Boldface items are for immediate action, when the aircraft may be lost if the items are not completed quickly and in the correct order. Correct and rapid execution of these steps is so critical and essential, that pilots must complete them from memory. Through training and repetition, the paired cognitive and motor activities required to perform the checklist are stored by the pilot as procedural memory (or ‘motor skills’).10 Despite notable exceptions (such as ‘choking’ under pressure), procedural memory retrieval is less affected by stress than declarative or episodic memory retrieval.11 For this reason, aircrew practice time critical emergency procedures regularly to aid in forming the correct ‘habits’. However, as soon as time permits, the checklist is used to confirm that the steps were executed as required.8
‘Non-boldface’ checklists form part of the normal framework of ‘job aids’, which might also include mnemonics and other rote learning tools, task visibility, context-sensitive help functions, decision support and instruction manuals. Mnemonics (such as ‘ABC’ for ‘Airway, Breathing, Circulation’ in resuscitation), for example, are sometimes used to retrieve procedural items where participants are likely to be subject to high cognitive load; however, mnemonics are more critical in situations where there is no later access to a physical checklist for confirmation.
Law school exams. I stumbled upon the power of checklists for managing complex problems while in law school. In a law class, a single three-hour long essay exam determines your final grade. You’re presented with one or two complex hypothetical situations and are required to identify and analyze all the legal issues in them. To excel on law school exams, knowing the law isn’t enough. You have to be adept at applying it to different legal scenarios.
Everything seemed fine, until the patient stopped responding and his heart rate skyrocketed. The patient's blood pressure was barely detectable. Nothing his medical team did improved it, so he was rushed to surgery. Only when he was opened up did the doctor finally realize the stab wound went much further inside the patient than he'd thought, cutting right into the aorta—the main artery from the heart. Although it seemed like a small knife wound, the patient had actually been struck by a bayonet—part of the assailant's costume.
Google Sheets beat Microsoft to the punch and introduced a Checkbox as one of the Data Validation options. You can go to Insert > Checkbox to quickly create one, and you can customize it by going to Data > Data Validation. I've updated most of the Google Sheets versions of my checklists to use that feature. I hope Excel gets smart and introduces a similar feature some day.
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