Error-proofing: Part 1
Helicopter flight paramedic

Error-Proofing: Part 1

By Bonnie Hutchinson

Most everybody recognizes that health care providers – nurses, paramedics, physicians, and other practitioners – ought to be in top form when they’re on the job.

But here’s a fact of life most everybody also knows. Human beings cannot always be in top form.

Unlike most other professions, in health care practice the stakes are so high that tolerance for error is zero. That’s even though, as a health care provider, you must make quick assessments and decisions in high-pressure environments, and even though no human being can be at an optimum level all the time.


Simulation training you can download to your smartphone or tablet – is designed to develop an essential component of patient care so that in times of high task difficulty in high-pressure environments (in other words, in your regular daily professional life!), you can still perform impeccably.

More about Recognize later. But first, let’s look at two components that influence performance – task difficulty and ability – and how you can error-proof yourself regardless of the challenges.

Task difficulty

By the time health care practitioners are licensed to practice, they have demonstrated the ability to deal with most of the tasks that may confront them. The most complex and difficult tasks are usually referred to specialist experts.

Recognize 1 - error-proofing

Even as the level of task difficulty increases, as long as practitioners are able to maintain their professional skill and ability, they can continue to perform the required tasks correctly and successfully, for the well-being of patients.


If you’re a registered member of your profession, you’ve demonstrated your ability to the satisfaction and high standards of the College or organization that registered you. Even if you’re still a student, you’ve probably already acquired some degree of ability.

Whether you’re a student or a registered member of your profession, you are keenly aware of the challenges that can affect your ability moment to moment. Pressure, time constraints, high mental workload, fear, embarrassment, feelings of being judged on performance, distraction, and information chaos – all these factors are common within acute care practice environments.

Most health care providers, probably including you, have developed a higher-than-average ability to screen out what’s irrelevant and to pull in all your mental acuity to focus on the symptoms and needs of your patients. However, despite that ability, all those challenges so prevalent in the health care environment are known to negatively affect medical practitioners’ abilities. Add to that any personal stressors and you have a high probability of less-than-optimum ability at that moment.

Recognize - Ability - error-proofing

Even with challenges to your ability, as long as the task difficulty does not increase too much, your ability will be sufficient to perform the necessary tasks correctly and successfully, in the best interest of the patient.

The error zone

You may not be aware that the third highest cause of death in North America is medical error – after heart disease and cancer. That’s shocking.

So when do medical errors occur? At times when…

  • the practitioner’s ability has decreased due to challenges in the environment or within the practitioner, AND

  • the task difficulty and complexity has increased, whether due to the characteristics of the patient or the nature of the professional task to be performed.

Recognize - performance errors occur

Challenges that reduce practitioners’ ability combined with increased task difficulty –that’s a dangerous combination. When the practitioner ability dips below the level required to perform a medical task, that’s when the greatest risk of medical error occurs.

Given the realities of typical health care environments and the human limits of even the most expert practitioner’s abilities, most health care providers (including you) will experience high-risk-of-error circumstances more than once in your career.

Is there a way to maintain your professional ability – to prevent declining ability regardless of pressure –and reduce the risk?


Error-proofing: Embedded ability

Suppose, just suppose, that you could embed the core skills of your profession so deeply in your brain and body that no matter what was happening around you, no matter what might be going on in the rest of your life, no matter what the complexity and difficulty of the task before you, those core professional skills and abilities would kick in and rise to the occasion. What would happen?

Recognize - Performance task success

You’d be able to do what needed to be done, correctly and successfully, in the best interest of the patient’s well-being.

Yes, such a thing is possible.

It’s not magic. There is a specific, science-based, research-proven, systematic method of learning that can take you to that level of peak performance. It’s within your reach.


Hone Virtual Education created Recognize simulation training modules to deal with the fact that health care providers are currently limited in their ability to train and prepare effectively for the reality of difficult, high-pressure patient interactions. The system is called Mastery Learning, and we’ll tell you more about that in Part 2.

Find out more

The first Recognize modules will be released early in 2019. In the meantime, you can…

Recognize - augmented reality - deliberate practice

Scientific articles

1.  Beasley, J. W., Wetterneck, T. B., Temte, J., Lapin, J. A., Smith, P., Rivera-Rodriguez, A. J., & Karsh, B. (2011). “Information Chaos in Primary Care: Implications for Physician Performance and Patient Safety.” The Journal of the American Board of Family Medicine, 24(6), 745-751, doi:10.3122/jabfm.2011.06.100255

2.  A Johns Hopkins study, led by Dr. Martin Makary of the Johns Hopkins School of Medicine, was released in 2016. A follow-up about whether anything had changed was reported by Ray Sipherd, special to  Published 9:31 AM ET Thu, 22 Feb 2018 and updated 9:39 AM ET Wed, 28 Feb 2018.

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