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SH129: We judge based on outcomes, not on process

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Manage episode 454917519 series 3516753
Content provided by Gareth Lock at The Human Diver. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Gareth Lock at The Human Diver or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://ppacc.player.fm/legal.

In this episode, we dive into the role of social conformity, biases, and decision-making in diving safety. Humans naturally seek group belonging, but this can lead to harsh judgments when incidents occur, particularly on social media. We explore how biases like hindsight and outcome bias affect our perceptions of accidents, often focusing on blame rather than understanding the decision-making processes behind them. To improve diving safety, it’s essential to create a "Just Culture"—a psychologically safe environment where mistakes can be shared without fear of humiliation or judgment. By examining flawed systems rather than individual outcomes and teaching the "why" behind protocols, we can foster better decision-making and prevent future incidents.

Original blog: https://www.thehumandiver.com/blog/we-judge-based-on-outcomes-not-on-process

Links: Learning teams blog: https://www.thehumandiver/blog/can-divers-learn-from-the-us-forest-service

Hindsight bias: https://www.thehumandiver/blog/incompetent-and-unaware-you-don-t-know-what-you-don-t-know

More about Just Culture: https://humanisticsystems.com/2016/11/24/just-culture-who-are-we-really-afraid-of%EF%BB%BF/

Tags: English, Gareth Lock

  continue reading

175 episodes

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iconShare
 
Manage episode 454917519 series 3516753
Content provided by Gareth Lock at The Human Diver. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Gareth Lock at The Human Diver or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://ppacc.player.fm/legal.

In this episode, we dive into the role of social conformity, biases, and decision-making in diving safety. Humans naturally seek group belonging, but this can lead to harsh judgments when incidents occur, particularly on social media. We explore how biases like hindsight and outcome bias affect our perceptions of accidents, often focusing on blame rather than understanding the decision-making processes behind them. To improve diving safety, it’s essential to create a "Just Culture"—a psychologically safe environment where mistakes can be shared without fear of humiliation or judgment. By examining flawed systems rather than individual outcomes and teaching the "why" behind protocols, we can foster better decision-making and prevent future incidents.

Original blog: https://www.thehumandiver.com/blog/we-judge-based-on-outcomes-not-on-process

Links: Learning teams blog: https://www.thehumandiver/blog/can-divers-learn-from-the-us-forest-service

Hindsight bias: https://www.thehumandiver/blog/incompetent-and-unaware-you-don-t-know-what-you-don-t-know

More about Just Culture: https://humanisticsystems.com/2016/11/24/just-culture-who-are-we-really-afraid-of%EF%BB%BF/

Tags: English, Gareth Lock

  continue reading

175 episodes

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In this episode, we explore the complexities of situational awareness (SA) in diving and why it's often only recognized as missing after an event has occurred. SA involves interpreting sensory data and predicting future outcomes based on experience. Experienced divers may notice subtle signs of danger, like coral movements indicating currents or rust falling in a wreck, while novices lack the knowledge to anticipate or respond. Distractions, limited mental capacity, or unclear information can divert attention from critical issues. Rather than focusing on "loss of SA," we discuss how effective briefings, experience, and deliberate focus can help divers pay attention to what truly matters underwater. Original blog: https://www.thehumandiver.com/blog/cant_pay_MORE_attention Tags: English, Decision Making, Gareth Lock, Non-technical Skills, Situation Awareness…
 
In this blog, a diver reflects on a simulated rescue scenario during a PADI Rescue Course, highlighting critical lessons about human factors in diving. The incident underscores the impact of high task focus, reduced situational awareness, and psychological stress, which led a student to run critically low on gas without asking for help. The writer explores contributing factors, including the challenges of operating in cold, low-visibility conditions, the pressures of performing under assessment, and the lack of a "just culture" where errors can be openly discussed and learned from. This real-life example emphasizes the importance of fostering psychological safety and vigilance in all roles during training dives. Original blog: https://www.thehumandiver.com/blog/rescuer-and-rescued Tags: English, Communications, Decision Making, Gareth Lock, Just Culture, Psychological Safety, Situation Awareness…
 
Pre-dive checks are essential for diving safety, but they’re often rushed or overlooked, especially on busy dive boats. Factors like time pressure, peer pressure, distractions, and overconfidence can lead divers to skip thorough checks, relying instead on past outcomes. However, regardless of experience, using a familiar checklist with your buddy is key to ensuring equipment works and everyone knows how to assist in an emergency. While dive boats may not always allow for perfect checks, taking time beforehand—at the dive shop or during the journey—to understand your buddy’s gear can mitigate risks. Dive Masters play a vital role in setting the standard by demonstrating thorough checks. Ultimately, effective pre-dive checks improve safety, reduce errors, and prepare divers for unexpected situations. Original blog: https://www.thehumandiver.com/blog/checks-on-a-dive-boat Tags: English, Checklists, Decision Making, Mike Mason, Teamwork…
 
In this episode, Gareth Lock explores the critical role of situation awareness and risk management in diving, emphasizing the importance of building accurate mental models to anticipate and manage potential hazards. He discusses how assumptions, experience, and training shape decision-making, and highlights the distinction between managing risks logically and addressing uncertainty through mental shortcuts and emotions. Gareth shares how The Human Diver promotes non-technical skills, psychological safety, and a Just Culture, fostering a learning approach to adverse events. With new programs and instructors worldwide, 2025 promises more opportunities to improve diving safety and teamwork. Original blog: https://www.thehumandiver.com/blog/making-sense-now Links: DAN Southern Africa webinar: https://www.youtube.com/watch?v=TSeKQidAZZA&t=547s Upcoming Face to Face courses: https://www.thehumandiver.com/hfid-level-2#section-1637697699737 Tags: English, Decision-Making, Gareth Lock, Situation Awareness…
 
In this blog, Bart Den Ouden shares a personal experience highlighting the importance of psychological safety, vulnerability, and human factors in diving. While teaching a rebreather instructor course, Bart forgot a critical piece of equipment, turning the oversight into a teachable moment. He emphasizes that instructors, as humans, can make mistakes, and fostering open communication and trust among divers is essential for safety and learning. By reflecting on errors—intentional or accidental—divers can improve team dynamics, decision-making, and preparedness, creating safer environments for themselves and others. Original blog: https://www.thehumandiver.com/blog/checking_each_other Tags: English, Bart Den Ouden, CCR, Human Error, Leadership, Psychological Safety, Rebreather, Teamwork…
 
The first-ever Human Factors in Diving Conference, held on September 24-25, 2021, brought together 27 speakers from around the world to explore the application of human factors, non-technical skills, Just Culture, and psychological safety in diving. Spanning nearly 25 hours of content over two days, the event showcased a global virtual conference model using the LexGo Live platform, with a focus on interactive and engaging experiences. Despite challenges with ticket sales, tight deadlines, and technical logistics, the conference provided invaluable insights and demonstrated the potential of human factors to enhance safety across recreational, military, commercial, and public safety diving. The event highlighted both the successes and lessons learned, paving the way for future efforts to bring this critical knowledge to the diving community. Original blog: https://www.thehumandiver.com/blog/acorn-to-conference Links: Conference website: https://www.hf-in-diving-conference.com/ Youtube channel: https://www.youtube.com/@thehumandiver863 LexGo platform: https://www.lexgo.work/ Marketing advisors: https://www.linkedin.com/in/rosconkie/ and https://www.linkedin.com/in/mickeywilsonfirestarter/ Tags: English, Gareth Lock, Human Factors…
 
Accidents in diving, and life, rarely stem from a single "root cause" but rather from a complex interplay of factors—technical skills, context, randomness, and non-technical skills like communication and decision-making. This episode explores how cognitive biases, such as the fundamental attribution error, often lead us to blame individuals rather than considering the broader system in which events unfold. Drawing parallels from diving, surgery, and other high-stakes environments, we discuss the importance of understanding the full context, embracing feedback, and focusing on interdependencies to improve safety and outcomes. Tune in to challenge your assumptions and expand your perspective on risk and decision-making. Original blog: https://www.thehumandiver.com/blog/the-root-cause-of-an-accident Links: Fundamental attribution bias: https://gue.com/blog/the-role-of-agency-when-discussing-diving-incidents-an-adverse-event-occurs-an-instructor-makes-a-mistake/ The rise of human factors paper: https://europepmc.org/article/med/31183182#free-full-text Tags: English, Gareth Lock, Incident Investigation, Investigations…
 
In this episode, Gareth Lock delves into the nature of human error, exploring concepts like slips, lapses, mistakes, and violations through the lens of safety research and diving experiences. Drawing on James Reason’s work, Gareth explains how understanding errors and violations—whether unintended or situational—can foster learning, reduce outcome bias, and improve safety systems. By openly discussing mistakes, instructors can lower authority gradients, increase psychological safety, and promote a Just Culture where errors are seen as opportunities for growth rather than blame. Tune in to learn how these principles apply to diving and beyond. Original blog: https://www.thehumandiver.com/blog/mistakes-errors-words-have-meaning Tags: English, Decision Making, Gareth Lock, Human Error, Psychological Safety…
 
In this episode, Gareth Lock explores the critical role of checklists in enhancing safety and reducing errors in high-risk environments like diving, surgery, and aviation. Drawing insights from Atul Gawande's The Checklist Manifesto , Gareth highlights how properly designed checklists can prevent lapses, improve communication, and establish a culture of accountability. Despite resistance from those who view checklists as unnecessary or a sign of weakness, evidence shows their ability to save lives by addressing "unknown unknowns" and mitigating human error. Gareth shares personal experiences and emphasizes the importance of embracing checklists to ensure safety, reliability, and performance in diving and beyond. Original blog: https://www.thehumandiver.com/blog/surgeons-and-checklists Links: Downloads and Transcripts of Atul Gawande’s lectures: http://www.bbc.co.uk/programmes/b00729d9/episodes/player The problem with not using checklists: http://aerossurance.com/helicopters/habits-kill/ The Checklist manifesto: https://cognitasresearch.wordpress.com/2015/01/17/only-20-of-surgeons-would-like-to-use-a-checklist-in-their-operations/0px%20!important;%22%20/%3E NHS checklist: http://www.nrls.npsa.nhs.uk/resources/?entryid45=59860 DAN study: http://www.alertdiver.com/checklists Checklist design: http://ti.arc.nasa.gov/profile/adegani/procedure-design/ Chain of events of things going wrong (1): http://silentdiversion.blogspot.co.uk/2015/01/human-error-dont-blame-rebreather.html?spref=fb&m=1 (2): https://www.navytimes.com/news/your-navy/2018/06/05/navy-officer-35-dies-in-off-duty-diving-mishap/ Tags: English, Checklists, Gareth Lock, Human Factors…
 
In this episode, Bart Den Ouden reflects on the importance of mastering the basics before taking on advanced challenges, using ice diving as a vivid example. During a rare opportunity for ice diving in the Netherlands, Bart observed several instructors rushing into instructor-level ice diving certifications without adequate experience. Drawing parallels with the Dunning-Kruger effect and highlighting the risks of "unknown unknowns," he emphasizes the dangers of overconfidence and taking shortcuts in training. Bart challenges dive professionals to lead by example, prioritize safety, and ensure they truly earn their certifications, reminding us all to slow down and build skills step by step. Original blog: https://www.thehumandiver.com/blog/run-before-walk Links: Micheal Thomas’ blog for TDI: https://www.tdisdi.com/tdi-diver-news/slow-down-young-fella-attitudes-in-technical-diving/ Dunning Kruger effect: https://vimeo.com/223029249 Tags: English, Bart Den Ouden, Decision Making, Instruction, Leadership…
 
In this episode, we explore the critical role of leadership and decision-making in diving safety, using a real-life story about a young instructor, “Jack,” who made a risky dive on a rebreather he wasn’t certified to use. Despite his confidence, Jack’s actions reflect dangerous cognitive biases like overconfidence, outcome bias, and normalization of deviance, shaped by a culture of cutting corners in his early training. Through this cautionary tale, we highlight the importance of setting the right example as dive leaders, understanding the consequences of our actions, and promoting a safety-first mindset. Tune in to learn why responsible leadership and listening to feedback are vital for creating a safer diving community. Original blog: https://www.thehumandiver.com/blog/lead-a-horse-to-water Tags: English, Bart Den Ouden, Decision Making, Situation Awareness…
 
In this episode, we explore how listening to your inner voice can be a lifesaver, both in diving and everyday life. Bart Den Ouden shares his personal journey of uncovering severe heart issues despite passing regular diving medicals, emphasizing the importance of recognizing warning signs and overcoming cognitive biases like denial and confirmation bias. We also discuss a diver’s near-fatal experience with immersion pulmonary edema (IPO) and how quick action and a well-equipped facility saved their life. These stories highlight the critical role of self-awareness, preventative measures, and teamwork in planning to fail safely—whether under water or on land. Listen in to learn why trusting that “little voice” could be the key to staying alive. Original blog: https://www.thehumandiver.com/blog/plan-to-fail-safely-part-2-passing-the-test-doesn-t-say-it-all Links: Angioplasty and Stent: https://www.nhs.uk/conditions/coronary-angioplasty/what-happens/ HSE Medical requirements: https://www.hse.gov.uk/diving/medical-requirements.htm IPO (IPE): http://www.ukdmc.org/medical-conditions/immersion-pulmonary-oedema/ BMJ article: https://heart.bmj.com/content/80/6/537 DAN article: https://www.diversalertnetwork.org/health/heart/cardiac-health Tags: English, Bart Den Ouden, Cognitive Biases, Decision Making, Medical…
 
In this episode, we delve into risk management and decision-making in diving, exploring the difference between personal and professional responsibilities. Using a case of a divemaster tasked with guiding divers on a challenging wreck dive, we examine the complexities of managing hazards, understanding acceptable risks, and the impact of assumptions and biases. The conversation highlights the importance of preparation, critical thinking, and a proactive approach to safety, while acknowledging the challenges of balancing rules with real-world scenarios. Ultimately, we discuss how diving professionals can navigate these grey areas, fostering safer practices while maintaining the adventurous spirit of diving. Original blog: https://www.thehumandiver.com/blog/who-owns-the-risk-in-diving Links: HSE Terms: https://www.hse.gov.uk/managing/theory/alarpglance.htm Normalisation of Deviance video: https://vimeo.com/174875861 Work as Imagined vs Work as Done: https://humanisticsystems.com/2016/12/05/the-varieties-of-human-work/ Tags: English, Decision Making, Gareth Lock, Risk, Risk Management…
 
In this episode, we explore the importance of preparing for failure in diving education, inspired by Hal Watts' quote: “The most dangerous thing about diving is divers themselves.” Using a real-life example from a scuba Instructor Examination, we highlight how training focused solely on passing exams can lead to complacency and poor decision-making in real-life scenarios. Diving instructors and trainers must teach students to plan for and respond to unexpected challenges safely. This involves reflecting on training methods, addressing blind spots, and fostering a mindset where failure becomes a learning opportunity, not a life-threatening event. Part 2 will delve deeper into personal strategies for planning to fail safely. Original blog: https://www.thehumandiver.com/blog/plan-to-fail-safely Tags: English, Dart Den Ouden, Instruction, Leadership…
 
In this episode, we explore the dangers of "normalisation of deviance"—the gradual erosion of safety standards through repeated shortcuts—and its impact on rebreather diving and other high-risk activities. Drawing on lessons from aviation and diving, we discuss how human factors, cognitive biases, and systemic drift contribute to accidents, emphasizing that outcomes should not be the sole focus when analyzing incidents. Using models like the Swiss Cheese Model and concepts of systems thinking, we unpack how multiple, seemingly minor factors can align to create critical incidents. Learn how applying tools like checklists, audits, and effective debriefs can help mitigate these risks and maintain safety margins in diving and beyond. Original blog: https://www.thehumandiver.com/blog/one-mistake Links: “If Only” documentary: https://www.thehumandiver.com/ifonly John Bantin’s Undercurrent article: https://www.undercurrent.org/blog/2020/06/01/the-tragic-and-un-necessary-death-of-brian-bugge/ Debrief model: https://www.thehumandiver.com/debrief Normalisation of Deviance: https://vimeo.com/174875861 Simple Swiss cheese model: https://vimeo.com/326723142 Big Hole animation: https://vimeo.com/326723122 Little Hole animation: https://vimeo.com/326723109 HSE report: https://www.hse.gov.uk/research/rrpdf/rr871.pdf Tags: English. CCR, Complacency, Decision Making, Gareth Lock, Human Factors, Rebreather…
 
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