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Published byPrimrose Briggs Modified over 8 years ago
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NCPSC – 2009 Who are we? Why are we here? What to be expect to learn?
When is this over? What happens next? Were we successful?
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LOTS OF QUESTIONS… Professional Pilots THE ANSWER IS…….. Vocation?
Something more? What does it take then? Is it ‘trainable’? If so, how? LOTS OF QUESTIONS… THE ANSWER IS……..
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LAST LINE OF DEFENSE Why here? Why now? CAPR 60-1 FLWG Supplement
Nothing better to do Give back to the aviation community Self improvement Make a difference. LAST LINE OF DEFENSE
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THREAT & ERROR MANAGEMENT (TEM)
Topics of Discussion AIRMANSHIP THREAT & ERROR MANAGEMENT (TEM)
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AIRMANSHIP Definition?
Hard to define, but easy to see examples of failures. “Total airmanship blends technical and tactical expertise, proficiency, and a variety of human factors to smoothly and effectively integrate the capabilities of the pilot and the machine.” Tony Kern – Flight Discipline
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AIRMANSHIP Principals PROFICIENCY SKILL Areas of Expertise DISCIPLINE
The bedrock that all else is built upon Poor foundation will never support the higher levels Areas of Expertise What we need to know to be successful Core structure needed to achieve the desired results Outcomes Endgame (Capstone) PROFICIENCY SKILL DISCIPLINE
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AIRMANSHIP Areas of Expertise Outcomes
What we need to know to be successful Core structure needed to achieve the desired results Outcomes Endgame (Capstone)
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There is only one kind of discipline …..
perfect discipline Gen George Patton
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Flight Discipline Defined
“Flight discipline is the strength of will required to systematically develop all areas of airmanship and execute sound judgment in the presence of temptations to do otherwise, as well as to safely plan and employ an aircraft within all operational, regulatory, organizational, and common sense guidelines.” Tony Kern – Flight Discipline
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Who creates Flight Discipline?
Individual Pilots Study habits, mission preparation, briefings, SOP adherence Crewmembers Active participation or just along for the ride. Commanders Zero Tolerance vs. Good Pilot Syndrome Organizations Internal (FLWG, NHQ, 1AF) External (ATC, FSS, FBO)
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CAUTION: ROUGE PILOT AHEAD
The ‘Other’ Side What happens when discipline fails? CAUTION: ROUGE PILOT AHEAD
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Rogue Pilots What is a ‘rogue’ pilot? Definite traits?
Once rogue – always rogue? Rogue defense.
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CZAR 52 Crew AC: 92 BWG DOV – 24 yr veteran Co-pilot: IP (325BS CC).
Radar Nav: 325BS Operations Officer Observer: 92BW VC, and was added as a safety observer by the WG CC. "Fini-flight," Upon landing, Colonel Wolff was to be met on the flight line by his wife and friends for a champagne toast to the end of a successful flying career.
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Fairchild AFB, 24 June 1994 Airshow Practice
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Rouge Outcomes Long-standing record of rogue behavior
Total failure of flight discipline at all levels. Superiors : “One of the best; a real SA guy” Junior Officers: “He is going to kill people one day and its NOT going to be me” DISCONNECT? What do we do to protect ourselves?
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Take a Good Long Look…
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Skill Levels Safety: Passed the checkride and now have a license to learn. Effectiveness: Basic mastery to perform our duties. F5/F91 level. Efficiency: Fly more efficiently than standard. Maximizes all resources. Precision and Continuous Improvement: “My 3kt window was ok. How could I have done it better?” Requires honest self-appraisal.
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Proficiency Legal vs. Safe Personal currency
NOT the same Personal currency Should be tailored to fit your (our) operations Night, Xwind, low vis / GPS approaches Not (necessarily) required by regulations Currency is just the beginning of proficiency
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Hands vs. Mind Mental Currency & Proficiency Factors involved
Cue recognition Mental response patterns & ability Decidedly cognitive processes Factors involved Time out of the seat Aging process Strategies Recognition “Chair Flying” = Reinforcement
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Force Multiplier Skill + Proficiency = CONFIDENCE
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NEVER BE THE HERO OF YOUR OWN STORIES
One Last Word Regarding skill and confidence………….. NEVER BE THE HERO OF YOUR OWN STORIES
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Areas of Expertise What areas of expertise do we need to build on our principals to be effective? SEL F TEAM E V I O R N M T A I R C R A F T RISK PROFICIENCY SKILL DISCIPLINE
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Self Medical Airworthiness (MAW) Psychological Airworthiness
Medications (prescriptions & self-medication) Fatigue, sleep, illnesses Vision Other (stress, alcohol) Psychological Airworthiness Attitude Anti-authority, get-home-it is, machismo, resignation, complacency, invulnerability, impulsiveness Maturity
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“I’M SAFE” I Illness: Do I have any symptoms? M
Medication: Are you using any kind of prescription or drugs? S Stress: Am I under psychological pressure from the job or home? A Alcohol: Have I been drinking within 8 hrs? Within 24 hrs? F Fatigue: Am I tired and not adequately rested? E Eating: Have I not been eating and drinking adequately?
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Team CRM – Crew Resource Management Who is the “Team” MO, MS
IC, AOBD, Mission Briefer ATC, FSS Automation
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Team Leadership Set and communicate the expectations and the standard
Set the tone and example Establish norms Break down boundaries (you vs. we) Establish the appropriate amount of authority based on the current capabilities and qualifications of the team
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Team Followership Bad Examples Good Examples Sheep Yes Men Survivors
Good listening skills Assertiveness Ask good questions, offer good suggestions, “get in the game”
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ALL OF US COMMUNICATION Team
The key to successful leadership and followership? COMMUNICATION Who are the examples of leaders here today? ALL OF US
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Environment Physical Environment Regulatory Environment
Terrain, weather, VMC/IMC, day/night, performance factors (DA) Regulatory Environment FAA, CAP, FLWG Organizational Environment Corporate culture Command responsibility “To condone is to encourage” Pilots all too often do what they observe, not what they are told.
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Aircraft Systems Knowledge Procedural Knowledge The key?
Don’t have to built it, but….. Procedural Knowledge “Notes, Cautions, and WARNINGS” Limitations The key? Continuous and systematic study.
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Risk Risk defined Risk assessment Risks to discipline The act of doing
ORM Perceived capabilities vs. mission requirements Personal capabilities - Mission demands = Margin of Safety Risks to discipline “Mission accomplished” Temptations caused by lack of oversight or supervision
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Risk Risks to skill and proficiency Risks to knowledge
Poor personal focus, inadequate resources, conflicting demands Risks to knowledge Personal attitude toward learning Rapidly changing technical data Organizational philosophy
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Risk – The Bottom Line Identify the known risks
Anticipate the unknown risks (what if’s) Do not accept unnecessary risk Make risk decision at the appropriate level Accept risk only when the benefits outweigh the costs
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SITUATIONAL AWARENESS
Capstone Outcomes JUDGEMENT SITUATIONAL AWARENESS SEL F TEAM E V I O R N M T A I R C R A F T RISK PROFICIENCY SKILL DISCIPLINE
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Capstone Outcomes SA Situational Awareness SA What has happened
What is happening What might happen
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CREWMEMBER EXPERIENCE
Situational Awareness CABIN TEMP VERTICAL NAV ALT WX ROUTE DISCREPENCY SYSTEM MALFUNCTION ALTITUDE AIRSPEED MISSION PROFILE You are here ALTERNATE WX HEADING ENGINES FUEL STATUS THUNDERSTORMS FLIGHT CONTROLS Terrain ARRIVAL ETA CREWMEMBER EXPERIENCE DESTINATION WX LATERAL NAV TRAFFIC TRIM
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SA for Eagle Drivers (Wagg 1993)
Building a composite image of the entire situation in three dimensions Assimilation of information from multiple sources Knowing spatial position and geometric relationships Periodically updating the current dynamic situation Prioritizing information and actions Making quality and timely decisions Projecting the current situation into the future
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SA for CAP Drivers Are we any different?
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Loss of SA – Symptoms Ambiguity or Confusion Fixation
Reduced communications Failure to meet targets Failure to stay ahead of the aircraft Failure to follow normal habit patterns Attempting to operate outside known limitations
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Loss of SA - Actions Get away from all rocks, trees, and dirt
Stabilize the aircraft, situation, and yourself Buy time to understand the situation Seek information Get back in the game When all is over – analyze!
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SA and CRM Define roles Manage distractions Reduce workload – delegate
Avoid complacency Test assumptions Intervene when necessary – Be assertive
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Joint Situational Awareness
SA is dynamic MO MS MP MS MP MO MS FO MO Communication !
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Threat & Error Management (TEM)
“Who Me? Make a error?” Threats? CAP specific Non-CAP specific
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Physical Distractions
Influences or threats that can lead to error Mission Completion Physical Distractions ATC Other Crew Terrain Weather Maintenance Similar call sign Line Crew Time pressures Flight diversion Heavy traffic System malfunction Unfamiliar airport Automation event Missed approach
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Threat Threats = Red Flags
Anything that increases the complexity of the operation. An event or error that happens outside the influence of the crew that if mismanaged could result in safety being compromised. Routine everyday occurrences Threats = Red Flags
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CREWMEMBER EXPERIENCE
Situational Awareness CABIN TEMP VERTICAL NAV ALT WX ROUTE DISCREPENCY SYSTEM MALFUNCTION ALTITUDE AIRSPEED MISSION PROFILE THREATS You are here ALTERNATE WX HEADING ENGINES FUEL STATUS THUNDERSTORMS FLIGHT CONTROLS ERRORS Terrain ARRIVAL ETA CREWMEMBER EXPERIENCE DESTINATION WX LATERAL NAV TRAFFIC TRIM
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Threat and Error Model TIME Threat Crew Error Undesired Aircraft State
Incident
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How to Manage Threat and Error
Avoidance Threat Management Countermeasures Error Management Undesired Aircraft State Management
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Countermeasure Skills
Communication Leadership Team Climate Threat and Error Avoidance Briefing Stating Plans Workload Assignment Contingency Management Planning Threat Management Error Management Monitor / Crosscheck Workload Management Automation Management Execution Undesired Aircraft State Management Review / Modify Evaluation of Plans Inquiry Assertiveness
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Threat and Error Avoidance
TIME Threat and Error Avoidance Threat Threat Management Crew Error Error Management Undesired Aircraft State Undesired Aircraft State Management Threat and Error Management Model Incident
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Judgment FAA Defined – “The process of recognizing and analyzing all available information about oneself, the aircraft, the flying environment, and the purpose of the flight. This followed by a rational evaluation of alternatives to implement a timely decision which assures safety. Pilot judgment thus involves one’s attitude towards risk-taking and one’s ability to evaluate risks and make decisions based on one’s knowledge, skill, and experience.” FAA 1988
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Judgment Involves decision-making Rule based Knowledge based
Requires both knowledge of the rules and the integrity to follow them Knowledge based Well-defined: Can be solved with checklists, SOPs, and good discipline Ill-defined: Need to call on all resources to make a good call. Team concept.
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Personal Final Word on Judgment
Answer the 3 questions……… IS IT LEGAL? IS IT SAFE? DOES IT MAKE SENSE?
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Decisions Then ……..
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Decisions Now …
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Kern’s Airmanship Model
JUDGEMENT SITUATIONAL AWARENESS SEL F TEAM E V I O R N M T A I R C R A F T RISK KNOWLEDGE SKILL DISCIPLINE
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What next? Responsibilities & Expectations COMMAND YOU FLWG PILOTS
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Command Responsibilities
Set the standard Clearly communicate the standard in what we do, what we say, what we write, and how we respond Enforce the standard
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Command Responsibilities
Support field operations Training Programs & Initiatives Training funding Support for the CP and CPE Create an open environment for discussion Reassess as necessary
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Field Input
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Check Pilot Responsibilities
Demonstrate Superior Airmanship “Walk the Talk” Set the Standard for knowledge, stick and rudder skills, appearance Be consistent Spread the word Help make good airmanship contagious Obligation to mentor Band of Brothers
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Check Pilot Responsibilities
Protect our members and our assets Make the Hard Calls Enforce the Standard ZERO TOLLERANCE for those that exhibit poor flight discipline Be a role model “I want to be like him” Be the Standard
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Who are we? A PILOT MEANS TO BE ONE OF THE TRUSTED. A PILOT MEANS TO BE SKILLFUL, STRONG, AND WISE. TO BE A PILOT IS TO HOLD LIFE IN YOUR HANDS. TO BE WORTHY OF FAITH. YOUR JOB IS A TRUST. YOU ARE ONE OF THE TRUSTED. WHO COULD BE MORE?
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"Fast is fine…but accurate is final"
Wyatt Earp "Fast is fine…but accurate is final"
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“NOT ON MY WATCH”
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