The Design of Everyday Things by Don Norman

Norman, a prominent figure in design and psychology, argues that design flaws, not user errors, are the root cause of difficulties with technology. The book introduces key concepts such as affordances and signifiers, the gulf of execution and evaluation, and the importance of conceptual models in effective design.

Key Takeaways

Norman's central argument is that when people have trouble using technology, the fault lies with the design, not the user. This reframing is foundational for anyone working in systems that serve people under stress — like emergency medicine.

Core Concepts

Affordances and Signifiers

Affordances are the possible actions between an object and a person. Signifiers are the perceivable cues that communicate where those actions should take place. In healthcare, we constantly deal with poor signifiers — medication packaging that looks identical, monitor interfaces that bury critical alarms.

The Gulf of Execution and Evaluation

The gulf of execution is the gap between a user's intention and the available actions. The gulf of evaluation is the gap between the system's state and the user's ability to perceive it. Both gulfs are massive in healthcare IT systems.

Conceptual Models

People form mental models of how things work. Good design aligns with these models. Bad design forces people to build new, often incorrect models. This is directly relevant to EHR design and clinical decision support.

Favorite Quotes

"Design is really an act of communication, which means having a deep understanding of the person with whom the designer is communicating." "Good design is actually a lot harder to notice than poor design, in part because good designs fit our needs so well that the design is invisible."

How This Connects to Emergency Medicine

The ED is a masterclass in poor design — from ambiguous medication labels to EHR workflows that fight clinical reasoning. Norman's framework gives us language to articulate why these systems fail and how to fix them. The concept of error as system failure rather than human failure directly parallels the patient safety movement.

Rating: 9/10

Essential reading for anyone who wants to understand why systems fail people. The principles are universal and especially powerful when applied to high-stakes environments like healthcare.