The Bromiley Case

Human Factors in the Clinical Environment
Examples illustrations from animation

Overview

Project Title: ‘The Bromiley Case, Human Factors in the Clinical Environment’

Project Sponsor:
Dr Evridiki Fioratou, Lecturer in Behavioural and Social Science

TILT Medical Artist: Eve Laws

The Bromiley Case is one of the most well-known clinical cases in which human factors lead to the tragic passing of 37-year-old Elaine Bromiley. Martin Bromiley, Elaine’s husband, has attended conferences and held lectures to raise awareness of human factors issues in the clinical environment. His talks focus on the importance of standardisation of procedures, emphasising the need for lessons to be learned without scapegoating individuals. Martin also founded the Clinical Human Factors Group, a charitable trust to raise awareness. The website can be found here.

Martin has also been involved in the creation of a video reconstructing the timeline and events of Elaine’s surgery, which can be viewed here. This is a fantastic educational resource and is widely used in staff and student educational sessions.

Screen capture of Elaine's introductory scene

A calm colour palette was used to match the tone of the animation

Opening sequence

Introductory sequence to the animation

Systems Thinking

Dr Evridiki Fioratou teaches students about the importance of systems thinking and understanding healthcare processes, whilst analysing best and worst practice in the clinical environment. The Systems Engineering for Patient Safety Model (SEIPS 2.0) (Carayon and Smith, University of Wisconsin) is frequently referred to and used by Dr. Fioratou. Incorporating elements of this model and the importance of human factors into one educational resource would benefit group work in Dr Fioratou’s sessions

Storyboard scenes

Storyboard examples

Animation as a Learning Tool

Animation has been shown to engage and stimulate learning in schools and educational institutions. Use of colour and contrast can highlight information and help viewers to retain it, and other aspects of animation can be used to stimulate the senses – visual movements onscreen and inclusion of sound, voiceover, as well as concise text. It was decided that a 2D animation with original illustrations would be created to engage student learning. The Bromiley Case events and timeline would be illustrated and described, with an emphasis on the SEIPS 2.0 Work System element included in the closing of the animation, therefore prompting student discussion after viewing. The animation would be trailed with medical students at the University of Dundee and feedback gathered on the successfulness of the method used (2D animation).

For animation work, a storyboard is essential in communicating ideas between the project sponsor and the medical artist. This allows for changes before the final animation is complete. ‘Just a Routine Operation’ the video reconstruction of Elaine’s story was used in research, and the original medical report was also used, available here, thanks to the generosity of Martin Bromiley making it accessible to the public.

Final Product

Screenshots

The animation was trailed with a group of medical students and overall, the animation was very successful, with 90% of students finding it needed no amendments. The medical artist was responsible for the illustrations, design choices and voiceover.

Scene in which nurse informs staff of ICU bed
Scene highlighting good staff levels and equipment
Oxygen level at 40% or lower for over 20 minutes
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