action slips

Why we mix up names of people we know well

  • A large survey sheds light on why we have slips of the tongue when we call very familiar people by the wrong name.

We've all done it: used the wrong name when we know the right one perfectly well. And we all know when it's most likely to happen. But here's a study come to reassure us that it's okay, this is just how we roll.

The study, based on five separate surveys of more than 1,700 respondents, finds that these naming errors (when you call someone you know very well by the wrong name) follow a particular pattern that tells us something about how our memory is organized.

Usually the wrong name comes from the same relationship category. So I call one son by the name of the other; on a bad day (e.g. when there's a lot going on, perhaps a lot of people around, and I'm thinking of many other things — say, at Christmas), I might run through both sons, my partner, and my father!

Not just family, you can mix up friends' names too. And the bit that's really enlightening: family members might also be called by the name of the family dog! Interestingly, only the dog; cat owners don't make such slips of the tongue. (Yes, dogs are family; cats not so much.)

Unsurprisingly, phonetic similarity between names is also a factor, although it's less important than relational category. Names with the same beginning or ending sounds, or with shared phonemes (e.g., John and Bob), are more likely to be muddled.

But it's not affected by physical similarity between people — not even by gender (which surprised me, but then, in my household I'm the only female).

More importantly, it's not a function of age. Misnaming errors are common across the board.

http://www.futurity.org/moms-families-dogs-names-1152392/

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Checklists dramatically reduce errors in operating room crises

February, 2013

A simulated study of life-threatening surgical crises has found that using a checklist reduced the omission of critical steps from 23% to 6%.

I reported recently on how easily and quickly we can get derailed from a chain of thought (or action). In similar vein, here’s another study that shows how easy it is to omit important steps in an emergency, even when you’re an expert — which is why I’m a great fan of checklists.

Checklists have been shown to dramatically decrease the chances of an error, in areas such as flying and medicine. However, while surgeons may use checklists as a matter of routine (a study a few years ago found that the use of routine checklists before surgery substantially reduced the chances of a serious complication — we can hope that everyone’s now on board with that!), there’s a widespread belief in medicine that operating room crises are too complex for a checklist to be useful. A new study contradicts that belief.

The study involved 17 operating room teams (anesthesia staff, operating room nurses, surgical technologists, a surgeon), who participated in 106 simulated surgical crisis scenarios in a simulated operating room. Each team was randomized to manage half of the scenarios with a set of crisis checklists and the remaining scenarios from memory alone.

When checklists were used, the teams were 74% less likely to miss critical steps. That is, without a checklist, nearly a quarter (23%) of the steps were omitted (an alarming figure!), while with a checklist, only 6% of the steps were omitted on average. Every team performed better when the checklists were available.

After experiencing these situations, almost all (97%) participants said they would want these checklists used if they experienced such a crisis if they were a patient.

It’s comforting to know that airline pilots do have checklists to use in emergency situations. Now we must hope that hospitals come on board with this as well (up-to-date checklists and implementation materials can be found at www.projectcheck.org/crisis).

For the rest of us, the study serves as a reminder that, however practiced we may think we are, forgetting steps in an action plan is only too common, and checklists are an excellent means of dealing with this — in emergency and out.

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Even tiny interruptions can double or treble work errors

January, 2013

A new study quantifies the degree to which tasks that involve actions in a precise sequence are vulnerable to interruptions.

In my book on remembering intentions, I spoke of how quickly and easily your thoughts can be derailed, leading to ‘action slips’ and, in the wrong circumstances, catastrophic mistakes. A new study shows how a 3-second interruption while doing a task doubled the rate of sequence errors, while a 4s one tripled it.

The study involved 300 people, who were asked to perform a series of ordered steps on the computer. The steps had to be performed in a specific sequence, mnemonically encapsulated by UNRAVEL, with each letter identifying the step. The task rules for each step differed, requiring the participant to mentally shift gears each time. Moreover, task elements could have multiple elements — for example, the letter U could signal the step, one of two possible responses for that step, or be a stimulus requiring a specific response when the step was N. Each step required the participant to choose between two possible responses based on one stimulus feature — features included whether it was a letter or a digit, whether it was underlined or italic, whether it was red or yellow, whether the character outside the outline box was above or below. There were also more cognitive features, such as whether the letter was near the beginning of the alphabet or not. The identifying mnemonic for the step was linked to the possible responses (e.g., N step – near or far; U step — underline or italic).

At various points, participants were very briefly interrupted. In the first experiment, they were asked to type four characters (letters or digits); in the second experiment, they were asked to type only two (a very brief interruption indeed!).

All of this was designed to set up a situation emulating “train of thought” operations, where correct performance depends on remembering where you are in the sequence, and on producing a situation where performance would have reasonably high proportion of errors — one of the problems with this type of research has been the use of routine tasks that are generally performed with a high degree of accuracy, thus generating only small amounts of error data for analysis.

In both experiments, interruptions significantly increased the rate of sequence errors on the first trial after the interruption (but not on subsequent ones). Nonsequence errors were not affected. In the first experiment (four-character interruption), the sequence error rate on the first trial after the interruption was 5.8%, compared to 1.8% on subsequent trials. In the second experiment (two-character interruption), it was 4.3%.

The four-character interruptions lasted an average of 4.36s, and the two-character interruptions lasted an average of 2.76s.

Whether the characters being typed were letters or digits made no difference, suggesting that the disruptive effects of interruptions are not overly sensitive to what’s being processed during the interruption (although of course these are not wildly different processes!).

The absence of effect on nonsequence errors shows that interruptions aren’t disrupting global attentional resources, but more specifically the placekeeping task.

As I discussed in my book, the step also made a significant difference — for sequence errors, middle steps showed higher error rates than end steps.

All of this confirms and quantifies how little it takes to derail us, and reminds us that, when engaged in tasks involving the precise sequence of sub-tasks (which so many tasks do), we need to be alert to the dangers of interruptions. This is, of course, particularly true for those working in life-critical areas, such as medicine.

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[3207] Altmann EM, Gregory J, Hambrick DZ. Momentary Interruptions Can Derail the Train of Thought. Journal of Experimental Psychology: General. 2013 :No - Pagination Specified.

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Aging - specific failures

Older news items (pre-2010) brought over from the old website

Failing recall not an inevitable consequence of aging

New research suggests age-related cognitive decay may not be inevitable. Tests of 36 adults with an average age of 75 years found that about one out of four had managed to avoid memory decline. Those adults who still had high frontal lobe function had memory skills “every bit as sharp as a group of college students in their early 20s." (But note that most of those older adults who participated were highly educated – some were retired academics). The study also found that this frontal lobe decline so common in older adults is associated with an increased susceptibility to false memories – hence the difficulty often experienced by older people in recalling whether they took a scheduled dose of medication.

The research was presented on August 8 at the American Psychological Association meeting in Toronto.

http://www.eurekalert.org/pub_releases/2003-08/wuis-fmf080703.php

Older adults better at forgetting negative images

It seems that this general tendency, to remember the good, and let the bad fade, gets stronger as we age. Following recent research suggesting that older people tend to regulate their emotions more effectively than younger people, by maintaining positive feelings and lowering negative feelings, researchers examined age differences in recall of positive, negative and neutral images of people, animals, nature scenes and inanimate objects. The first study tested 144 participants aged 18-29, 41-53 and 65-80. Older adults recalled fewer negative images relative to positive and neutral images. For the older adults, recognition memory also decreased for negative pictures. As a result, the younger adults remembered the negative pictures better. Preliminary brain research suggests that in older adults, the amygdala is activated equally to positive and negative images, whereas in younger adults, it is activated more to negative images. This suggests that older adults encode less information about negative images, which in turn would diminish recall.

Charles, S.T., Mather, M. & Carstensen, L.L. 2003. Aging and Emotional Memory: The Forgettable Nature of Negative Images for Older Adults. Journal of Experimental Psychology: General, 132(2), 310-24.

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Typing test reveals two processes in error detection

December, 2010

A study involving skilled typists shows how the part of a person that does the thinking relies on different feedback than the part that does the doing.

There are a number of ways experts think differently from novices (in their area of expertise). A new study involving 72 college-age typists with about 12 years of typing experience and typing speeds comparable to professional typists indicates that our idea that highly skilled activities operate at an unconscious level is a little more complex than we thought.

In three experiments, these skilled typists typed single words shown to them one at a time on a computer screen, while occasionally the researchers inserted errors in the words they typed, or corrected errors they made. When asked to report errors, typists took credit for corrected errors and accepted blame for inserted errors, claiming authorship for the appearance of the screen. Not surprising in the first experiment, when the typists weren’t told what the researchers were doing. But even in the later experiments, when they knew some of the errors and some of the corrections weren’t theirs, they still tended to take responsibility for what they saw.

Nevertheless, regardless of what they saw and what they thought, their typing rate wasn’t affected by inserted errors. Only when the typists themselves made errors, regardless of whether or not the researchers corrected them, did their fingers slow down.

In other words, it wasn’t the feedback of the look of the word on the screen that triggered the finger slow-down, but the ‘knowledge’ the fingers had as to what they had done.

But it was the appearance of the words on the screen that governed the typists’ reporting of errors, leading the researchers to propose two error detection processes: an outer loop that supports conscious reports and an inner loop process that slows keystrokes after errors.

Reference: 

Logan, G.D. & Crump, M.J.C. 2010. Cognitive Illusions of Authorship Reveal Hierarchical Error Detection in Skilled Typists. Science, 330 (6004), 683-686. http://www.sciencemag.org/content/330/6004/683.abstract?sid=140a96b9-ef5...

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Have I done it?

October, 2010

Watching another person do something can leave you with the memory of having done it yourself.

I’m not at all sure why the researcher says they were “stunned” by these findings, since it doesn’t surprise me in the least, but a series of experiments into the role of imagination in creating false memories has revealed that people who had watched a video of someone else doing a simple action often remembered doing the action themselves two weeks later. In fact in my book on remembering intentions, which includes a chapter on remembering whether you’ve done something, I mention the risk of imagining yourself doing something (that you then go on to believe you have actually done it), and given all the research on mirror neurons, it’s no big step to go from watching someone doing something to remembering that you did it. Nevertheless, it’s nice to get the confirmation.

The experiments involved participants performing several simple actions, such as shaking a bottle or shuffling a deck of cards. Then they watched videos of someone else doing simple actions—some of which they had performed themselves and some of which they hadn’t. Two weeks later, they were asked which actions they had done. They were much more likely to falsely remember doing an action if they had watched someone else do it — even when they had been warned about the effect.

It seems likely that this is an unfortunate side-effect of a very useful ability — namely our ability to learn motor skills by observing others (using the aforesaid mirror neurons) — and there’s probably not a great deal we can do to prevent it happening. It’s just a reminder of how easy it is to form false memories.

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[1839] Lindner I, Echterhoff G, Davidson PSR, Brand M. Observation Inflation. Psychological Science [Internet]. 2010 ;21(9):1291 - 1299. Available from: http://pss.sagepub.com/content/21/9/1291.abstract

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Interruptions associated with medication errors by nurses

April, 2010

A study of medication administrations in hospitals has found scarily high rates of procedural and clinical failures, of which 2.7% were considered to be major errors — which were much more likely to occur after interruptions, particularly repeated interruptions. Nurse experience provided no protection and indeed was associated with higher procedural failure rates (common with procedural failures — expertise renders you more vulnerable, not less).

As we all know, being interrupted during a task greatly increases the chance we’ll go off-kilter (I discuss the worst circumstances and how you can minimize the risk of mistakes in my book Planning to remember). Medication errors occur as often as once per patient per day in some settings, and around one-third of harmful medication errors are thought to occur during medication administration. Now an in-depth study involving 98 nurses at two Australian teaching hospitals over 505 hours has revealed that at least one procedural failure occurred in 74.4% of administrations and at least one clinical failure in 25%. Each interruption was associated with a 12.1% increase in procedural failures and a 12.7% increase in clinical errors. Procedural failures include such errors as failure to check patient's identification, record medication administration, use aseptic technique; clinical failures such errors as wrong drug, dose, or route. Interruptions occurred in over half of the 4000 drug administrations. While most errors were rated as clinically insignificant, 2.7% were considered to be major errors — and these were much more likely to occur after interruptions, particularly after repeated interruptions. The risk of major error was 2.3% when there was no interruption; this rose to 4.7% with four interruptions. Nurse experience provided no protection against making a clinical error and was associated with higher procedural failure rates (this is common with procedural failures — expertise renders you more vulnerable, not less).

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