, skills, experience Family problems Physical limitations (such as color blindness) Indistinct problem solving skills

Work environment (present site conditions) Prior conditions that increase the likelihood of



an error Distractions / Interruptions Unexpected conditions: equipment,

environment Adverse conditions: climate, terrain

Slide 23

SH page 10

The Error Trap ModelSAY: We can see other sources of Error TrapsDefine TAPE: These are the first letters of each section.

T ime A ctivity P erson E nvironment

Highlight some of the tryour company name under each category

Slide 24?

Show video: A video on a subject that shows some type of error

Video Debrief Questions:ASK:

How would you go about finding the real causes of this event?

What were some causes of the incident?

Distribute the MODULE ONE QUIZ.Notes may be used to complete it.Grade and discuss; COLLECT QUIZ



HUMAN PERFORMANCE CONCEPTS AND PRINCIPLES

Error Prevention PrinciplesREVIEW

SAY: We’ve looked at different types of errors and how they can occur. Let’s look at how to prevent errors.

Recognize that humans make mistakes.So we:

Implement controls, processes, procedures to prevent them

So we can:

Predict, manage, and prevent situations that are “error-likely”

Complex procedures Situations having unique/mitigating

circumstances Error tryour company name are present

Know that behaviors in the workplace are influenced by the organization’s processes and values

Support and value safety Have clear directions, guidelines, roles

Positive reinforcement and encouragement Leaders Peers Subordinates

Understanding the reasons behind the errors Event Alerts

Applying lessons from past errors Safety training Regular safety meetings Pre-job Briefs Sharing Event Alerts



Slide 26 5 Principles of Human Performance

SH pages 11-12

♥SAY: Understanding these principles allows us to be proactive rather than reactive in preventing errors.

People are fallibleBy our very nature, as humans, we are susceptible to error. Fallibility cannot be altered but it can be recognized and compensated for.

Error-likely situations are predictable.It is important to recognize that we can foresee the possibilities of errors and the conditions that create them.

Organizational processes & values influence individual behavior.Organizations are characterized by goal directed and production oriented behavior. Therefore, cultures, processes and management planning can contribute to human performance problems.

Reinforcement affects performance.All behavior, good or bad, is reinforced whether by immediate consequences or past experience. Human Performance is a function of behavior. Behavior is influenced by consequences.

Understanding past events helps avoid events.It is better to proactively anticipate and prevent errors and events, than to improve performance due to analysis and corrective actions based on past events.

Briefly discuss the class’s feelings on the definitions.

Slide 27 Layers of Responsibility Contributing to Human Performance

This is a reminder of the 3 layers responsible for performance.



Slide 28 Student Activity

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SAY: The goal of these shooters is not total points but simply to hit the “Bull’s Eye”.Each shooter gets five rapid fire shots and is asked to hit the bull’s eye as often as possible.DO: Click mouse – “Bullet Holes” appear

Click mouse - Second group of “holes” appears

Ask the question at the bottom of the slide.

Ask: Which one would you say performed better?Discuss: The person on the right may not have had the best “results” but they were more consistent in their behavior and achieved better performance.ASK - What are potential reasons for performance?ASK - What are possible ways to improve performance?

Slide 29

SH page 13

SAY: We can’t just focus on results. There are two parts to the equation of performance.

Behavior, in conjunction with the results produced, equate to your performance.

Behavior plus Results = Performance (P=B+R)If we want consistent, positive results and performance,

we must have consistent positive/correct behavior.

♥A healthy attitude toward the potential for error is to have a sense of uneasiness or a wise cautiousness.

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Slide 30

SH pages 14-15

♥

Functions of Defense Create Awareness

Develop and understanding of risks/hazards Detect and Warn

Identify non-normal condition(s) /danger Protect

Guard against injury or damage Recover

Restore from non-normal condition to safe state

ContainRestrict accidental release of harmful energy/substance

Enable EscapeEnable removal of potential victims from the presence of hazards/danger

Defenses are put in place to balance human fallibility and vulnerability

DISTRIBUTE EXERCISE ONE (1)Complete exercise; Grade; CollectDISTRIBUTE EXERCISE TWO (2)Complete exercise; Grade; Collect

Slide 31 Defense in Depth

• In our business we have many protective layers. However, some of these barriers can erode or break down. Additional layers can prevent an event from occurring.

• A common problem: over time individuals and organizations can allow erosion in some defenses.

• Therefore we must be proactive and vigilant.

• When defenses begin to erode and we don’t see it, we think we have defense in depth but really have flawed defenses and broken barriers.

• It is important to examine near misses and keep an open mind about what may be flawed.



Slide 32 Sources of Organizational Weakness

SH page 16

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Processes• Organizational Structure

Control of work Training Accountability policy Process Development Use of manpower

Values Relationships

Priorities Measures and Controls Coaching and Teamwork Rewards and Sanctions Reinforcement

Distribute the MODULE TWO QUIZNotes may be used to complete it.Grade and discuss; COLLECT QUIZ



APPLY THE PRINCIPLES OF HUMAN PERFORMANCE

Slide 34 Case study

SH page 17

Show video a video showcasing some type of error situation such as Landing on the HudsonIntroduce the video activity.Instruct participants to consider the HP concepts as they watch the video. Be prepared to address the items on the following slide:

SEE next Slide

Slide 35

Questions for case studyIf group is large enough (9-18) think about dividing it into

smaller groups for “discussion and report”.

What factors contributed to the incident? Leader Organization Individual

What “modes” were the individuals in? (slide 21) Knowledge based (the brother) Rules Based (Odie – gotta’ beat the weather) Skill Based

Were there: (slide 19) Mistakes (yes; beating weather became priority) Slips your company names Violations (yes)

Debrief and ensure they use HP principles and concepts in the discussion.

Answers for number 5 on the slide, Error Try our company name:

Non-adherence to a procedure; Pressure and stress; Leader-Follower mentality; communication; Weather conditions dictating action

HUMAN PERFORMANCE TOOLSSlide 37 – 39 Pause briefly on each slide to allow class to read

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SH pages 18-22 Quickly Highlight tools on each slide

Slide 40 ♥Self-Checking (S.T.A.R.)

Paraphrase bullet points

Slide 41 ♥Peer-Checking (Team S.T.A.R.)


Slide 42 ♥Sometimes we just blow it!

How could this have been prevented? STAR TEAM STAR

Slide 43 ♥3-Way Communication (repeat back)Paraphrase bullet points

Communication=Defense 3-way communication is required during safety-

sensitive activities Ask: How can this defense become flawed?Answer: This defense can become flawed if we

take shortcuts, instead of reading back each step completely.

Slide 44 What Dennis said vs. What Don heard

Slide 45 The Result 3-Way communication could have prevented this.

Slide 46 ♥Pre-Job Briefing (best tool for identifying error your company name)


Slide 47 ♥“STOP” if unsure


Slide 48 ♥Two-Minute Drill

Paraphrase bullet pointsSAY: The 2-minute drill tool may be used by crews or

individuals.This tool helps maintain environmental awareness.Use this tool before entering a vehicle, as part of thePre-job Briefing or anytime “hazard awareness” is desired.

Slide 49 ♥Questioning Attitude


Slide 50 ♥Turnover




Slide 51 ♥ Place KeepingParaphrase bullet points

Slide 52 ♥ FlaggingParaphrase bullet points

Slide 53 ♥ Phonetic AlphabetParaphrase bullet points

Slide 54 ♥Phonetic AlphabetPrint this slide if any want a copy of it.

Slide 55 ♥ Conservative Decision MakingParaphrase bullet points

Slide 56 ♥ Procedure Use and AdherenceParaphrase bullet points

Slide 57 ♥ Concurrent VerificationParaphrase bullet points

Slide 58 ♥ Post Job ReviewParaphrase bullet points

Distribute the MODULE THREE QUIZNotes may be used to complete it.Grade and discuss; COLLECT QUIZ



APPLY THE TOOLS

Case Study Insert Case study video here

Slide 60

SH page 23

How valuable is good communication?Click on the slide – GERMAN COAST GUARD

Which tool(s) would help this become a successful rescue? (Slides 37-39)

Peer Checking (ask for help) Concurrent Verification Which Performance Mode was the man in?

Answer: Knowledge Based (See slide 21) Questioning Attitude

Slide 61

Little League Football - Click on the slideWhat was the root cause(s) of the defense’s failure to

stop the score? Coach’s lack of knowledge Players’ mental vision of how a play should start

What tool(s) would have been useful? Questioning Attitude Procedure Use and Adherence (there was no

whistle blown; take him down)

Slide 62Objective ReviewDid we do what we set out to accomplish?

Slide 63

The Big QuestionUsing the Human Performance tool:Questioning Attitude –

Ask, as frequently as needed, “What’s the worst thing that could happen and how am I going to prevent it?”

Slide 64 WHAT QUESTIONS DO YOU HAVE?

Slide 65 THANK YOULET’S PUT IT ALL TOGETHER

Slide 66KNOWLEDGE CHECKA score or 80% or better is required to pass the course.

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EvaluationNote: Distribute the Knowledge Check and have each participant complete the test. They may use any provided references, handouts and/or notes.

Distribute course feedback forms, have them completed and returned.

SUMMARY

Content ChangesREVISION DATE REASON FOR CHANGEAugust 21, 2013 Formatted by the WECC HPWG for generic use.


Documents

2a-Human Performance Fundamentals: Lesson Plan Perfor… · Web viewInstruct students to review the Student Handout, page three. The Department of Energy identified Human Performance