Tomorrow's demons: a scoping review of the risks associated with emerging technologies.

Society faces a growing set of risks from advanced emerging technologies. While there has been discussion on some of these risks, a comprehensive overview does not exist, and it is not clear what methods are suited to identify future risks. This scoping review aimed to synthesise current knowledge regarding the risks associated with emerging technologies. The findings show that a diverse set of technologies and risks have been considered, with ten risk themes identified: risks to human health and wellbeing, sub-standard technology risks, legal and ethical risks, privacy and security risks, socioeconomic impacts, ecological and environmental risks, malicious use risks, geopolitical risks, technological unemployment risks, and existential threats. It is concluded that there is a need to expand the focus of prospective risk assessments to consider the organisational, sociotechnical and societal systems in which emerging technologies will be deployed. The development of a future technology risks classification scheme is also recommended. PRACTITIONER STATEMENT: This scoping review provides practitioners with a comprehensive overview of the risks associated with future advanced technologies. This will support the proactive development of suitable controls, with the findings also signposting ergonomics methods that can be used to support future risk assessments.

Prospectively identifying risks and controls for advanced brain-computer interfaces: A Networked Hazard Analysis and Risk Management System (Net-HARMS) approach.

The introduction of advanced digital technologies continues to increase system complexity and introduce risks, which must be proactively identified and managed to support system resilience. Brain-computer interfaces (BCIs) are one such technology; however, the risks arising from broad societal use of the technology have yet to be identified and controlled. This study applied a structured systems thinking-based risk assessment method to prospectively identify risks and risk controls for a hypothetical future BCI system lifecycle. The application of the Networked Hazard Analysis and Risk Management System (Net-HARMS) method identified over 800 risks throughout the BCI system lifecycle, from BCI development and regulation through to BCI use, maintenance, and decommissioning. High-criticality risk themes include the implantation and degradation of unsafe BCIs, unsolicited brain stimulation, incorrect signals being sent to safety-critical technologies, and insufficiently supported BCI users. Over 600 risk controls were identified that could be implemented to support system safety and performance resilience. Overall, many highly-impactful BCI system safety and performance risks may arise throughout the BCI system lifecycle and will require collaborative efforts from a wide range of BCI stakeholders to adequately control. Whilst some of the identified controls are practical, work is required to develop a more systematic set of controls to best support the design of a resilient sociotechnical BCI system.

The effect of information integration on team communication in a simulated submarine control room task.

Submarine control rooms are characterised by dedicated individual roles for information types (e.g. Sonar operator processes sound energy), with individuals verbally reporting the information that they receive to other team members to help resolve uncertainty in the operational environment (low information integration). We compared this work design with one that ensured critical information was more readily available to all team members (high information integration). We used the Event Analysis of Systemic Teamwork (EAST) method to analyse task, information, and social networks for novice teams operating within a simulated submarine control room under low versus high information integration. Integration impacted team member centrality (importance relative to other operators) and the nature of information shared. Team members with greater centrality reported higher workload. Higher integration across consoles altered how team members interacted and their relative status, the information shared, and how workload was distributed. However, overall network structures remained intact.

Wider integration (distribution) of information within teams in a simulated submarine control room altered the content of the information shared between team members and the centrality and workload of team members. Practitioners must consider how to integrate information in sociotechnical systems such that information traditionally held by specialist positions can be distributed within teams to benefit team performance and other outcomes.

Improving health system responses when patients are harmed: a protocol for a multistage mixed-methods study.

INTRODUCTION: At least 10% of hospital admissions in high-income countries, including Australia, are associated with patient safety incidents, which contribute to patient harm ('adverse events'). When a patient is seriously harmed, an investigation or review is undertaken to reduce the risk of further incidents occurring. Despite 20 years of investigations into adverse events in healthcare, few evaluations provide evidence of their quality and effectiveness in reducing preventable harm.This study aims to develop consistent, informed and robust best practice guidance, at state and national levels, that will improve the response, learning and health system improvements arising from adverse events. METHODS AND ANALYSIS: The setting will be healthcare organisations in Australian public health systems in the states of New South Wales, Queensland, Victoria and the Australian Capital Territory. We will apply a multistage mixed-methods research design with evaluation and in-situ feasibility testing. This will include literature reviews (stage 1), an assessment of the quality of 300 adverse event investigation reports from participating hospitals (stage 2), and a policy/procedure document review from participating hospitals (stage 3) as well as focus groups and interviews on perspectives and experiences of investigations with healthcare staff and consumers (stage 4). After triangulating results from stages 1-4, we will then codesign tools and guidance for the conduct of investigations with staff and consumers (stage 5) and conduct feasibility testing on the guidance (stage 6). Participants will include healthcare safety systems policymakers and staff (n=120-255) who commission, undertake or review investigations and consumers (n=20-32) who have been impacted by adverse events. ETHICS AND DISSEMINATION: Ethics approval has been granted by the Northern Sydney Local Health District Human Research Ethics Committee (2023/ETH02007 and 2023/ETH02341).The research findings will be incorporated into best practice guidance, published in international and national journals and disseminated through conferences.

The Chartered Institute of Ergonomics and Human Factors at 75: perspectives on contemporary challenges and future directions for Ergonomics and Human Factors.

As the UK's Chartered Institute of Ergonomics and Human Factors (CIEHF) celebrates its 75th anniversary, it is worth reflecting on our discipline's contribution, current state, and critical future endeavours. We present the perspectives of 18 EHF professionals who were asked to respond to five questions regarding the impact of EHF, contemporary challenges, and future directions. Co-authors were in agreement that EHF's impact has been only limited to date and that critical issues require resolution, such as increasing the number of suitably qualified practitioners, resolving the research-practice gap, and increasing awareness of EHF and its benefits. Frequently discussed future directions include advanced emerging technologies such as artificial intelligence, the development of new EHF methods, and enhancing the quality and reach of education and training. The majority felt there will be a need for EHF in 75 years; however, many noted that our methods will need to adapt to meet new needs.Practitioner statement: This article provides the perspectives of 18 Ergonomics and Human Factors (EHF) professionals on the impact of EHF, contemporary challenges and critical future directions, and changes that are necessary to ensure EHF remains relevant in future. As such, it provides important guidance on future EHF research and practice.

Challenges and opportunities of artificial intelligence implementation within sports science and sports medicine teams.

The rapid progress in the development of automation and artificial intelligence (AI) technologies, such as ChatGPT, represents a step-wise change in human's interactions with technology as part of a broader complex, sociotechnical system. Based on historical parallels to the present moment, such changes are likely to bring forth structural shifts to the nature of work, where near and future technologies will occupy key roles as workers or assistants in sports science and sports medicine multidisciplinary teams (MDTs). This envisioned future may bring enormous benefits, as well as a raft of potential challenges. These challenges include the potential to remove many human roles and allocate them to semi- or fully-autonomous AI. Removing such roles and tasks from humans will make many current jobs and careers untenable, leaving a set of difficult and unrewarding tasks for the humans that remain. Paradoxically, replacing humans with technology increases system complexity and makes them more prone to failure. The automation and AI boom also brings substantial opportunities. Among them are automated sentiment analysis and Digital Twin technologies which may reveal novel insights into athlete health and wellbeing and team tactical patterns, respectively. However, without due consideration of the interactions between humans and technology in the broader system of sport, adverse impacts are likely to be felt. Human and AI teamwork may require new ways of thinking.

Where do we intervene to optimize sports systems? Leverage Points the way.

Sport and sports research are inherently complex systems. This appears to be somewhat at odds with the current research paradigm in sport in which interventions are aimed are fixing or solving singular broken components within the system. In any complex system, such as sport, there are places where we can intervene to change behaviour and, ideally, system outcomes. Meadows influential work describes 12 different points with which to intervene in complex systems (termed "Leverage Points"), which are ordered from shallow to deeper based on their potential effectiveness to influence transformational change. Whether research in sport is aimed at shallow or deeper Leverage Points is unknown. This study aimed to assess highly impactful research in sports science, sports nutrition/metabolism, sports medicine, sport and exercise psychology, sports management, motor control, sports biomechanics and sports policy/law through a Leverage Points lens. The 10 most highly cited original-research manuscripts from each journal representing these fields were analysed for the Leverage Point with which the intervention described in the manuscript was focused. The results indicate that highly impactful research in sports science, sports nutrition/metabolism, sports biomechanics and sports medicine is predominantly focused at the shallow end of the Leverage Points hierarchy. Conversely, the interventions drawn from journals representing sports management and sports policy/law were focused on the deeper end. Other journals analysed had a mixed profile. Explanations for these findings include the dual practitioner/academic needing to "think fast" to solve immediate questions in sports science/medicine/nutrition, limited engagement with "working slow" systems and method experts and differences in incremental vs. non-incremental research strategies.

Reducing crash risk for young drivers: Protocol for a pragmatic randomised controlled trial to improve young driver sleep.

Background: Road trauma is a leading cause of death and disability for young Australians (15-24 years). Young adults are overrepresented in crashes due to sleepiness, with two-thirds of their fatal crashes attributed to sleepy driving. This trial aims to examine the effectiveness of a sleep extension and education program for improved road safety in young adults. Methods: Young adults aged 18-24 years (n = 210) will be recruited for a pragmatic randomised controlled trial employing a placebo-controlled, parallel-groups design. The intervention group will undergo sleep extension and receive education on sleep, whereas the placebo control group will be provided with information about diet and nutrition. The primary outcomes of habitual sleep and on-road driving performance will be assessed via actigraphy and in-vehicle accelerometery. A range of secondary outcomes including driving behaviours (driving simulator), sleep (diaries and questionnaire) and socio-emotional measures will be assessed. Discussion: Sleep is a modifiable factor that may reduce the risk of sleepiness-related crashes. Modifying sleep behaviour could potentially help to reduce the risk of young driver sleepiness-related crashes. This randomised control trial will objectively assess the efficacy of implementing sleep behaviour manipulation and education on reducing crash risk in young adult drivers.

When tomorrow comes: A prospective risk assessment of a future artificial general intelligence-based uncrewed combat aerial vehicle system.

There are concerns that Artificial General Intelligence (AGI) could pose an existential threat to humanity; however, as AGI does not yet exist it is difficult to prospectively identify risks and develop requisite controls. We applied the Work Domain Analysis Broken Nodes (WDA-BN) and Event Analysis of Systemic Teamwork-Broken Links (EAST-BL) methods to identify potential risks in a future 'envisioned world' AGI-based uncrewed combat aerial vehicle system. The findings suggest five main categories of risk in this context: sub-optimal performance risks, goal alignment risks, super-intelligence risks, over-control risks, and enfeeblement risks. Two of these categories, goal alignment risks and super-intelligence risks, have not previously been encountered or dealt with in conventional safety management systems. Whereas most of the identified sub-optimal performance risks can be managed through existing defence design lifecycle processes, we propose that work is required to develop controls to manage the other risks identified. These include controls on AGI developers, controls within the AGI itself, and broader sociotechnical system controls.

Applying a systems thinking lens to anti-doping: A systematic review identifying the contributory factors to doping in sport.

The use of performance enhancing substances and methods (known as "doping") in sport is an intractable issue, with current anti-doping strategies predominantly focused on the personal responsibility and strict liability of individual athletes. This is despite an emerging understanding that athletes exist as part of a broader complex sports system that includes governance, policymakers, media, sponsors, clubs, team members, and athlete support staff, to name a few. As such, there is a need to examine the broader systemic factors that influence doping in sport. The aim of this systematic review was to identify and synthesise the factors contributing to doping and doping behaviours, attitudes, and beliefs and the extent to which this knowledge extends beyond the athlete to consider broader sports systems. The review followed PRISMA guidelines with risk of bias and study quality assessed by the Mixed Methods Appraisal Tool, and identified contributory factors synthesised and mapped onto a systems thinking-based framework. Overall, the included studies were determined to be of high quality. Support personnel, the coach, and the coach-athlete relationship represent key influences on the athletes' decisions to dope. From the evidence presented, doping is an emergent property of sport systems and represents a complex systemic problem that will require whole-of-system interventions. The implications for this and the focus of future research are discussed.

Testing the reliability of accident analysis methods: a comparison of AcciMap, STAMP-CAST and AcciNet.

Accident analysis methods are used to model the multifactorial cause of adverse incidents. Methods such as AcciMap, STAMP-CAST and recently AcciNet, are systemic approaches that support the identification of safety interventions across sociotechnical system levels. Despite their growing popularity, little is known about how reliable systems-based methods are when used to describe, model and classify contributory factors and relationships. Here, we conducted an intra-rater and inter-rater reliability assessment of AcciMap, STAMP-CAST and AcciNet using the Signal Detection Theory (SDT) paradigm. A total of 180 hours' worth of analyses across 360 comparisons were performed by 30 expert analysts. Findings revealed that all three methods produced a weak to moderate positive correlation coefficient, however the inter-rater reliability of STAMP-CAST was significantly higher compared to AcciMap and AcciNet. No statistically significant or practically meaningful differences were found between methods in the overall intra-rater reliability analyses. Implications and future research directions are discussed.

Practitioners who undertake accident analysis within their organisations should consider the use of STAMP-CAST due to the significantly higher inter-rater reliability findings obtained in this study compared to AcciMap and AcciNet, particularly if they tend to work alone and/or part of relatively small teams.

What Enables Child Sexual Abuse in Sport? A Systematic Review.

Sporting environments provide opportunities for perpetrators to commit child sexual abuse (CSA). While awareness of CSA in sport and preventative interventions are increasing, CSA in sport still occurs at alarming rates. A systematic review was conducted to identify and synthesize the extant literature on the enabling factors for CSA in sport. The 34 included articles were peer-reviewed and were primary sources; had full-text versions in English; included the individual, situational, environmental, or systemic antecedent factors and characteristics which enable CSA in organized sport (clubs, schools, universities, and representative teams); and focused on abuse in children (0-18 years old), and included retrospective incidents. The enabling factors from across the broader sports system were identified and mapped using a systems thinking-based approach, the Risk Management Framework (RMF) and the associated AcciMap method. The results indicated that enabling factors for CSA in sport were identified at multiple levels of the sporting system hierarchy. The results show that 24.1% (n = 46) of the enabling factors identified in the literature relate to the hierarchical level of the Athlete, teammates, opponents, and fans levels, and 52.9% (n = 101) of the enabling factors relate to the level of Direct supervisors, management, medical, and performance personnel level. However, only 13% (n = 25) of enabling factors to CSA in sport were identified at the combined top four hierarchical levels. Results indicate that the problem of CSA in sport is a systems issue, and future research is required to explore how these factors interact to enable CSA in sport.

Experience-based codesign approach to improve care in Australian emergency departments for complex consumer cohorts: the MyED project protocol, Stages 1.1-1.3.

INTRODUCTION: Emergency department (ED) care must adapt to meet current and future demands. In Australia, ED quality measures (eg, prolonged length of stay, re-presentations or patient experience) are worse for older adults with multiple comorbidities, people who have a disability, those who present with a mental health condition, Indigenous Australians, and those with a culturally and linguistically diverse (CALD) background. Strengthened ED performance relies on understanding the social and systemic barriers and preferences for care of these different cohorts, and identifying viable solutions that may result in sustained improvement by service providers. A collaborative 5-year project (MyED) aims to codesign, with ED users and providers, new or adapted models of care that improve ED performance, improve patient outcomes and improve patient experience for these five cohorts. METHODS AND ANALYSIS: Experience-based codesign using mixed methods, set in three hospitals in one health district in Australia. This protocol introduces the staged and incremental approach to the whole project, and details the first research elements: ethnographic observations at the ED care interface, interviews with providers and interviews with two patient cohorts-older adults and adults with a CALD background. We aim to sample a diverse range of participants, carefully tailoring recruitment and support. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Western Sydney Local Health District Human Research Ethics Committee (2022/PID02749-2022/ETH02447). Prior informed written consent will be obtained from all research participants. Findings from each stage of the project will be submitted for peer-reviewed publication. Project outputs will be disseminated for implementation more widely across New South Wales, Australia.

Identifying risk controls for future advanced brain-computer interfaces: A prospective risk assessment approach using work domain analysis.

Brain-computer interface (BCI) technologies are progressing rapidly and may eventually be implemented widely within society, yet their risks have arguably not yet been comprehensively identified, nor understood. This study analysed an anticipated invasive BCI system lifecycle to identify the individual, organisational, and societal risks associated with BCIs, and controls that could be used to mitigate or eliminate these risks. A BCI system lifecycle work domain analysis model was developed and validated with 10 subject matter experts. The model was subsequently used to undertake a systems thinking-based risk assessment approach to identify risks that could emerge when functions are either undertaken sub-optimally or not undertaken at all. Eighteen broad risk themes were identified that could negatively impact the BCI system lifecycle in a variety of unique ways, while a larger number of controls for these risks were also identified. The most concerning risks included inadequate regulation of BCI technologies and inadequate training of BCI stakeholders, such as users and clinicians. In addition to specifying a practical set of risk controls to inform BCI device design, manufacture, adoption, and utilisation, the results demonstrate the complexity involved in managing BCI risks and suggests that a system-wide coordinated response is required. Future research is required to evaluate the comprehensiveness of the identified risks and the practicality of implementing the risk controls.

From Anti-doping-I to Anti-doping-II: Toward a paradigm shift for doping prevention in sport.

Doping remains an intractable issue in sport and occurs in a complex and dynamic environment comprising interactions between individual, situational, and environmental factors. Anti-doping efforts have previously predominantly focused on athlete behaviours and sophisticated detection methods, however, doping issues remain. As such, there is merit in exploring an alternative approach. The aim of this study was to apply a systems thinking approach to model the current anti-doping system for four football codes in Australia, using the Systems Theoretic Accident Model and Processes (STAMP). The STAMP control structure was developed and validated by eighteen subject matter experts across a five-phase validation process. Within the developed model, education was identified as a prominent approach anti-doping authorities use to combat doping. Further, the model suggests that a majority of existing controls are reactive, and hence that there is potential to employ leading indicators to proactively prevent doping and that new incident reporting systems could be developed to capture such information. It is our contention that anti-doping research and practice should consider a shift away from the current reactive and reductionist approach of detection and enforcement to a proactive and systemic approach focused on leading indicators. This will provide anti-doping agencies a new lens to look at doping in sport.

Understanding complexity in a safety critical setting: A systems approach to medication administration.

'Medication errors' are a significant concern and are associated with a higher incidence of adverse events and unintentional patient harm than any other aspect of healthcare. While much research has focused on adverse medication errors, limited studies have specifically examined 'normal' medication delivery performance and the interactions between tasks, agents, and information within the medication administration system. This article describes a study that applied the Event Analysis of Systemic Teamwork (EAST) model to study the hospital medication administration system to identify opportunities to optimise performance and patient safety. Key findings of this study demonstrate that this is a highly complex system, comprising many social agents and a relatively closely linked series of tasks and information. However, most of the workload relies on a small proportion of healthcare professionals. Significantly, the patient has a minimal role in the medication administration system during their hospital stay. The research has shown that this approach enables mapping networks and their interdependencies to optimise the system as a whole rather than its parts in isolation.

Towards a unified model of accident causation: refining and validating the systems thinking safety tenets.

The systems thinking tenets were developed based on a synthesis of contemporary accident causation theory, models and approaches and encapsulate 15 features of complex systems that interact to create both safety and adverse events. Whilst initial testing provided supportive evidence, the tenets have not yet been subject to formal validation. This article presents the findings from a three-round Delphi study undertaken to refine and validate the tenets and assess their suitability for inclusion in a unified model of accident causation. Participants with expertise in accident causation and systems thinking provided feedback on the tenets and associated definitions until an acceptable level of consensus was achieved. The results reduced the original 15 tenets to 14 and 10 were identified as important to include in unified model of accident causation. The refined systems thinking tenets are presented along with future research directions designed to facilitate their use in safety practice.Practitioner summary: This article presents a refined and validated set of systems thinking tenets which describe features of complex systems that interact to create adverse events. The tenets can be used by practitioners to proactively identify safety leading indicators and contributory factors during adverse event analysis.

Using systems thinking-based risk assessment methods to assess hazardous manual tasks: a comparison of Net-HARMS, EAST-BL, FRAM and STPA.

Formal risk assessment is a component of safety management relating to hazardous manual tasks (HMT). Systems thinking approaches are currently gaining interest for supporting safety management. Existing HMT risk assessment methods have been found to be limited in their ability to identify risks across the whole work system; however, systems thinking-based risk assessment (STBRA) methods were not designed for the HMT context and have not been tested in this area. The aim of this study was to compare the performance of four state-of-the-art STBRA methods: Net-HARMS, EAST-BL, FRAM and STPA to determine which would be most useful for identifying HMT risks. Each method was independently applied by one of four analysts to assess the risks associated with a hypothetical HMT system. The outcomes were assessed for alignment with a benchmark analysis. Using signal detection theory (SDT), overall STPA was found to be the best performing method having the highest hit rate, second lowest false alarm rate and highest Matthews Correlation Coefficient of the four methods.Practitioner summary: A comparison of four systems thinking risk assessment methods found that STPA had the highest level of agreement with the benchmark analysis and is the most suitable for practitioners to use to identify the risks associated with HMT systems.

Understanding the systemic influences on maritime pilot decision-making.

Maritime incidents occurring during pilotage are of international concern. Maritime pilots control most pilotage operations worldwide, yet despite the safety criticality of their role, research examining pilot decision-making processes during these complex and dynamic operations is scarce. This article describes the findings from two studies that utilised an integrated systems thinking framework to understand how pilots make decisions and what factors are perceived to influence their decisions. Interviews were held with 22 pilots (Study 1) and 17 maritime safety stakeholders (Study 2) in the New Zealand maritime context. The findings illustrate the challenges pilots face during pilotage and provide insights into their decision-making processes and the systemic factors that can be addressed to improve maritime safety. Given the multiple causal pathways to incidents occurring during pilotage identified by this research, it is suggested that multiple systems-wide interventions are needed, which is likely to require a long-term, strategic approach.