SH284: LEODSI and PETTEOT: A Systems Approach for Understanding How Diving Really Works

SH284: LEODSI and PETTEOT: A Systems Approach for Understanding How Diving Really Works

When something goes wrong in diving, people often ask “who made the mistake?”, but that question usually oversimplifies what really happened and stops us from learning. The Learning from Emergent Outcomes framework (LEODSI) takes a different approach by looking at diving as a system, where outcomes are shaped by many interacting factors rather than one person’s actions. It examines seven key elements—people, environment, tasks, equipment, external pressures, organisation, and time—to understand how decisions made sense in the moment and how conditions combined to produce the result. Instead of blaming individuals, LEODSI focuses on why events unfolded the way they did, recognising that both successes and failures come from the same system. By using this approach in everyday debriefs, not just after incidents, divers and teams can learn more effectively, improve safety, and make meaningful changes that reduce risk in the future.

https://www.thehumandiver.com/post/what-is-leodsi-petteot

Links: Learning from Emergent Outcomes course: https://www.thehumandiver.com/lfeo

Tags: Learning, Incidents & Just Culture

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Jaksot(284)

SH283: You're Accountable. You're Responsible. You're It!

SH283: You're Accountable. You're Responsible. You're It!

This piece explores how diving incidents are often misunderstood by focusing too quickly on blame rather than learning. It explains the important difference between responsibility (who was involved) a...

30 Touko 17min

SH282: Isolation Amplifies Drift: When Remote Operations Make Small Deviations Invisible

SH282: Isolation Amplifies Drift: When Remote Operations Make Small Deviations Invisible

This blog by Michael John Snow explores how small equipment issues on a remote expedition vessel can gradually become accepted as “normal,” not because of poor decisions, but because of how isolated s...

27 Touko 11min

SH281: HMS Scylla Wreck Penetration Tragedy: Two Perspectives on Learning

SH281: HMS Scylla Wreck Penetration Tragedy: Two Perspectives on Learning

This episode looks at the 2021 wreck diving tragedy on HMS Scylla, where three experienced divers entered the wreck and only one survived. It first examines the kind of reaction often seen on social m...

23 Touko 37min

SH280: This Could Happen to Any Dive Operator: What We Can Really Learn From The Perth Diving Academy Incident

SH280: This Could Happen to Any Dive Operator: What We Can Really Learn From The Perth Diving Academy Incident

This episode explores the serious incident in which two divers were accidentally left behind by a dive boat near Rottnest Island while diving with Perth Diving Academy. Rather than treating it as the ...

20 Touko 9min

SH279: The Tower Was Already Full of Holes

SH279: The Tower Was Already Full of Holes

This episode looks at how diving incidents are often explained by blaming the last person involved, much like blaming the person who pulls the final brick from an already unstable Jenga tower. While t...

16 Touko 9min

SH278: Be Curious, Not Judgemental

SH278: Be Curious, Not Judgemental

This episode looks at how quick judgement, especially online, can block learning and make diving less safe. Using a real example of an adaptive scuba training video that received harsh criticism, it e...

13 Touko 6min

SH277: You are entering water with known problems, and don't kid yourself that it's any different.

SH277: You are entering water with known problems, and don't kid yourself that it's any different.

This episode explores why people often go diving even when something feels “off,” and how risk usually starts before anyone gets in the water. It explains that danger doesn’t come from one big mistake...

9 Touko 11min

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