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Thoughts on Crew Resource Management (CRM)

by Tori Williams 1. December 2018 18:18
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Crew Resource Management (CRM) is defined by the Federal Aviation Administration as, “the effective use of all available resources: human resources, hardware, and information.” The history of CRM comes from NASA research that took place in the late 1970s. NASA focused its research solely on the human error element involved in aircraft accidents with multiple crews. During this time of research, much of the focus of CRM was on the pilot/copilot relationship. It was discovered that select airline captains thought very little of their first officers. In turn, first officers felt that they could not challenge their captain when they didn’t agree with his or her actions. They felt that it was disrespectful to challenge them as captains were the boss in the cockpit. The purpose of the research at that time was to “gain an environment of equal respect, teamwork and cooperation to safely accomplish the mission of the flight.” The most recent CRM model has evolved into “teaching pilots risk management strategies, focusing on workload management, recognizing hazardous attitudes or patterns, maintaining situational awareness, and communicating effectively to operate efficiently and safely in all aspects of flight.” CRM is an important aspect to any flight training department and is critical for an airline pilot’s career.

CRM covers many different concepts including decision-making and risk management. The decision-making side of CRM covers pilots that are faced with an in-flight decision. Pilots are trained to use the knowledge and technology they have available to them when they are faced to make a decision during flight. CRM includes not only pilots but other crew members, flight attendants, ATC, weather reports, and maintenance workers. Pilots can utilize these people and tools to help them make their in-flight decision. Risk management involves preventing risks and how to manage them appropriately if they do arise. Risks include not only environmental such as weather or operational policies but pilot’s personal risks. Pilots can have personal risks such as fatigue, illness or stress that they are aware of but not always tell their crew members about. Factors such as aircraft weight and runway conditions can also influence risks. Two flight cases below highlight the importance of CRM and why proper training is crucial before the flight crew steps in the cockpit.

Korean Air Cargo Flight 8509 is a perfect case study into what tragedies can happen when there is a breakdown of CRM. The Boeing 747 was flown by a crew of 4 out of London Stansted Airport on December 22, 1999. Maintenance personnel warned the Flight Engineer that the captain’s Attitude Director Indicator (ADI, or artificial horizon) was unreliable during a roll before they boarded the aircraft. It was dark outside at the time of takeoff, so the captain was flying entirely by instruments. The captain began a sharp left turn after takeoff, which was not reflected on his inoperable ADI. The CRM breakdown in this instance was that the co-pilot’s ADI was functioning normally but he remained silent as to not challenge the captain. The Flight Engineer began yelling “Bank!” repeatedly, and an alarm rang out warning of the error, but the pilot continued his sharp turn until the left wing dragged the ground and the plane smacked the ground at high speed and 90 degrees of left bank. All 4 crew onboard perished in the cash.

Southwest Airlines Flight 1248 is another example of where CRM training is crucial. On December 8, 2005 a Boeing 737-7H4 ran off the departure end of runway 31 center just after landing at Chicago Midway Airport. The aircraft rolled through the blast pad fencing and the airport’s perimeter fence where it finally came to a stop after striking a vehicle, which killed a child that was in the vehicle. The cause of the accident was the pilots’ failure to use available reverse thrust in a timely manner to safely slow or stop the airplane after landing. This failure occurred because the pilots’ first experience and lack of familiarity with the airplane’s autobrake system distracted them from thrust reverser during the challenging landing. This case shows that not only were the pilots at fault for the accident but Southwest Airlines as a company. The company failed to train the pilots and assure that they were clear on the operating procedures for the aircraft they were flying.

Between 60-80% of aviation accidents are caused by human error, and a large portion of that are specifically caused by poor Crew Resource Management. Millions of dollars have been invested into CRM training at airlines, flight schools, and other businesses that operate aircraft. Continual CRM training that focuses on teaching pilots and aircraft crew error avoidance, early detection of errors, and minimizing consequences resulting from CRM errors generally has a positive outcome and desired behavioral change. However, it can be difficult to evaluate the impact of CRM training as it is hard to quantify the concept of accidents avoided. Thus, it was determined that more research into the long-term effects of CRM training needs to be conducted in the coming years.

Companies are wanting to dig deeper into how they can better equip and train their employees to use CRM tactics. The FAA has an Advisor Circular (AC) published specifically for crew resource management training. In addition to the certain essential that are universal to CRM, the Advisory Circular also lists effective CRM characteristics which include: CRM is a comprehensive system of applying human factors concepts to improve crew performance, CRM embraces all operational personnel, CRM can be blended in all forms of aircrew training, CRM concentrates on crewmembers’ attitudes and behaviors and their impact on safety, CRM uses the crew as a unit of training, CRM is training that requires the active participation of all crewmembers. It provides an opportunity for individuals and crews to examine their own behavior, and to make decisions on how to improve cockpit teamwork. The number one goal in aviation is safety. Where CRM characteristics are compromised or left out, there’s room for error to slip in which can lead to incidents or accidents that could cause fatalities. Companies in the aviation industry need to ensure that they are taking all of the right steps in training their crews before they are put on the aircraft with souls on board.

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Aircraft Accidents | Aviation History | Aviation Safety

When Is An Aircraft "Destroyed" Versus "Repairable"?

by Greg Reigel 12. November 2018 15:27
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Unfortunately, the terms "destroyed" and "repairable" are not defined anywhere in the regulations. But, as you might expect, the FAA has a policy/opinion about what these terms mean. In fact, the FAA has issued Order 8100.19, Destroyed and Scrapped Aircraft which spells out what these terms mean and how they are to be applied by FAA inspectors. If an aircraft is capable of being repaired and returned to service after it was unserviceable due to wear and tear, damage, or corrosion then it is "repairable." But this means that when the repair is complete the aircraft to returned to service in "its original (or properly altered) condition that conforms to its type design."

The FAA clarifies further that an aircraft is only eligible for repair if it has at least one primary structure around which a repair can be performed. According to the FAA, it "considers an aircraft’s primary structure to be the structure that carries flight, ground, or pressurization loads, and whose failure would reduce the structural integrity of the aircraft." If only some, but not all, of the major structures of an aircraft are replaced, then that would still be considered a repair.

However, if all of an aircraft's primary structures must be replaced then the FAA does not consider the aircraft to be "repairable." Rather, in that situation the aircraft is being "replaced" after being "destroyed." And if the identification plate from the original aircraft was then placed on the "destroyed" aircraft that would violate 14 CFR § 45.13(e) ("No person may install an identification plate removed in accordance with paragraph (d)(2) of this section on any aircraft, aircraft engine, propeller, propeller blade, or propeller hub other than the one from which it was removed.”)

In order to comply with Section 45.13(e), the primary structure must be identifiable and traceable to the particular aircraft and its identification plate. As an example, if a heavily damaged aircraft is repaired by performing many major repairs on its fuselage and replacing all other primary structures that may be destroyed such as the wings and the empennage, that aircraft would not be considered destroyed because the fuselage is repairable. But if the fuselage of that aircraft also needed to be replaced along with the other primary structures, then the aircraft would be considered destroyed.

The Order also provides the following examples for use in determining if an aircraft is destroyed:

  1. All primary structures of an airplane or glider, including the fuselage, all wings, and empennage are beyond repair.

  2. The fuselage and tail boom of a rotorcraft are beyond repair.

  3. Only the aircraft identification plate is reusable.

How is this determination made by FAA inspectors? Well, according to the Order, "FAA accident investigators will apply their specialized knowledge and expertise and follow the guidelines in this order when evaluating aircraft wreckage to determine whether an aircraft is repairable or should be declared destroyed."

Fortunately an aircraft owner can dispute a determination that an aircraft is destroyed by providing the appropriate FAA FSDO or ACO with a repair process that explains how the damaged aircraft can be repaired provided that at least one primary structure of the aircraft is capable of being repaired rather than requiring replacement. If you are faced with a situation where it is unclear whether an aircraft has been "destroyed" or is still "repairable", you will definitely want to consult the Order, as well as the aircaft's maintenance manual.

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Aircraft Accidents | Aviation Safety | Greg Reigel

Runway Incursions: What's the Big Deal?

by Tori Williams 1. November 2018 14:46
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A runway incursion is defined by the FAA as, “Any occurrence at an aerodrome involving the incorrect presence of an aircraft, vehicle or person on the protected area of a surface designated for the landing and takeoff of aircraft." There are four categories of runway incursions, Categories A-D. Category A being the most severe and Category D being the least severe. Category A is classified as an “incident in which separation decreases and participants take extreme action to narrowly avoid a collision.” An accident can be the result of a runway incursion, and therefore exceeds the categories described.

The FAA estimates that approximately three runway incursions happen every day at towered airports in the United States. Thus, the number of unreported incursions at non towered airports must be much larger. Although a runway incursion is by definition a near miss at the worst, they are often a contributing cause in serious aircraft accidents. An accident that perfectly illustrates the dangers of runway incursions is the 1996 collision of United Express flight 5925 and a Beechcraft King Air 90A in Quincy, Illinois. A miscommunication between the landing Beechcraft, the departing King Air, and a third taxing aircraft turned deadly when the King Air failed to look for traffic and the Beechcraft wrongly assumed a radio transmission confirmed they were okay to land. Although the airport was not towered, the presence of both aircraft on intersecting runways was extremely dangerous and lead to a collision at the intersection. A total of 12 people lost their lives in that accident that could have been easily avoided.

Another infamous accident involving a runway incursion is the Russian Aeroflot Flight 3352 that took place in 1984. In short, the ground Air Traffic Controller fell asleep after he authorized several maintenance vehicles to enter the runway. A commercial aircraft carrying 170 passengers came to land at the airport, and the approach controller, oblivious to the maintenance crew on the runway, cleared them to land. To make matters worse, visibility was extremely low and the maintenance trucks did not have their rotating beacons illuminated. The commercial aircraft collided with the vehicles, resulting in 178 fatalities. In this example, the accident investigators placed the majority of the blame on the Air Traffic Controller, but there were mistakes made by all parties involved.

The airport environment is a complex operation with hundreds of moving parts. Pilots, air traffic controllers, and airport designers have to understand the hazards that come with miscommunications and poorly designed airport layouts. It only takes one moment of confusion for a runway incursion to happen, which could be deadly.

The FAA has a record of 1747 total runway incursions happening in the Fiscal Year 2017. There are several reasons that runway incursions occur. One of the most prevalent ones is miscommunication or a total lack of any communication. Many times, pilots and air traffic controllers get “stepped on” or, talked over on the radio frequency. It is highly critical that pilots repeat back their instructions to confirm with the controllers that they heard them correctly and that the directions were for their aircraft and not another. As in the above case study, although there was not a tower at the airport, the landing aircraft assumed that the aircraft announcing they would be holding short was the only one holding short. There was a misunderstanding in this case because one pilot’s radio transmission got covered up by the other aircraft holding short making the pilot of the landing aircraft assume that there was only one aircraft and they were holding short. Other common types of runway incursions include incorrect entry or vacating of an aircraft or vehicle onto the runway protection area, incorrect runway/taxiway crossing, incorrect spacing between departing and arriving aircraft, and landing or taking off without air traffic control clearance.

According the the FAA, approximately 65 percent of all runway incursions are caused by pilots. Detailed investigations of runway incursions over the past 10 years have identified three major areas contributing to these events including failure to comply with air traffic control instructions, lack of airport familiarity, nonconformance with standard operating procedures. Clear, concise, and effective pilot/controller communication is paramount to safe airport surface operations. This is something that is often stressed during initial and recurrent pilot training, but evidently the information does not always stick in the pilots’ minds.

Air traffic control instructions must be fully understood and complied with. Air traffic controllers are in place to assist pilots and want to help when there is confusion but many pilots don’t ask for the help. They are caught up in other tasks such as checklists, taxi directions, and non-essential chatter with the copilot. Pilots are to taxi with their heads-up and eyes outside to ensure they are aware of all aircraft and airport vehicles.

Major factors that increase the risk of runway confusion and can lead to a wrong runway departure include airport complexity, close proximity of runway thresholds, joint use of a runway as a taxiway (FAA, 2017). During the summer construction time, many airports will close runways or taxiways to resurface them or replace them. If a taxiway is closed, this can force aircraft to use runways as a means of getting to another open taxiway. It can also force the aircraft to back taxi on the runway they are departing from.

Thorough planning is essential for safe taxi operations. Aircraft accidents are more likely to happen on the ground than in the air because there are so many moving parts on the airfield. Pilots need to utilize the following services/tools in order to ensure safe airport surface movement: Notices to Airmen (NOTAMS), Automated Terminal Information Service (ATIS), Airport/Facility Directory (A/FD), and recognizing Hot Spots. Although using these pilot tools will not end all runway incursions, they will lower the risks if all pilots are equipped with the proper and current information.

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Aircraft Accidents | Airlines | Aviation Safety | Tori Williams

Top 5 Most Common Mistakes Among Pilot In Training

by GlobalAir.com 27. September 2016 15:06
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I want to first off begin this post by saying that I highly encourage everyone to go see the movie Sully now playing in theaters. In fact, this past weekend I went with the Sooner Aviation Club to see the movie at the Warren Movie Theater in Moore, Oklahoma. Here’s a group picture that we took right before we went and saw the movie.

Now onto more important things. With the semester in full swing and everyone trying to survive there first major exams and essay, I’ve also noticed that a lot of private pilots are taking a major step in their aviation career by soloing for the first time. I will never forget the first time I soloed back of October 13th 2015, and it’s a day that sticks with you for the rest of your life. As these students begin to work on the cross county portion of their private pilot’s license, I want to share my top 5 most common mistakes that students, and even myself, have made and continuously make.

#1- Forgetting the Checklist- By now I’m sure everyone has heard their flight instructor repeat this phrase multiple times “Are you forgetting to do something?” and 99% of the time they are referring to a checklist. Believe me I’ve heard this multiple times when it comes to flying and it’s definitely something that is easy to forget; however, it’s there for a reason and that is for the safety of yourself, your passengers, and the aircraft so if you are constantly forgetting a checklist this is a habit you need to break ASAP especially when it comes to a check ride.

#2- Landing too fast or to slow- When it comes to landing on final it’s all about your airspeed and making sure you are keeping it constant which means you absolutely need to be working the throttle constantly; however, never add too much power or pull it out when you are on final. This can lead to floating down the runway for a long time, or in the case of taking too much power out, you risk the chance of stalling the aircraft. In any case you feel like it’s going to be a bad landing it’s okay to call a go around, in fact it’s the best option. Remember you aren’t forced to land the aircraft on your first try if it looks like it’s going to be an unsafe landing.

#3- not flaring or over flaring- Along with the speed of the aircraft, a lot of people forget to flare the aircraft before hitting the runway which can lead to a hard landing, bouncing down the runway and even possible damage to the aircraft. Believe me if you don’t flare you could possibly damage the front of the aircraft or worse the propeller, so make sure you add that flare once you are over the runway to ensure not damaging the front. Equally as important is not to over flare since it could lead to a tail strike damaging the back of the aircraft and damaging the landing gear. The biggest thing I’ve noted when it comes to flaring is to just add small amounts of back pressure as I get closer to the ground preventing me from damaging the front or the back of the aircraft.

#4- wind corrections- So this is by far the biggest thing I always get harped on, not going to lie. Remember as pilot in command you are responsible for adding any wind correction because at any time a sudden burst of wind can hit your aircraft and possibly cause for you to flip over. It’s also important you add wind correction during takeoff and landing for the exact same reason, you don’t want to end up upside down like this aircraft.

#5- Situational Awareness- When it comes to flying it’s very easy to get fixated on your instrument especially during a maneuver. For example, when I use to do steep turns I would always focus on my turn coordinator to make sure I rolled on the proper heading. Next thing I knew the nose of the airplane was facing down and I was losing 500ft per minute and it took me a while to break that habit. While your instruments are a great resource, guess what? Your eyes are a better resource and you should always be aware of what’s going on around you. For all you know there could be another aircraft in your area, you could have a bird strike, or in my case you could be losing altitude so always be looking out outside to make sure you are aware of your surroundings.

 

By Cameron Morgan

The Rise of the Angle of Attack Indicator for General Aviation Airplanes

by Sarina Houston 1. October 2015 21:24
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Earlier this year, the National Transportation Safety Board (NTSB) added the prevention of loss of control accidents in general aviation to its Most Wanted List, a list of advocacy priorities the organization releases yearly.

Loss of control accidents (stalls, spins, etc.) made up 40 percent of fatal fixed wing general aviation accidents between 2001 and 2011, according to NTSB statistics. More than 25 percent of all fatal general aviation accidents occur during the maneuvering phase of flight, and more than half of these maneuvering accidents result in a stall/spin scenario. The NTSB continues to emphasize an industry-wide need to focus on preventing these accidents in order to reduce the accident and fatality rates for general aviation pilots. Preventing loss of control accidents should include awareness, as well as educating and training pilots, says the NTSB, and the organization is taking their own advice - in October the agency will host a forum to discuss some of the ways the industry can improve. The topics of discussion will include a statistical review, new training techniques, and equipment and technology improvements, and will most certainly include the installation and use of angle of attack (AOA) indicators in light general aviation aircraft.

Over the past few years, the NTSB, FAA and General Aviation Joint Steering Committee (GAJSC), with support from industry groups like AOPA, have been working together to advocate the use of AOA indicators in light airplanes as a way to encourage recognition and prevention of stall accidents. In the past, pilots and aircraft owners haven’t been all that eager to install them, though, based on cost and the red-tape problems associated with the installation process. In 2014, the FAA streamlined the process of installing AOA indicators, making it easier for aircraft owners to enjoy their benefits.

We know that a stall will occur any time the wing’s angle of attack - the angle between the chord line and the relative wind – exceeds its critical limit. But historically, pilots have been trained to monitor and fly precise airspeeds in order to prevent stalls. This is helpful, but only when the aircraft is in straight and level, coordinated, unaccelerated flight, when the aircraft’s stall speeds are quite low and where they are known and familiar for that particular flight configuration. But an aircraft can – and will - stall at any airspeed, any weight, any configuration, and any attitude when the critical angle of attack has been exceeded. While airspeed is a good guideline to use, it shouldn’t be the only one. Pilots should understand that the angle of attack, which is invisible, matters much more than the airspeed.

Enter the much talked about angle of attack indicator. It’s designed to help pilots determine the aircraft’s true angle of attack in real time, allowing the pilot to “see” the angle of attack in a way that’s not possible otherwise. This will be especially valuable to new pilots, who, through its use, will better understand the concept of angle of attack as it relates to different aircraft configurations and phases of flight.

So what will it take to install an AOA indicator? According to this article on AvWeb, not much. After the FAA approved the more streamlined process, most general aviation aircraft will not require an STC and the modification can be done by any A&P mechanic with just a logbook entry. AOA indicators for small general aviation aircraft like the Cessna 172 cost between $400 - $2000, depending on whether it’s electrical or mechanical, heated or not, pressurized or not, and other variables.



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