Margin of Manoeuvre: A Safe Space for Emergency and Disaster Responders

GIBSON, Carl A.a and PUPULIDY, Ivanb

a Risk Management, La Trobe University, Melbourne, Australia, e-mail: b Office of Learning, US Forest Service, Boise, Idaho, USA, e-mail:

Abstract — Emergency and disaster responders face a range of operational challenges that can impair their operational performance and safety. Serious injury and fatalities are not uncommon consequences. However, there is considerable evidence that a significant proportion of such harm and loss of life occurs in situations where the responders believe themselves to be in safe conditions. Recent advances in neuroscience indicate a variety of ways in which the brain can mislead perception and assessment of risk, resulting in inappropriate decision making and behaviours. A recent innovation: ‘Margin of Manoeuvre’ (MoM) provides a means of better managing cognitive and emotional dissonance experienced by responders engaged in operational tasks. It provides a means of better managing limitations in working memory, provides a simple and intuitive approach for detecting, assessing and communicating about dynamic change occurring in volatile conditions and promotes improved group sensemaking. MoM provides a visualisation of the amount of ‘space’ individuals and teams have to understand their changing environment, make decisions and act upon them. It allows the ‘room for error’ and ‘space for adaptation’ to be easily conceived during high stress operations. In addition to its early adoption by some US and Australian wildland firefighters, it is being introduced to other emergency services. It has also been recently adopted by the Australia’s Victorian State Government as a means of assessing changes in resilience capability of the State’s critical infrastructure.

Keywords – Margin of Manoeuvre, sensmaking, risk, resilience, neuroscience, emergency responder, operational performance, safety

1 Introduction

By the very nature of their work, first responders and other emergency workers often place themselves into situations of personal danger. Their work environment is such where the risk of physical injury, psychological harm or fatality is not uncommon. For many emergency personnel, the risk to their personal safety is intertwined with operational performance and is often normalised by these same personnel (Gibson and Pupulidy personal observations).

Differences in the perception of risk have long been recognised, and at times such perceptions will be substantially different from the prevailing operational conditions that will be encountered. Risks in this environment are not static, predictable or controllable. First responders often accept risk commensurate with a sense of reward that is often tied directly to their identity (Avolio 2011). This equates to mission focus that can blind them to changes in the environment.

This paper describes the development of a novel approach for making sense of changing operational conditions and capabilities, gaining a more intuitive understanding of shifting risk, better communicating this understanding and more effectively changing behaviours to reduce this risk. This concept, termed ‘Margin of Manoeuvre’ has been introduced in training to early adopter groups of wildland firefighters in the USA and Australia, seeing operational deployment at wildfires during 2014.

2 The Operational Environment

When the general community consider the risks being faced by firefighters, common beliefs will focus on the dangers of being trapped by fast moving fires, or of explosions and structural collapses, as often portrayed in the media and in movie and TV fictional accounts. However, these do not describe the only fireground fatalities and, while dramatic, under-represent the common risks faced on the fireground, which remains the highest single category for loss of life. An examination of firefighter fatalities in the USA demonstrates that such commonly portrayed losses on the fireground represent one third of the total firefighter lives lost (Figure 1). Almost as many firefighters lose their lives whilst travelling to, or returning from emergency call outs (28.1%), whilst deaths during training (11.2%) and other non-emergencies account for the remainder of fatalities (26.3%).

Figure 1: Percentage of US firefight fatalities 2003-2013 by type of activity (Information sourced from NFPA, 2004,2005,2006,2007,2008, 2009, 2010, 2011, 2012, 2014; and FEMA 2013)

Whilst the level of ‘responding’ fatalities over the 2003-2013 period has shown a continuing decline (Figure 2), other activity related fatalities have remained reasonable consistent over the same period (including fire ground fatalities).

Figure 2: Numbers of US firefight fatalities 2003-2013 by type of activity (Information sourced from NFPA 2003, 2004,2005,2006,2007,2008, 2009, 2010, 2011, 2012, 2014; and FEMA 2013)

Surprisingly the most common proximal cause of death of firefighters is due to stress/overexertion generally comprising cardiac arrest, or less commonly an aneurism (Figure 3), rather than from trauma resulting from the fire itself. The US Forest Service has recognized that many cardiac events occur post exertion and thus off duty. These cardiac events are often untracked for a variety of reasons, which may add significantly to this statistic.

Figure 3: US firefight fatalities 2003-2013 by type of activity (Information sourced from NFPA 2003, 2004,2005,2006,2007,2008, 2009, 2010, 2011, 2012, 2014; and FEMA 2013)

Over the period 2003 to 2013, there has been a slight decreasing trend for numbers of deaths resulting from ‘stress’ and being struck by, or contact with objects, the majority involving vehicle accidents (Figure 4). Fatalities from other causes have remained generally consistent over time.

Figure 4: Numbers of US firefight fatalities 2003-2013 by cause of death (Information sourced from NFPA 2003, 2004,2005,2006,2007,2008, 2009, 2010, 2011, 2012, 2014; and FEMA 2013)

Over this same period there has been extensive work undertaken on accident investigations, after action reviews and learning reviews, as well as considerable time and resources expended on implementing improved first responder training, personal protective equipment and procedural improvements.

However, in common with accident and incident investigations in many other industries and contexts, there has a propensity to lodge blame with the inadequacies of the decision making and behaviours of ‘negligent’ individuals. This in turn has led to human error being identified as the cause rather than as a consequence of these incidents (reviewed in Dekker, 2014), which has, in many jurisdictions, prevented learning from occurring and for accidents and sub-optimal operational performance to persist (Pupulidy, 2013a). Furthermore, accident investigations, based on the benefits of 20:20 hindsight, often implicate “loss of situational awareness” as a key causal factor (Sheen, 1987; Wickens, 2008; ATSB, 1996; MacPherson, 1999; Kennedy, 2001; USDA, 2006, 2008; Higgins, Heffey and Kerr, (2009). Such findings have then been used to allocate blame and in some rare cases criminally indict those involved.

Recent work (Dekker, 2014) highlights the problematic nature of using the situational awareness construct. This instead emphasises the need to better understand what sensemaking was engaged in by those involved in such incidents. For example, Professor Karl Weick refers to sensemaking, how individuals construct a plausible narrative to account for what they are experiencing and how this influences their decisions and actions (Weick, 1995; Pupulidy 2013b).

3 Perception of Risk

Closely aligned with the sensemaking concept is how we perceive risk, particularly that which is associated with highly dynamic and complex environments, typified by the operational environments experienced by first responders. In such environments the perception of risk can be substantially altered, particularly where high uncertainty can manifest fear and anxiety (Furedi, 2007), resulting in worse case scenarios becoming more available and clouding more rationale analysis. A common response to the generation of this fear is for organisations to impose ever more restrictive control. Overtime this can create an illusory culture of unrealistic optimism (McKenna, 1993) in being able to manage the risk, whilst, often unrecognised, these imposed controls further restrict the ability of front line personnel to adapt to changing conditions.

Furthermore, in situations such as this, where there is an unreasonable confidence in the effectiveness of these constraining control regimes, individual and team vigilance decreases, with an increasing potential for these people to take increasing risks in their operations (Horswill and McKenna, 1999). Organisational attempts to control risk volatility, conversely results in lowered ability to cope with emerging risk and an increase in risk seeking behaviour of operational personnel.

Compounding this situation is the very nature of many risk assessment methodologies which may be creating perverse views of the risks being faced by emergency responders. Most current methodologies are ultimately derived from those originally used to assess insurance risk, i.e. some estimation of the consequence that could arise and the associated problem of that consequence occurring, as typified in many variations of national and international standards (ISO, 2010). Such methodologies have been developed to work exceptionally well in simple systems were linear cause - effect relationships can be described. As they are applied to increasingly complicated systems (several/many causes with several/many consequences) through to completely non-linear complex systems (a multitude of potential causes and effects which defy simple description or prediction), these risk assessment approaches become less useful. These complex environments are typified by high consequence/low probability events, where our current risk assessment methodologies can exclude important risks or result in unrecognized acceptance of high-risk tasks (reviewed in March and Shapira, 1987; Camerer and Kunreuther, 1989; Kelsey and Quiggin, 1992).

Such linear based risk assessment methodologies are also generally based upon assumptions that the risk environment follows a normal distribution, whereas it is highly likely that significantly skewed risk distributions persist in the operational environment experienced by first responders.

There is no such thing as “real risk”, risk is an assumption-laden, highly subjective social construct (Garvin, 2001). Even for systems where linear risk assessment is appropriate and is founded with quantitative data (for example in engineering), any estimate of risk is still based on theoretical models and is judgement-dependent (Slovic, 1999).

4 Neuroscience of Emergency Response Conditions

The potential for creating unrealistic risk assessments is further amplified by the very manner in which the human brain works, creating different risk perceptions in different individuals. We all perceive, conceive and communicate about risk information differently. We are all subject to a range of heuristics and biases that influence how we consider, explain, rate and prioritise risk information (Tversky and Kahneman, 1974), based upon our prior experiences, emotional conditions, psychological priming, etc. Furthermore, the prevailing conditions can influence the brain’s ability to analyse information and make decisions, depending upon how the brain’s two predominant thinking and decision-making systems operate together (Kahneman, 2011).

In routine environments, the brain’s deliberative conscious cognitive system provides executive control over risk perception and key information analysis used for decision making, particularly where there is quantification of that information. A proportion of the information is also processed by the brains’ automatic emotionally influenced thinking system. In such routine environments these two thinking systems are usually working together to provide an individual with an optimum (and appropriate) level of cognition. However, in highly demanding, complex and dynamic environments the mind can be placed under increasing stress. This results in significant demands on working memory, leading to decreasing capacity to cope with incoming information, the analytical thinking system becomes overwhelmed and starts to lose its executive control, and the emotional thinking system starts to ‘run-off’ on its own, which in turn starts to further obstruct the higher level analytical thinking system of the neocortex (Gemar, et al, 2007) and further degrade the executive control capabilities of the this analytical system (Monkul et al, 2012).

Under these conditions, the amygdala (in concert with the hippocampus) is also able to take over the working memory (Roussow, 2012), controlling attention and planning functions. Whilst this can be advantageous in allowing rapid intuitive responses to imminent threat, it is unable to carry out the detailed analysis that would normally occur under the control of the prefrontal cortex. Where the emotional system is affective for prolonged periods in non-routine environments this again contributes to declining sensemaking and impaired decision making.

Under these conditions, perception of risk can be change dramatically and rapidly. Affects such as change blindness, inattentional blindness, confirmation bias, and a range of accessible heuristics can proliferate, further influencing misperception (Wickens 1984).

The potential for inappropriate decisions (based on these perceptions) increases, further amplified by the influence of the emotional system. There is often a deterioration in group sensemaking, which can further consolidate misperception and impaired decision making. Overall, the effect on cognitive decline of exposure to extreme environments can manifest as impairment of attention, vigilance and higher level reasoning, reduced reaction time, deficiencies in memory and learning (Liberman et al, 2002; 2005). Such environments can also have profound adverse affect on behavioural and emotional states (Vasterling, 2006).

The safety and performance of emergency responders therefore appears to be subject to two broad challenges, both of which limit cognition of risk and associated decision making, and affect behaviours. The environmental conditions experienced by emergency responders during volatile and unpredictable events can lead to rapidly declining cognitive and affective capabilities, which result in serious accidents and fatalities during operations. However, the significant proportion of injuries and fatalities (see Figures 1-4 above) indicate that emergency responders in familiar non-extreme conditions can still be prone to impaired sensemaking and inappropriate decision making as risk becomes normalised and false perception of safety in work systems prevail. It is believed that individuals have unique propensities to take, or said another way, each persons has their own risk level with which they are comfortable and accordingly adjust their behaviours, increasing or decreasing their perceived exposure to risk (Adams, 1995). In the presence of increased control measures (e.g. airbags in cars, personal protective equipment, etc.), individuals engage in riskier behaviours (e.g. drive faster) under the belief that the system is “safe” (Adams, 1995).

5 Safety and Operational Challenges

This points to the need to improve the safety and operational performance of emergency and disaster response personnel, by addressing a number of challenges including:

  • The challenge of recognition: dynamic environments continuously reduce focus on key information and divert attention towards emerging issues. However, inattentional blindness and change blindness can result in such new information being missed or unattended to. Being aware of how the brain can be misled into missing changing conditions or patterns in the environment, becomes the foundation for addressing this challenge.
  • The challenge of understanding: once information is attended to, its significance needs to be assessed appropriately. The challenge to sensemaking is amplified by conditions of high ambiguity and uncertainty. A range of tools and practices are available that not only improve attention and focus (thereby improving recognition of change), such as mindfulness activities (Kabat-Zinn, 2003; Dane, 2011) but also improve cognition, learning and performance in high demand operational environments (Weick et al, 1999; Jah et al, 2007; Jah et al 2010; Stanley and Jah, 2009).
  • The challenge of communication: particularly where there is a need to convey information on changing conditions and on consequently changed decisions to others within or external to the team. This needs to be conducted in such a manner that sensemaking becomes a shared activity rather than individual isolated one.
  • The challenge of action: It is not sufficient to move a team response towards concerted action. Even with effective sensemaking, chosen options may still not be appropriate to operating within a volatile and dynamic environment. Action in these environments usually involves creating adaptation, where adaptation requires experimentation and learning from perceived errors (reviewed in Harford, 2011) and successes. Furthermore, this action needs to be appropriate to the prevailing priorities and objectives which may be subject to ongoing reframing and revision in dynamic situations.

The way the brain works presents an overarching challenge with regard to the resolution of the challenges listed above. This larger challenge regards the resolution, integration and provision for reflection (Figure 5), all without overloading working memory and the capacity of the analytical system.

One approach that has proven successful is based on a concept of ‘Margin of Manoeuvre’.

Figure 5: An integrated and reflexive response to the cognitive challenges

6 Introducing Margin of Manoeuvre

The basic concept of margin of manoeuvre is not new, the idea of having sufficient space within which to act has been used in economics (Capistran et al, 2011), politics (Kaiser, 1971; Amr, 1988; Eisenstadt, 2010), societal security (Porch and Rasmussen, 2008), and in safety (Woods, 2011; Gotcheva, et al, 2013). We have expanded upon this collection of abstract and theoretical concepts and reconfigured ‘margin’ into a codified construct that can be applied by first responders in an operational context.

We have conceived Margin of Manoeuvre (MoM) as a (visualised) sphere that represents the amount of ‘space’ an individual or team has, within which they have to prepare for and/or respond to challenges arising from changes in the operational context/environment. The larger the sphere (the larger the MoM) the more room there is to experiment, make errors, learn from those errors and generate adaptation to the challenges. The smaller the sphere (the smaller the MoM) The less room to experiment and learn, and the more likely that errors will have unrecoverable harmful consequences.

Changing parameters within both the external environment (including affect of other players) and from within the individual or team internal environments will influence the expansion or contraction of MoM. These external parameters (Figure 6): include:

  • The task scape, comprising for example: the nature of the operational response being undertaken, the complexity of the problem being tackled, the alignment of the actions with the problem, presence of time constraints, clarity and relevance of the operational objectives.
  • The hazard scape: the presence, severity and complexity of hazards and threats, interrelationships and amplification among hazards and threats, changes in patterns of exposure.
  • The volatility of the conditions: degree and rate/speed of change in conditions.
  • Ambiguity and uncertainty in the environment: the degree to which multiple meanings can be derived from what is happening (ambiguity), the extent to which there is an absence of data, information or understanding about what is happening.
  • Functionality of relationships: the degree to which relationships with other external ‘actors’ provide positive contributions to making sense of changing conditions, establishing the task scape, and providing access to resources.
Figure 6: External parameters affecting MoM
Figure 7: Adaptive capacity contributing to an expanding MoM

There are a range of internal parameters (of the individual or team) which if executed appropriately can counter the inward pressure on the MoM. These parameters collectively create adaptive capacity (Figure 7) and include:

  • Group sensemaking: The degree to which sensemaking is shared within and across teams is critical to creating sufficient MoM. Where teams have a reliance on a single individual being responsible for sensemaking, rather than seeking input and sharing insight, MoM can be reduced to the extent where critical failures occur (BoEMRE, 2008; Teague, et al, 2011). Formal structures, such as those created as part of incident management systems can facilitate shared sensemaking in dynamic and volatile conditions (Christianson, et al 2011).
  • Emergent leadership: As conditions change, it is likely that different leadership skills will be required. Teams that are able to encourage leadership to emerge outside of strict hierarchies and are able to shift leadership to those with the appropriate expertise will be more able to expand their MoM. Emergent leadership involves the ability to recognise emergent problems and the emergent properties as conditions change and to solicit feedback from additional sources. Emergent leadership, can arise where organisational culture promotes trust and individuals are willing to, and comfortable with adopting a transient leadership role.
  • Innovation (Adaptation): The ability to conceive and create novel solutions to the challenges presented by dynamic operational conditions. This includes the recognition that errors do not represent failures, but rather as opportunities for learning through experimentation.
  • Capability to act: The degree of reliability, robustness, redundancy, and resilience of work systems, information systems and resources will significantly contribute to expanding the MoM.

7 Summary and Conclusion

Work has commenced on introducing MoM into emergency services in the State of Victoria in Australia, and into Federal firefighters in the US. MoM provides an intuitive assessment of changing conditions and the emergency responders’ capability to recognize and adapt in the dynamic conditions under which they work.

For example in an operational situation, first responders receive a substantial continuing stream of information: physical hazard identification, changing weather patterns, variable task objectives, multiple directions of approach, changing resource availability, constant radio communication, etc. This information is being derived from multiple sources, by direct observation, communication with other team members, communications with other teams, incoming messages from more centralised command structures and the environment itself. The complex nature of this work is further amplified by the dynamic and often unpredictable changing conditions requiring information to be continuously updated.

MoM works in these situations because a provides personnel with a number of advantages. MoM provides a new lens for what operational personnel already do, in a simpler and more intuitive way (It is not a new methodology or practice). MoM is intuitive; it is quick to learn and is easily incorporated in existing operational training regimes and personal practice. Because it is intuitive, it does not require complex principles to be remembered and, therefore, it can be readily recalled and used in fast moving high stress situations. A real advantage of MoM is that it takes advantage of the way that the brain works and helps to cope with some of the problematic functioning of the brain in complex stressful conditions.

For example, MoM provides a means of coping with the limitations of the mind, the propensity of the emotional thinking system to mislead under conditions of high stress. In complex environments, working memory rapidly becomes overwhelmed. It appears that MoM allows working memory to be freed up. MoM allows a multiplicity of information to be considered on a continuing basis and to be more simply conceived as either an increase or decreasing MoM, thus freeing up working memory. MoM also allows information to be considered in a way that limits adverse influence of the emotional thinking system.

By considering MoM as a change in state, i.e. margin is either increasing or decreasing, operational personnel can rapidly determine and communicate if conditions and their capability to cope are declining to an extent where they no longer ‘feel’ comfortable or safe. Describing how they are perceiving MoM, personnel can use an easily understood common language and communicate rapidly and simply and range of previously complex information, without getting into a discussion of perceived risk. Teams can thus rapidly assess and react to volatile and dynamic situations, thus maintaining performance levels and optimising safety.

MoM has also been successfully used as part of a new way of examining fatal accidents and creating meaningful lessons learned (USDA, 2013; USDA, 2014). It has also been incorporated into a novel critical infrastructure criticality assessment tool for the Victorian Government in Australia. MoM provides the operators of critical infrastructure with a simple means of visualizing and subsequently measuring their resilience capability.

Work is continuing on the development MoM and it is becoming apparent that it has applications beyond the traditional emergency and disaster management disciplines, and appears to provide a useful adjunct to higher level strategic analysis.


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Gibson, C. A. and Pupulidy, I. (2015): Margin of Manoeuvre: A Safe Space for Emergency and Disaster Responders. In: Planet@Risk, 3(2): 1-4, Davos: Global Risk Forum GRF Davos.