The Principles of Human Performance: Enhancing Safety in Healthcare and Beyond


We humans have gleefully embraced rapidly advancing science and technology, which is perhaps strange because inside us, and crucially inside our brains, little has changed in thousands of years. Essentially, we are cavemen and women equipped with laptops and mobile phones. Simple creatures driven by the same needs we have always needed, armed with the same basic capabilities we have always had, facing the same limitations we always faced.

Humans are incredibly capable beings, combining cognitive processes with learned behaviours to complete ever more complex tasks. Unfortunately, as we have often found in our healthcare consultancy work, these performance capabilities are vulnerable to insidious failures and finite limitations.

What is human performance?

Human performance is all about how and why people do what they do. Whereas human factors is the science which applies what we know about that ‘how and why’ to the design of machines, equipment, work environments, procedures and anything else involving human interaction.

Why is it important to study human performance?

In the aviation industry, the study of human performance has led to huge improvements in safety by introducing changes across training, crew resource management, briefing and debriefing. Much of this can be applied to the healthcare sector where understanding human performance helps to improve patient safety.

Studying human performance gives us a better understanding of how people make decisions, learn new skills, and adapt to their environment. This in turn helps us to develop interventions and training programs that can help people reach their full potential.

Ultimately, it allows systems and procedures to be designed that are safer and more efficient, which can be applied in a variety of industries, such as aviation and healthcare.


What are the main principles of human performance?

Human performance is a complex phenomenon that is influenced by physical capabilities, mental abilities, motivations, and environmental conditions. Understanding the following principles of human performance can help us to enhance safety in a variety of settings, from healthcare to the workplace and everyday life.

Capabilities and limitations

Everyone has unique strengths and weaknesses that influence their ability to perform tasks. Understanding our own capabilities and limitations is essential for setting realistic goals and developing effective strategies for success. If, for example, we were motivated to swim across a river, the ability to swim would be an essential capability if we are to succeed. Therefore, when assigning someone to a task, no matter how keen and motivated they may be, we must be sure they possess the requisite capabilities.

Humans really only have access to two capability channels. One is cognitive, requiring active thought, while the other is learned from repetition, failure and practice. Mental calculation is a cognitive process for example, whereas standing up or driving a car are largely learned.

Interpretation and sense-making

People interpret situations differently based on their individual experiences, knowledge, and biases. This means that two people can observe the same situation and come to different conclusions about what is happening and what needs to be done.

Adapting to dynamic situations

One of the human’s great strengths is its adaptability. This endows us with resilience in changing situations or circumstances never before experienced. However, this same adaptability can be unpredictable, leading to uncertainty of outcomes and ultimately risk.

Assessing risk and making trade-offs

It is important to understand how people assess risks and trade that off against getting the job done. In formal assessments risk is often quantified in terms of likelihood and severity. How likely is it to happen and if it happens, how bad will it be?

Humans, faced with a new problem, are less inclined to make this kind of assessment and will probably resort to experience and intuition to determine how risky it is. Have I seen or done anything like this before and if so, did it cause any harm? The ability to make sound decisions under pressure is an essential skill for success in many industries.

Relationships with people, technology, and the environment

Humans are social creatures who are constantly interacting with other people, technology, and their environment. These interactions can have a significant impact on our performance, both positively and negatively.


Learning and improvement

Humans have the ability to learn from their experiences and improve their performance over time. People learn new skills and knowledge through a variety of methods, such as instruction, practice, and experience. This ability is essential for success in any field of endeavour and an organisational culture which promotes this is essential.

Motivation and goals

Long ago Abraham Maslow set out a hierarchy of our human needs. We build on foundations of physiological and safety needs, and grow our senses of belonging and status to achieve self-worth. If this is what we need then it is fair to assume it is also what motivates us in life, so if we expect someone to fulfil a task with diligence and care we should probably understand which of these needs it will meet.

It is important to know, to the extent it is possible, what is motivating an individual, because if for some reason that particular input is withdrawn, the motivation may simply cease and the task be abandoned. Abraham Maslow’s hierarchy of human needs gives some insight into the spectrum of desires, and hence motivations, we humans share.

What prevents humans from performing well?

Sadly, human capability channels have vulnerabilities and can fail us suddenly and unpredictably. These limitations can impact otherwise sound capabilities and significantly hamper performance. Cognitive thought can be prone to distraction, complacency or overload, whereas learned capabilities can be eroded by lack of practice or mis-applied in an unfamiliar environment.

Common misunderstandings of human performance

Several common misunderstandings surround human performance, often leading to ineffective interventions and frustration. It is important to challenge these misconceptions and develop a more nuanced understanding of human performance as it will allow us to better design systems, training programs, and interventions that maximise human potential.

Human performance is dynamic and complex, not a straightforward progression from poor to excellent, so individuals should not be expected to consistently achieve their maximum potential. As well as this, motivation is not the sole factor influencing performance so it should not be overemphasised. Other factors, such as skills, knowledge, opportunity, and environmental conditions, also significantly impact performance outcomes.

There may also be a misconception that technology is a panacea for all performance issues. While technological advancements such as EVA will undoubtedly play a role in improving human performance and safety, one should not overlook the importance of human aspects, such as adaptability, decision-making, and interpersonal skills, which are essential for effective performance in many situations.

Another misunderstanding is assuming that performance improvement can be achieved quickly and easily. Significant and sustainable performance improvement often requires sustained effort, dedicated practice, and tailored strategies. It is important to appreciate that human performance is an ongoing process where the correct management tools need to be in place including goals which help to foster a culture of continuous learning and development, as well as identifying and fixing problems.


Does poor management and leadership affect human performance?

The impact that management and leaders within an organisation have on human performance should not be underestimated. The environment and culture in which employees operate, as well as the resources they are provided with, can have a significant impact on human performance.

Organisations that want to improve human performance should focus on developing strong leaders and managers. By providing leaders and managers with the training and support they need, organisations can create a work environment that is motivating, supportive, and productive. Verita provides a workplace investigation service which looks at organisational culture, providing recommendations and actions to ensure a supportive environment is in place.

An example of how poor management and leadership can affect human performance is not having the skills or knowledge to identify and assess risks effectively. This can lead to a failure to take appropriate steps to mitigate risks, which can increase the likelihood of problems occurring. When problems do occur, poor managers and leaders may fail to learn from the experience, leading to the same mistakes being made over and over again.

It is essential that those in a position of leadership build cohesive teams and avoid fostering a culture of fear and blame, which can discourage employees from reporting problems or taking risks. Instead, managers who create a just culture which promotes safety and continuous improvement, as well as encouraging open communication and feedback from employees, can get valuable insights and perspectives.

The role of human performance in service improvement

The study of human performance is an important field of research that has the potential to make a significant positive impact on the provision of services across a number of industries, especially healthcare. Understanding how people interact with medical devices and equipment helps healthcare providers create processes which are more resilient to human error, as well as design devices that are safer and easier to use.

Additionally, developing more effective training programs for healthcare providers allows a greater retention of information and skills. Organisations should design their products, services, and workplaces by considering the needs, abilities, and limitations of the people who will be using them.


Our Human Performance training courses explain in simple terms how our capability channels function and equally how they can be hampered and inhibited. If you would like to know more about the principles of human performance and how they can enhance the services of your organisation, please book a free consultation or contact Ed Marsden on 020 7494 5670 or [email protected].


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