What’s New in the Patient Safety World

March 2012

Add a Cognitive Walkthrough to Your FMEA



ISMP Canada (ISMP Canada 2012) has a good article about a technique that we were unfamiliar with and which has the potential to improve your FMEA’s (Failure Mode and Effects Analyses). The technique is called a “cognitive walkthrough”.


Rather than just brainstorming and throwing out ideas during a FMEA, the technique involves having a representative user (eg. a front-line practitioner) simulate all parts of the task(s) and “think out loud” while doing so. We often talk about how we need to put ourselves in the mind of the participants when we are doing a root cause analysis of an untoward event. Well, it makes sense to do the same during a FMEA. The technique allows observers to see the task from the perspective of the participant. The technique is especially useful because it not only identifies what the participant was thinking but also helps identify points where the participant had frustrations, confusion, or doubts in doing (or not doing) specific tasks.


The article goes on to describe who can facilitate a cognitive walkthrough, how to choose a participant or participants (making sure no biases are present), and how to conduct the cognitive walkthrough. It even provides helpful hints for the facilitator to coax the participant into revealing what is going on in his/her mind at the time.


This is a very interesting technique that makes a lot of sense. We’ll definitely try it the next time we are doing a FMEA.






ISMP Canada. Include Cognitive Walkthrough in Proactive Risk Assessments. ISMP Canada Safety Bulletin 2012; 12(1): 1-3 January 23, 2012


















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