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Hus Bos Winter Lectures 2009

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Presentation on theme: "Hus Bos Winter Lectures 2009"— Presentation transcript:

1 Hus Bos Winter Lectures 2009
Airmanship Chas Cowley CFI – 21 Feb 09

2 QUESTION: Where is this?
(what sort of place would have a road called ‘Airmanship Road’ ?

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4 Recognise it yet?

5 ANSWER: …which is the home of: RAF College Cranwell
Central Flying School

6 What is AIRMANSHIP ? Airmanship is skill and knowledge applied to aerial navigation, similar to seamanship in maritime navigation. Airmanship covers a broad range of desirable behaviours and abilities in an aviator. It is not simply a measure of skill or technique, but also a measure of a pilot’s awareness of the aircraft, the environment in which it operates, and of his own capabilities Wikipedia

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8 LMQ (‘Crew Resource Management’ trainers)
What is AIRMANSHIP ? …some other suggested definitions AIRMANSHIP is: The (technical and non technical) knowledge, skills and attitudes aircrew employ to operate an aircraft effectively, efficiently and safely. LMQ (‘Crew Resource Management’ trainers) (Author of ‘Airmanship’ – Carey Edwards is a director)

9 Airmanship is acquired through experience and knowledge
What is AIRMANSHIP ? …some other suggested definitions Airmanship is the application of flying knowledge, skill and experience which fosters safe and efficient flying operations. Airmanship is acquired through experience and knowledge Transport Canada

10 What is AIRMANSHIP ? …some other suggested definitions
‘…true airmanship is the ‘total package’ requiring both physical and cognitive skills and an appropriate attitude. These three essential ingredients can be labelled as judgement, control and discipline. Airmen need a balance of these to excel at their job. ‘ Human Factors Department at Advanced Technology Centre Good airmanship is that indefinable something, perhaps just a state of mind, that separates the superior airman/airwoman from the average. It is not particularly a measure of skill or technique, nor is it just common sense. Rather, it is a measure of a person's awareness of the aircraft and its flight environment and of her/his own capabilities and behavioural characteristics, combined with good judgement, wise decision making, attention to detail and a high sense of self-discipline. Recreational Aviation Australia Inc

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12 Airmanship = safe flying = avoiding getting into a high risk situation
What is AIRMANSHIP ? …some other suggested definitions Airmanship = safe flying = avoiding getting into a high risk situation AND recovering OK when something bad does happen Chas Cowley

13 Why do we need safer gliding?
BGA ‘Safer Gliding’ program Why do we need safer gliding? Fewer tragedies Avoid over regulation Retain insurance Fewer repetitions of common accidents does not mean avoiding normal risks or taking the fun out of gliding 13

14 Numbers of accidents in 2008
fatal injury serious injury minor Injury crash minor/no damage all 2008 6 12 51 69 120 2007 4 9 16 53 73 126 2006 3 7 8 54 91 145 weighted average 2.7 4.4 11 39 108 14

15 Serious injury accidents in 2008
Undershoot, instructing Field landing, unlandable terrain, mutual Field landing, overshooting, cartwheel Spin from final glide Undershot, hit tree Lost locally, landed through barbed wire 15

16 Pattern of crashes in 2008 no collision, fewer winch, fewer stall/spin
16 field landing; 19 field landing including the 3 in stall/spin 12 landing on home airfield; this is double the average rate otherwise, a repeat of the average pattern 16

17 2008 was the first year since 1985 with no fatal accidents
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19 Winch accidents in 2008 no fatal or serious injury accidents 4 crashes
Two no-injury accidents/incidents could have been fatal glider climbed to a stall after hitting the ground followed by back release of the cable pilot slid up the seat and inadvertently pulled the stick back to cause a stall So no grounds for complacency 19

20 Winch accidents 2006-2008 (the 3 years of the BGA safe winch launch campaign)

21 Winch accident summary 2006-8
one fatal accident, cartwheel one serious injury accident, cartwheel 10 crashes 35 accidents and incidents 21

22 Winch fatal and serious injury accident rates from 1974-1998 and from 1999-2005 were identical
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23 23

24 Winch fatal and serious injury accident rates from 2006-2008 were lower
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25 25

26 Winch summary 2 fatal/serious injury accidents instead of the 7 expected at the rate for no fatal/serious injury accidents from uncontrolled flight 10 crashes instead of 21 wing drop accidents continue instructing accidents continue lesser accidents continue 26

27 What does this data mean?
It suggests: real progress in educating inexperienced pilots on how to winch launch safely no success in persuading experienced pilots to release if they cannot keep the wings level no success in reducing instructing accidents 27

28 Conclusions for 2008 zero fatal accidents is only significant if it repeats in 2009 except for winch launches, accidents in 2008 reflect the way we do things fewer accidents requires changes in the way we do things 28

29 Tony Kern’s airmanship model

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31 Situational Awareness
Judgement Situational Awareness Self Team Risk Aircraft Environment Proficiency Skill Discipline Tony Kern’s airmanship model

32 Know the rules: Stick to them: Rules of the air Air Navigation Order
BGA Laws & Rules Club Flying Order Book Good practices ‘Common sense’ Stick to them: Personal pride Embarrassment Peer pressure ‘Consequences’ Safety culture Discipline Tony Kern’s airmanship model

33 Four levels of skill: Precision & continuous improvement
Efficiency Effectiveness Safety Skill Discipline Tony Kern’s airmanship model

34 Currency: ….flying is NOT like riding a bike
Just because it’s legal doesn’t mean it’s safe (3 landings in the last 90 days???) Assessing proficiency? Be conservative – ‘trust no one’ Patterns of physical skill loss – fastest in areas of finesse Mental proficiency – lost faster than physical skills ‘Chair flying’ – a good idea to rehearse – sitting and thinking… Proficiency Skill Discipline Tony Kern’s airmanship model

35 Tony Kern’s airmanship model
I Illness M Medication S Stress A Alcohol F Fatigue E Eating Under / over CONFIDENCE Personality type Press-on-itis Macho Complacency Deference Stress Self Proficiency Skill Discipline Tony Kern’s airmanship model

36 eg: Type conversion Tony Kern’s airmanship model The FLIGHT MANUAL
Knobs and levers Systems: – GPS / Flight computers / Varios Weight & Balance Ventilator / demisting Flaps Wheel Complex types…checklists eg: Type conversion Self Aircraft Proficiency Skill Discipline Tony Kern’s airmanship model

37 CRM….Crew Resource Management
Teamwork Decision making … ‘risky shift’… ‘groupthink’ Communication Error management …Intervention Leadership / followership ‘Sterile cockpit’ in critical phases (US Air Force use this) Self Team Aircraft Proficiency Skill Discipline Tony Kern’s airmanship model

38 Tony Kern’s airmanship model
Airfield Weather Traffic Terrain Airspace Club / BGA CAA / EASA Foreign countries Self Team Aircraft Environment Proficiency Skill Discipline Tony Kern’s airmanship model

39 Tony Kern’s airmanship model
Self Team Risk Aircraft Environment Proficiency Skill Discipline Tony Kern’s airmanship model

40 ? Risk RISK = Potential Consequence x Probability
of a HAZARD of an incident ?

41 Consequence (eg No. of deaths)
EXAMPLE of the risk calculation ALARP = risk ‘As Low As Reasonably Practicable’ - Lord Justice Asquith 1949 UK Health & Safety Exec - Risk management: ALARP Suite of Guidance 1 in a thousand Intolerable Probability 1 in a million ALARP ‘Tolerable’ 1 in 100 million 1 10 100 Consequence (eg No. of deaths)

42 ….and the ‘Swiss Cheese’ theory of incidents
Hazard/ Risk Barriers or Controls Undesirable outcome Risk Management ….and the ‘Swiss Cheese’ theory of incidents

43 DAL 39 10 Dec 1998; 10:32

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45 RUNWAY 24

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47 OPERATIONAL CONDITIONS
On the day of the incident, low visibility and a low cloudbase made visual control from the tower impossible. Radar had to be used to direct air and ground traffic A few minutes earlier, Air Traffic Control had changed runway use configuration from two landing runways (19R and 01R) and one departure runway (09) to the so-called outbound mode with one landing runway (19R) and two departure runways (09 and 24)

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49 The DAL 39 event scenario Pilots see 747 and abort take-off
Poor ergonomics of radar screens and runway stopbar controls Pilots see 747 and abort take-off Routine violation of tow procedures Complex airport structure Tower combining training and operations during difficult periods Controller gives clearance without assurance of tow position

50 PROBABLE CAUSE The following causal factors were identified:
Low visibility weather conditions which prevented Air Traffic Control to visually identify vehicles on the ground Inadequate information during the radio communications between tow (yellow van) and Tower Misinterpretation of position and movement of the tow Take-off clearance without positive confirmation that the runway was unobstructed Insufficient teamwork and supervision.

51 KEY LEARNINGS The incident was triggered by a momentary loss of ‘Situation Awareness’ But there were several underlying ‘latent failures’ which colluded: - unclear tow procedures - poor communication between controllers - poor ergonomics of ground radar displays - poor ergonomics of runway access barrier controls - poor shift change procedure - insufficient supervision during training - pressure to deliver operational performance Lack of MINDFULNESS (airmanship…?)

52 Linate airport, Milan, Italy, 8 Oct 2001 118 dead

53 Tenerife airport, Canary Islands, 27 March 1977 560 dead

54 ? Risk RISK = Potential Consequence x Probability
of a HAZARD of an incident ?

55 Managing Risk identify hazards assess the risks
maintain good barriers: - to reduce the probability of things going wrong - and also to cope in case they do

56 Situational Awareness
Self Team Risk Aircraft Environment Proficiency Skill Discipline Tony Kern’s airmanship model

57 Situational Awareness
What’s happening around you ? What does it mean to me ? What’s going to happen ? What ? So what ? Now what ?

58 Situational Awareness
Five ways to improve it Define roles Manage distractions Reduce workload Avoid complacency Test assumptions Intervene (…actually it’s six…)

59 Situational Awareness
Judgement Situational Awareness Self Team Risk Aircraft Environment Proficiency Skill Discipline Tony Kern’s airmanship model

60 Judgement Decision-making: Assess the situation Determine options
Rule-based decisions (STANDARD PROCEDURES) Knowledge-based decisions Aviate….Navigate…..Communicate ‘Threat & Error Management’ - a recent and very current technique that is used in airlines, the RAF etc…

61 Situational Awareness
Judgement Situational Awareness Self Team Risk Aircraft Environment Proficiency Skill Discipline Tony Kern’s airmanship model

62 Threat and Error Management
‘Defensive driving’ for pilots Asks - what are the likely hazards ? - What are likely errors I could make? …based on analysis / history Plan accordingly

63 Airmanship Have fun – and stay safe!

64 Airmanship - Tony Kern video
Postscript: links to a few sites I found interesting: Airmanship - Tony Kern video PPrune avweb airmanship The Inner Art of Airmanship


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