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Training, Practice, Experience and Judgement

What is more important, training or experience? And when is a course—you bought a new DPV did you?—preferable to learning on your own? Tech educator and author of Deco for Divers fame, Mark Powell, discusses the sweet spot between training and experience and why practice and judgement are also required to maximize your performance and safety and become a competent tekkie.

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by Mark Powell
Header and other images courtesy of Mark Powell

What is more important, training or experience?

One of the most popular discussions when it comes to diving is, “What is more important, training or experience?”

You often see divers on the internet asking, “Why does anyone need dry suit training? I just bought a dry suit and picked it up as I went along,” or “I can’t believe some instructors offer a course on how to deploy a DSMB, isn’t it obvious?” These are examples of people who believe that training is pointless and you can pick anything up through experience. On the other hand, you also see people who expect a diver to be absolutely perfect at the end of a course, insinuating that an instructor is a poor one unless the students are perfect at every skill.

In reality, this is one of those pointless questions. Of course, the real answer is that both training and experience are important and, in fact, practice and judgement are also required to become a fully rounded, competent diver.


Is Training Really Necessary?

“Why do I need a course to learn how to use a dry suit, DSMB, twinset, or rebreather. I can just jump in and learn it by trial and error.”

It is possible to learn by trial and error and building up experience. However, different people learn in different ways. Some would prefer to learn by trial and error while some learn better by having it explained to them or seeing a demo. Just because you prefer to learn by doing it doesn’t mean that others prefer the same method. For many people receiving training from a good instructor is the best way for them to learn.

Experienced divers often assume that, since they know how to do something, it is easy and other people can pick it up easily. They underestimate the time and effort it took for them to learn that skill.

Experience is a great way of learning, but it is also an expensive way in terms of time, money, and risk. 

“Experience is a dear teacher but fools will learn at no other”. 

Benjamin Franklin


Learning from an experienced instructor is one of the most efficient ways of picking up new knowledge and skills. It can be much more effective than trial and error or learning from experience. It allows students to draw on the knowledge of many other divers, and not just their own experience. It can help avoid blind alleys or practices that seem like a good idea at the time but have hidden flaws that may not be immediately obvious.



Learning from an instructor can be much safer than making dangerous mistakes. Sometimes a dangerous mistake can result in no ill effects, in which case the diver learns the wrong lesson—they ‘got away with it’ and did not acknowledge it was a mistake. In other instances, the dangerous mistake causes an issue which the diver manages and takes as a lesson. In this case, making a dangerous mistake—and surviving it—can be a very effective learning situation. However, at other times, the dangerous mistake may result in a situation that the diver cannot deal with and may result in very serious consequences.

It can also be much cheaper in the long run to pay for quality training than making costly mistakes, especially when it comes to buying the wrong kit. When I run a course for a diver looking at getting into tech diving, I recommend that they do not buy their kit in advance. Part of the course is to look at the various kit configurations, compare the pros and cons of each and allow the student to determine what kit will suit them best. After this exercise, the students often realize that what they thought they needed is not what they actually need, so they can then buy the right kit straight off. Time after time, this approach has meant that students save more money in avoiding buying unsuitable kit than the cost of the course.

Training, no matter how thorough, does not produce the finished article 

It is not reasonable to expect a student to have mastered each skill by the end of a realistic training course. This statement may surprise some people, as some agencies do suggest that the student should display “mastery” of a skill as a performance requirement of the course. In reality, this can only be achieved by redefining “mastery” to such an extent that it means no more than “competent under good conditions.” This is not real mastery.

After training comes real-life practice.


There is simply not enough time to achieve real mastery in a training course. And there shouldn’t be. There is a time for working with an instructor and practicing with feedback from the instructor and a time for practice on your own. Both are required in order to achieve mastery but only one needs to be done as part of the course. Practicing on your own needs to be done over an extended period of time, with breaks to allow for consolidation. It is just not feasible or even necessary to do this with an instructor.

What this means is that the end of a training course is not the end of the learning process; rather, it is just a checkpoint in the student’s long-term progress. I have seen many students that were the strongest in the group at the end of the course, but after six months they had not progressed or had often gotten worse. However, I have seen other students who only just scraped through the course, but realized they needed to practice, and with determination and practice they had much stronger skills after six months.

Good students are not the ones that get it right the first time. They are the ones that know they need to keep practicing after the course. They are the ones that realize that training is only valuable with follow up practice. 



“Don’t practice until you get it right, practice until you can’t get it wrong.”

Unknown

Good instructors are not those who get their students to a good level at the end of the course or who get students to “practice until they get it right,” but a good instructor is one who makes sure the students will continue practicing in the future and “will practice until they can’t get it wrong.”

Welcome to the Real World

No matter how good your training and how much you practice, you also need to have real world experience. Even the most realistic training is not “real,” so you need to put the training into practice in the water. Training situations are often clear and unambiguous, but the real world is not always like that.

Welcome to the real world.

If the training environment is different to the real-world environment then it takes time to apply the training lessons to the real world. Different visibility, cold water vs fresh water, sea vs fresh, currents, entry points, different dive buddies, boats, and local procedures may also add variables they could not practice in training.

When training and practicing, the diver can focus primarily on the activity they are doing without too many distractions. Experience involves using those skills, not in isolation but as part of the whole dive, possibly when you are distracted by other considerations such as environmental challenges, your buddy, or the situation you are in.

“Experience is something you don’t get until just after you need it.”

Steven Wright

Experience is obtained by putting yourself in different environments. If you do 100 dives at the same location, in the same conditions, that is not really 100 separate dives but rather the same dive repeated 100 times. By exposing yourself to different environments, you encounter different conditions and challenges which may make the activity more, or sometimes less, challenging. 

This is the real meaning of mastery. It is not when you can do it reasonably well on a couple of occasions in good conditions. True mastery is being able to perform a skill each and every time under different or challenging conditions.

Can you perform the skill in a strange environment?

“Victory comes from finding opportunities in problems.”

Sun Tzu

With experience will hopefully come judgement

It is your judgment that will be relied upon to make the right decisions on how to avoid a potential problem or deal with a difficult situation. Judgment cannot be bought, or fast-tracked; there is no zero-to-hero option. It is the result of time spent practicing and gaining experience in a variety of conditions.

Powell doing his pre-breathe

Good judgement means making a sensible decision at the moment it is needed. It means picking the right tool at the right time. It also means knowing when a rule is applicable but also knowing when to break a rule. Judgement means knowing when to call a dive when the situation is not right and avoiding an incident rather than having to deal with the consequences.

Unfortunately, judgement is not an automatic result of the previous steps. Often, we see divers that do something dangerous and get away with it;  their experience tells them it is okay and skews their judgement as to what is acceptable. As a result, some divers become arrogant and think that they have so much experience that none of the rules apply to them. 

“Good judgment comes from experience, and a lot of that comes from bad judgment.”

Will Rogers

Finally, judgement means recognizing that you don’t know it all and that additional training, practice, and experience are always valuable. Keeping an open mind and learning from others is an important aspect of developing your judgement.

Only practice might reveal that there is a hole in your knowledge.

This means that the process is not a straight line but is a cycle. Practicing something might reveal that there is a hole in your knowledge and you need to circle back to an instructor for additional training. As you gain experience, you may realize that there are additional skills or combinations of skills you need to practice or further training you need. Good judgement often results in the realization that you need training on a different area of diving before undertaking deeper dives or progressing further into a wreck. The best divers are constantly learning and actively seek out opportunities for new training, practice, and experience. 

“Unless you try to do something beyond what you have already mastered, you will never grow.”

Ronald E. Osborn
What is more important, training or experience? And when is a course—you bought a new DPV did you?—preferable to learning on your own? Tech educator and author of Deco for Divers fame, Mark Powell, discusses the sweet spot between training and experience and why practice and judgement are also required to maximize your performance and safety and become a competent tekkie.

Additional Resources:

Stories by Mark Powell:

X-Ray: Achieving Our Teaching Objectives

X-Ray: Permanent Change: We Have We Learnt?

X-Ray: One for All or All For One?

Deco For Divers


Mark had his first experience of diving at the age of 10 when he did a try-dive in a local pool. He was hooked from that point onwards. He learnt to dive in 1987 and has been diving ever since. 
Mark became an instructor in 1994 and has been actively instructing since then. In 2002, Mark set up Dive-Tech, a dedicated technical diving facility, with the intention of providing the highest quality technical diving training. Dive-Tech provides technical training at all levels up to and including CCR Advanced Mixed Gas Instructor Trainer. 
Mark is a TDI/SDI Instructor Trainer and a member of TDI/SDI’s Global Training Advisor Panel. He also represents TDI/SDI on a number of international standards groups. He is a regular contributor to a number of diving magazines and a regular speaker at diving conferences around the world.
In 2008, Mark published Deco for Divers, a widely acclaimed overview of the theory and physiology of decompression. This has quickly become the standard text on the subject and is recommended reading by a number of the technical diving agencies. In 2010, Deco for Divers was awarded “Publication of the Conference” at the EuroTEK.10 technical diving conference, and in 2014 it won the Media Award at TEKDive USA. In 2019, Mark followed this up with a new book, Technical Diving: An Introduction.

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The Role of Agency When Discussing Diving Incidents: An Adverse Event Occurs—An Instructor Makes a Mistake

Human Factors educator and coach Gareth Lock examines the role of our innate attribution biases and language, in forming our collective judgements when incidents occur—in this case, by considering a student diving injury that occurred during a class. Was the instructor to blame? Was anyone?

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by Gareth Lock

Header Photo by Alexandra Graziano

What do you think when you read the following? Who is at fault? Where do you think the failures lie?

“The instructor failed to notice that the gas pressure in one of their four student’s cylinders was dropping faster than was expected, and consequently, missed that this particular student had run out of gas. The student then panicked and bolted for the surface which ended up with them having an arterial gas embolism.”

It would be normal for the majority of Western-cultured divers to believe that the fault would lie with the instructor, especially as I framed your thought processes with the subtitle, ‘An Instructor Makes a Mistake’. 

The instructor would have had a clear level of responsibility to make sure that the event didn’t happen the way it did, and because the student ended up with an out-of-gas situation and an arterial gas embolism, that instructor needs to be held accountable for the mistakes that were made. 

Financial compensation to the diver might be involved. As for the instructor, specific solutions for ways to prevent future mishaps would be standard. The instructor might be advised to be more aware, to monitor students more closely, and follow standards and/or training.

The problem with this approach is that it can miss significant contributory factors. Over thousands of years, we have developed a mindset that searches for the cause of an adverse event so that we can prevent the same thing from happening again. There are two parts behind this sentence that we are going to look at in this article—agency and attribution.

Agency and Attribution

Photo by Alexandra Graziano.

The first is Agency—an agent is a person or thing that takes an active role or produces a specific effect. ‘The instructor failed to notice the faster-than-normal pressure drop.’ In this example, the instructor is the agent. While we can easily identify the action and agent, we cannot determine from this simple statement whether the instructor intentionally didn’t monitor the gas, whether they accidentally missed the increased consumption rate or leak, whether the student didn’t inform the instructor, or if there was another reason. A reader of this short case study would normally assume that the instructor had some choice in the matter, that they were a free agent with free will, and that a professional with training should know better. This assumption can heavily influence how an ‘investigation’ develops from a blame-worthy event to one where wider learning can happen. 

Research has shown that the attribution of agency is subjective and is swayed by a number of different factors including culture, experience, and the language of the observer. Furthermore, the language used and how this frames the event has also been shown to directly influence the assignment of guilt, blame and/or punishment. This is especially the case if the only reports available are based around litigation and insurance claims, as these are purposely written to attribute blame. 

Societally, and developmentally, we believe that the attribution of cause behind an action is important, especially if it is an adverse event because it allows us to identify who or what needs to change to prevent the same or similar events from occurring in the future. In the out-of-gas event above, it might be obvious to some that it is the instructor who needs to change or ‘be changed’!

The Fundamental Attribution Bias

While agency is relatively clear when we describe an event, where this attribution of agency is applied is very subjective. Attribution theory was developed in the 1950s by Fritz Heider in which he described behaviours that could be attributed to internal characteristics or disposition (personality, abilities, mood, attitude, motivations, efforts, beliefs…) or to the influences external to them which were situational in nature (culture, social norms, peer pressure, help from others, organisational pressures, rules, environmental conditions…). For example, a diving student might not perform as expected despite having been given the training detailed in the course materials. This could be because of performance anxiety, lack of confidence, not paying attention to the demonstrations… (internal or dispositional attribution), or it could be caused by an argument they had had at home that morning, mortgage worries, homework which is due, promotion or threat of being fired, or poorly serviced equipment… (external or situational attribution).

Photo by Alexandra Graziano.

This subjectivity is so powerful and prevalent that there is a recognised cognitive bias called the fundamental attribution bias or error. This bias shows that there is a tendency to look for dispositional attribution when an adverse event involves someone else (they didn’t pay attention, they didn’t have the skills or experience), but the tendency to look for situational attribution when the adverse event involves us (high workload led me to be tired, the students were spread far apart, their gauge was in their BCD pocket). “When explaining someone’s behavior, we often underestimate the impact of the situation and overestimate the extent to which it reflects the individual’s traits and attitudes.” As a consequence, it is much easier to ascribe the failure to the individual rather than to look at the wider situation. This aligns with Lewin’s equation, B=f(P, E), which states that an individual’s behavior (B) is a function (f) of the person (P), including their history, personality and motivation, and their environment (E), which includes both their physical and social surroundings. 

Research has shown that culture can strongly influence how agency is attributed. Those from Western cultures e.g. Anglo-American or Anglo-Saxon European, have a tendency to be more individualistic in nature, whereas those from Far Eastern cultures have a more collective view of the world which increases collaboration, interdependence and social conformity. The research also shows that “Compared to people in interdependent societies, people in independent societies are more likely to select a single proximal cause for an event. Western cultures therefore have a tendency to erroneously attribute control and decision to the human actor closest to the event, even if this was not the case. This has huge implications when it comes to litigation and organisational/community learning.

Self-Serving and Defensive Attribution Bias 

When it comes to an adverse event, those cultures that have high individualistic behaviours are more likely to find a way to identify someone other than ourselves as the cause i.e. “the dive center manager didn’t tell me the time had changed, and so I was late for the boat.” Conversely, when we have a successful outcome, we are more likely to look to our own performance and traits (dispositional attribution) rather than the context (situational attribution) i.e. “I had spent time practising the ascents, so my buoyancy was good for the final dive.” without noticing that their buddy was rock solid in the water and provided a very stable platform to reference against. This is known as self-serving self-attribution.

As the severity of the event increases, we mentally distance ourselves further from the traits or behaviours that would have led to this event. “I wouldn’t have done that because I would have spotted the situation developing beforehand. I am more aware than that diver.” This defensive attribution is also known as distancing through differencing.

This is a protection mechanism; if we can shift the blame to someone else because they have a different disposition (internal behaviours/traits), we can convince ourselves that what we are doing is safe, and we carry on with what we were doing in the same way we’ve always done. This might appear to be simplistic; however, much of what we do is relatively simple in theory, it is how it is weaved into our daily lives that makes things complicated or complex. 

Photo by Alexandra Graziano.

Language Matters – Invisible Meanings

The subtitle of the first section “An adverse event occurs. An instructor makes a mistake.” will have invoked a number of mental shortcuts or heuristics in the reader. We will likely make an assumption that the two events are linked and that the instructor’s mistake led to the adverse event. I purposely wrote it this way. That link could be made stronger by changing the full stop to a comma.

Language can have a large impact on how we perceive agency and causality. The problem is that how we construct our messaging is not normally consciously considered when we write or speak about events. As with many other aspects of culture, it is invisible to the actor unless there is some form of (guided) active reflection.

For example, research has shown that there is a difference between how Spanish and English-speaking participants considered the intentional or unintentional actions in a series of videos. In one example, the actor in the video would pop a balloon with a pin (intentional) or put a balloon in a box with a (unknown) pin in it and the balloon would pop (unintentional) as the balloon hit the pin.“The participant descriptions were coded as being either agentive or non-agentive. An agentive description would be something like, “He popped the balloon.” A non-agentive description could be, “The balloon popped.” The study concluded that English, Spanish, and bilingual speakers described intentional events agentively, but English speakers were more likely than the other groups to use agentive descriptions for unintentional events. Another study showed similar results between English and Japanese speakers.



Another powerful bias exists in the form of framing. This is where information is given to another party to influence their decisions and is either done consciously or not. For example, take two yoghurt pots, the first says “10% fat” and the other says “90% fat free”. The framing effect will more likely lead us to picking the second option, as it seems likely it is the healthier yoghurt. If we look at how this applies to diving incidents and agentive language “The diver ran out of gas near the end of the dive.” or “Their cylinder was empty near the end of the dive.” The first appears to put the diver at fault but we don’t know how or why this happened; whereas, the second statement is not personal and therefore allows a less confrontational conversation. Consequently, we must be careful with how we attribute agency as it limits our attention to the context immediately surrounding the person involved. If we want to learn, we have to expand our curiosity beyond the individual and look at the context.

Another example of how language matters and the shortcuts we use is the use of binary oppositions e.g., right/wrong, deep/shallow, recreational/technical, success/error, or deserved DCS/undeserved DCS. While binary modes might work for technical or mechanical systems (work/don’t work), they are not suited for systems involving people (socio-technical systems) due to the complicated and complex interactions that are present. “They didn’t use a checklist.” Is often seen as a final reason why something went wrong, as opposed to asking questions like “What sort of checklist should have been used?”, “When would the checklist normally be used?”, “What were others doing at the time”, “Which checklist? Manufacturer’s, agency’s, or their own?” 

When it comes to these socio-technical systems, we can only determine success or error/failure AFTER the event. If the actors knew that what they were doing would end up as a failure due to an error, they would do something about that ‘error’ before it was too late.

Isn’t this just semantics?

All of this might appear to be semantics, and technically it is because semantics is the branch of linguistics and logic concerned with meaning. “Words create Worlds” (Heschel and Wittgenstein) for the better or worse. Think about how you frame an event or attribute agency because it WILL impact your own and others’ learning.

Look back at the original narrative in the second paragraph, which was purposely written in the manner it was, and consider where attribution has been placed, how it limits learning and what questions you can ask to improve your understanding of the event. We are cognitively efficient creatures, always looking for the shortcut to save energy. However, this efficiency comes at the expense of learning.

In this event, there were many other factors that we needed to consider, many of which would be focused on the limitations of our cognitive system. We CANNOT pay more attention; it has a limited capacity. What we can do is make it easier to prioritise and focus on the most important/and or relevant factors, and we do this by designing systems that take our limited capacity into mind. 

Monitoring four students is going to be at the limits of what is safely possible, especially when other factors are taken into consideration, such as instructor experience, visibility, current, task loading, comfort levels, etc. These factors are readily apparent and their significance obvious after the event, but in real-time with all of the other conflicting goals present, not so. When designing systems and processes, try to apply the key human factors principle: make it easier to do the right thing, and harder to do the wrong thing.

As an example of how this language can manifest itself, have a look at any agency training materials which describe adverse events or incidents, and look to see how agency and attribution are applied, and how little the context is considered. e.g. the following example is from a leadership-level training manual: a supervisor left the dive site before accounting for all of the divers in the group and two were left behind and suffered from hypothermia. The reason given for the abandonment was that the supervisor was distracted. The material then goes on to say that despite the supervisor having normally conducted good accounting procedures, this would not help in a lawsuit as a court would look at the event that occurred not what they normally did. What is missing is understanding ‘how the supervisor came to be distracted’ and what the context was. This would provide a much greater learning opportunity than the normal ‘make sure you account for everyone otherwise you could be in a lawsuit.’ “We cannot change the human condition, but we can change the conditions in which humans work.”—Professor James Reason.

Summary

We have a tendency, especially in Western cultures, to want to find out ‘who did it’ and ascribe blame to an individual agent. More often than not, the agent is the person who was closest to the event in time and space. In effect, we play the game of ‘you were last to touch it, so it was your fault’ but this rarely prevents future events from occurring. In reality, divers, instructors, instructor trainers, and dive centre managers are all managing complex interactions between people, environment, equipment and cultural/societal pressures with sensemaking only being made after the event. 

Photo by Peter Gaertner.

To be able to identify a single cause of an adverse event in diving is impossible because it doesn’t exist and yet this is what the language we use focuses on. We look for a root cause or a trigger event for an accident or incident. The research from Denoble et al, which described four stages (trigger event, disabling event, disabling injury and cause of death) of fatalities misses the context behind the trigger events and yet it is still used in incident analyses. Compare this to modern safety investigation programmes which have moved away from a root cause approach to a more systemic approach, like Accimap or Human Factors Analysis and Classification System (HFACS) that take into account systems thinking and human factors principles/models. 

A response from Petar J Denoble’s response, Click Here

There are no formal investigation and analysis programmes or tools in the sports diving sector so any data that is produced is heavily biased by personal perspectives. However, that gap will be addressed before the end of 2021 when an investigation course will be launched to the public by The Human Diver. 

This two-day programme will provide an introduction to a systems- and human factors-based approach to event learning and will be based on current best practices from high-risk industries and academia and then tailored and focused on non-fatal events in the diving industry. There will also be a number of research programmes being developed over the next year or so which look at incidents, their causality and how to report them. The methodology will be relevant to fatalities but these investigations are often undertaken by law enforcement officers or coroners.

Photo by Kirill Egorov.

For the diving community, there is a need to look at how adverse events happen, not by attributing agency to individuals, but to look wider, to the system and the context so that we can understand how it made sense for that human agent to do what they did at the time. Ivan Pupulidy covers this clearly in the US Forest Service Learning Review, “In order to change culture, you have to change the assumptions that drive the culture.”

After note: The article was heavily influenced by the work of Crista Vesel whose referenced paper examined agentive language and how it influenced how the US Forest Service moved from Serious Accident Investigation Guide to a Learning Review. The review allowed more genuine inquiry to occur and find out the real reasons why serious events, including fatalities, occurred. You can find Vesel’s paper here: “Agentive Language in Accident Investigation: Why Language Matters in Learning from Events.”

Footnotes:

1. Lexico. Explore: agent. http://www.lexico.com/en/definition/ agent (accessed July 30, 2021). 

 2. Agentive Language in Accident Investigation: Why Language Matters in Learning from Events Crista Vesel ACS Chem. Health Saf. 2020, 27, 1, 34–39. 2020 3. Myers, D. Social Psychology, 11th ed.; McGraw-Hill: New York, 2013; pp 100−117

4. Fausey, C.; Long, B.; Inamon, A.; Boroditsky, L. Constructing agency: the role of language. Frontiers in Psychology 2010, 1, 1−11. 

5. Dekker, S. Why We Need New Accident Models; Lund University School of Aviation: Sweden, 2005.

6. Fausey, C. M.; Boroditsky, L. In English and Spanish Speakers Remember Causal Agents Differently, Proceedings of 30th Annual Meeting of the Cognitive Science Society, Washington, DC, July, 2008. https://escholarship.org/uc/item/4425600t (accessed November 13, 2019).

7. Denoble, P.J; Caruso J.L.; de L Dear G.; Pieper C.F. and Vann R.D. Common Causes of Open Circuit Recreational Diving Fatalities. 2008

8. Learning Review (LR) Guide (March 2017); U.S. Department of Agriculture Forest Service accessed 30 Jul 2021


Gareth Lock has been involved in high-risk work since 1989. He spent 25 years in the Royal Air Force in a variety of front-line operational, research and development, and systems engineering roles which have given him a unique perspective. In 2005, he started his dive training with GUE and is now an advanced trimix diver (Tech 2) and JJ-CCR Normoxic trimix diver. In 2016, he formed The Human Diver with the goal of bringing his operational, human factors, and systems thinking to diving safety. Since then, he has trained more than 350 people face-to-face around the globe, taught nearly 2,000 people via online programmes, sold more than 4,000 copies of his book Under Pressure: Diving Deeper with Human Factors, and produced “If Only…,” a documentary about a fatal dive told through the lens of Human Factors and a Just Culture. In September 2021, he will be opening the first ever Human Factors in Diving conference. His goal: to bring human factors practice and knowledge into the diving community to improve safety, performance, and enjoyment.

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In this article published online on  September 2, 2021, Gareth Lock systematically examines the role of innate attribution biases and language, talks about agency and attribution, and explains why incident investigation may fail to help prevent similar incidents from occurring again. As an example of a failed approach, Lock refers to the paper “Common causes of open-circuit recreational scuba fatalities”, which I co-authored with my colleagues in 2008. While I appreciate Gareth’s work in general and the content of this particular article, I have to point out that our paper never intended to do what Gareth assumes and attributes to it.
1. In our paper, we do not investigate individual incidents. Instead, we attempted an epidemiological analysis based on the reported results of separate incident investigations.
2. We do not claim that triggers are the root causes. We provide clear, pragmatic definitions for all four categories we used in the paper.
3. We never attribute agency in the sense of subjective factors; our only agent is similar to an epidemiological agent, like a mechanical agent of injury (boat hitting diver), CO causing intoxication, and similar.
4. We are aware that there were causes beyond what was reported and that in most cases probably there were multiple causes, and we state it explicitly in the paper.
5. We aimed to identify contributing factors that could be targeted with preventive interventions (which we did not prescribe).
6. We assumed, that although we may never know the primordial cause(s), we still could intervene by preventing the domino effect or by interrupting the chain of events leading towards the fatal outcome. If we were not right in assuming it, why bother with teaching divers all possible corrective measures in an adverse event?I am looking forward to a bright future with much-improved incident analysis methods. I hope that my younger colleagues will have high-quality reports to work with trying to devise the best preventive interventions.

-PJ Denoble