Crew Resource Management
SITUATIONAL AWARENESS
True situational awareness is an individual's accurate perception of reality. The "Theory of the Situation" is what one assumes to be true for a specific period of time. If a discrepancy exists between the individual's Theory of the Situation and the Reality of the Situation, a loss of situational awareness occurs and an error chain could begin.
Elements of Situational Awareness
Theory of the Situation - A set of beliefs about what is happening and what action and individual should take. It is based on the interpretation of available information. It is a human's perception of reality.
Reality of the Situation - Actually reality, without human perceptions
Theory of Practice - a person's concepts and skills developed over time used to build and respond to Theories of the Situation. It is the sum of experience.
It is normal for people to defend their Theory of the Situation rather than to change it, or inquire about possible error. Many accidents have occurred where a crew was using a faulty Theory of the Situation and overlooked data that indicated otherwise.
You are MOST likely to change your Theory of the Situation when you
- Operate under low stress
- Have access to and accept feedback
- Develop inquiry skills into your Theory of Practice. Guard against interpreting information to support your Theory of the Situation
You are LEAST likely to change your Theory of the Situation when
- Your Theory of Practice is over-learned
- You have a complacent attitude - "we've always done it that way"
- It is a crisis situation
- The Theory of the Situation is central to your self esteem, ego
In attempting to change your Theory of the Situation, as in Conflict Resolution, the important factor is
What is right, not who is right
The CRM principles of inquiry, advocacy, conflict resolution and critique will assist in clarifying the Reality of the Situation, and provide the basis for higher quality decision making.
Fatal Accidents
Worldwide Commercial Jet Fleet - 1959-1990
Exposure percentage based on average flight duration of 1.6 hours
Excludes:
Sabotage
Military action
Clues to the Loss of Situational Awareness
Low Stress Level - When the amount of information being processed is significantly low, the level of situational awareness is low. Low stress level is common on long flights when we become bored or when we are fatigued. This lack of alertness will result in a loss of recognition of warning signals and reduce our ability to react quickly and correctly in an emergency.
High Stress Level - When the amount of information being processed is significantly above an individual's capacity. If our stress level is very high, we operate at low levels of situational awareness. This is commonly referred to as information overload.
Ambiguity - When information can be understood in more than one way, there can be a fifty per cent chance of an accident occurring. A classic example is the captain calling "take-off power" and the first officer reduces the power to idle.
Confusion or Unresolved Discrepancies - When information is unclear, or two or more pieces of information do not agree, we must search for information until the discrepancies are resolved. A simple example with catastrophic consequences is the acceptance of a clearance to descend below published minimum safe altitudes.
Fixation or Preoccupation - The ability to detect other important stimuli is lost when an individual is fixated, preoccupied or distracted. This situation can easily result in no one flying or looking outside the aircraft unless there is proper assignment of responsi-bilities essential to safe flight. The entire crew's preoccupation with a malfunctioning nose gear indication light resulted in an L-1011 crashing into the Florida Everglades. No one was monitoring the flight instruments; no one was flying the aircraft.
Departures from sops/Regulations - Violating minimums or using improper procedures puts pilots into a gray area without being able to predict safe outcomes with certainty. Consistent and blatant violations of rules often reveals other systemic problems within an organization.
Failure to Meet Planned Targets - In flight, pilots are constantly setting planned targets such as airspeeds, altitudes, checkpoints, times, etc. When planned targets are not met, like being high and fast on an approach, we must question why and recognize the consequences of not meeting set targets.
Gut Feeling - This is often the most detectable and reliable clue to the loss of Situational Awareness. Our bodies are able to detect stimuli long before we have consciously put the big picture together. Learn to recognize your own signs, such as stomach butterflies, muscle tension, mood swings, etc. Trust your feelings; policemen sometimes place their lives on gut feelings.
Maintaining Situational Awareness
The following eight skills will favourably contribute to gaining and maintaining Situational Awareness
Experience - Experience creates a mental file. Pilots draw upon it every time they fly and use it to assess conditions and make decisions. Under pressure, people tend to revert to previous patterns of behaviour. An individual's experience file helps establish how one will interpret and respond to a given set of conditions.
Training - Training does far more than perfect skills. Training adds to a pilot's experience file by creating events that rarely happen in real life. For example, a flight simulator session can generate a lifetime of experience in a very short period of time. Few pilots will ever actually have an engine fail at V1. Yet through training, it can become part of a pilot's experience so that if and when it does occur, there will be something to draw upon.
Spatial Orientation - Spatial orientation is position awareness; knowing where the aircraft is in relation to VOR's, airports, runways, terrain, or other aircraft. It is knowing where you are and where you are going.
Physical Flying Skills - As the pilot's role becomes that of a cockpit manager, it must be remembered that pilots still have to be able to fly the aircraft proficiently. Flight control manipulation continues to be an important part of a pilot's job.
Ability To Process Information - This is an ability to use information from sense inputs, instruments, and other sources to form an accurate picture of what is happening. It is the ability to integrate all the elements that contribute to Situational Awareness.
Cockpit Management Skills - These contribute to a pilot's ability to manage the total of the flight environment.
Personal Attitude - Professionalism is a matter of attitude. Safety does not just happen; it is a conscious effort. To be safe, one must think safe.
Emotional / Physical Conditions - An individual's emotional and physical condition affects their perception of the environment. Emotional problems, mental illness, physical conditions, and frame of mind can cloud or distort an accurate perception of events or conditions.
Summary
Crew Resource Management principles stress that all resources must be considered before a quality decision can be made. Therefore, the quality of the decisions are directly related to the amount and the accuracy of information gathered pertaining to the crew, aircraft and the environment.
If a pilot suspects that a loss of Situational Awareness has occurred, revert immediately to the basics
- Maintain Control - Fly the Aircraft
- Assess the Problem in the Time Available
- Gather Information from All Sources
- Assess All the Options - Choose the Best
- Monitor the Results - Alter Plan as Required
Continual use of the 5 CRM principles will assist crew members to retain their Situational Awareness at all times
Inquiry
Advocacy
Conflict Resolution
Critique
Decision Making
Copyright © 1996-2005 by Neil C. Krey unless otherwise indicated.
Non-commercial reproduction rights granted if the following notice is included:
"Source: Neil Krey's CRM Developers Forum, http://www.crm-devel.org"