Back seat drivers: An under valued safety net (or: On perception and decision making)

Have you ever been driving with your mother on the passenger's seat identifying all sort of potential threats? Well, this is what I am talking about: to what extent is this a nuisance and to what extent, if used effectively and appropriately, could serve us as a safety net in our safety critical work:

In human factors we best describe the way how we arrive to take decisions through what is called the Human Information Processing Model.

In a nutshell we receive data from outside in the form of stimuli. This 'raw data' is received through our senses. We perceive this data through an internal processing system (something like when a computer processes data to produce information). Internally we process the data through a series of iterations between our short term (or working) memory, which temporarily keeps the data we receive and the longer term memory from which we retrieved learned information (that we acquired through previous experiences). We mish-mash, reiterate, and make sense of the situation (situational awareness). This awareness is kept in the short term memory, and through it we take decisions.

I put a drawing to illustrate the process.

[caption id="" align="aligncenter" width="272"] Human information process model[/caption]

In safety critical operations (but not just) we want to take correct decisions, and using the model above, the correctness depends on a number of factors which include our ability of physically receive the data, to have a will functioning long and short term memory and that the long term memory contains relevant content (skill / knowledge / experience).

But we also depend on perception.

And perception can be tricked. What we perceive depends on context, on the situation, on our long term memory and on a number of other factors that are beyond our control. Beyond our control because we have evolved this way. We need this perception processing to help us make sense of the world, it is just that sometimes, our perception is not adapted to the situation and it tricks us...and we take wrong decisions...

Watch this very interesting TED video on perception if you have any doubts on what I am saying.

 Convinced?

Well, then what do we do?

The first step is to be aware of it (as many people unfortunately are not and think that what they perceive is the same as what is physically out there.)

The second is to find methods for mitigation and what can these be in our safety critical operations?

Well here is some advise:

1. If we are designers of systems, procedures, programmes, etc. we should be aware and sensible about perception and how our brain works. In small projects where resources and impact are limited, we should consider whether we could create situations, where without wanting, the minds of those operating could be 'tricked' into wrong decisions. If we are talking about bigger projects, then we should involve Human Factors Experts and have a process like Eurocontrol's Human Factors' Case.

2. If we are those on the hot seat, we will need to find ways to mitigate. Here are some:

Train ourselves to identify patterns where things may start going into a wrong direction: Example of these, is to be aware of the environment and identify feedback received by it, and start noticing and questioning when this feedback seems 'strange'. It is like sharpening our instincts. This can be done through training, but mainly involves experience, power of observation and self criticism.

Another mitigation is team situational awareness. Having a team working we are adding more resources that can identify patterns and we are adding diversity to perception bias. Team situational awareness means that other team members, are aware of what you are doing and are following the same situation but from a slightly different role / angle. The trick is not to do the same tasks, as here we are reducing diversity. It is to have complimentary tasks whilst sharing similar awareness of the situation. How do this? To start with we need to have a minimum degree of competence in the tasks. We also need to be familiar with the team, and with the individuals composing the team, how we all work, procedures, practices, etc. This is a process which is built over time and through meetings, sharing of experiences, etc. We need to have agreed ways of working as a team, not to give each other unnecessary frights (remember your mother on the passengers seat giving you the fright of your life?) Then the person making the decisions (I am thinking short term decisions, such as taking actions whilst controlling aircraft or maintaining a system) should articulate the decision they are about to take. This allows the other team member(s) to follow the process and to be aware of what is going on. Other team members would need to keep to their tasks and not get 100% involved in the task of the team member they are helping out (we're not talking of 2 drivers here). For example, if we have a situation with an executive controller and a coordinator, those who have experienced this would agree that whilst both following the same situation, if the roles are respected, the coordinator is able to keep a view of the broader picture, whilst following what the executive is doing. On the other hand, the executive is focussing on responding and taking an active role in the decisions. As those who have observed someone in the hot seat would tell you, from the back seat you see things that you wonder how come the person acting has not yet seen, yet when the observer switches seats and goes into the hot zone, his / her perspective also changes. This happens in every day life with back seat driving - thus the example which gave the title to this post. In ATC this happens with the instructor role for example.

What we need to do is to make the best of this situation and use it to identify issues that are being missed by the hot seat and assist in this way. This is team situational awareness...

To summarise:

  • We experience the environment in a processed manner called perception.
  • While what we perceive feeds into the decisions we take, what we perceive is not necessarly what is going on. This is not a weakness, it is a state of us being human and alive.
  • In order to mitigate this danger we need to first be aware of this.
  • Then we can do a number of things to mitigate further. Two of these are:
    • Train ourselves in identifying feedback patterns from the environment where things seem to be wrong, a sort of sharpening our instincts. This comes with training but mostly with experience
    • Build team situational awareness. For this we need a team. We need to share tasks in a complimentary manner to allow things to be perceived through at least slightly different contexts. We need to articulate our decisions, and we should not be afraid of having situations where one of us is on the hot seat and the other on the back seat. Both are complimentary functions.

 These are the kind of things we at AriaTM teach and facilitate during our Team Resources Management sessions.

Security breach: Remotely hacking into aircraft FMS

I do not consider myself someone who alarms himself easily, nor someone who likes to alarm others. However, recently, I came across a presentation, which was also was reported on some websites, about someone, Hugo Teso, who reported having managed to remotely hack into the FMS system of an aircraft by using ACARS. This report was done during a security conference in Amsterdam earlier this year.

He reported he managed to hack into a replica of a Flight Management System (FMS) in a simulator and cause the aircraft to crash. If this is the case, the implications may be great and security upgrades should be implemented fast on the vulnerable systems. In the presentation it says that he used two vulnerable systems which are in wide use: he used ADS-B to find an aircraft, as the ADS-B gives information about the aircraft's 4d position (time, lat, long & altitude), then through ACARS he contacts the aircraft and tries to hack into the FMS (as ACARS has a connection to uplink information to the FMS, so the connection exists).

Once into the FMS he was able to manipulate it.

Well for me this is very worrying, much more worrying than bringing liquids which have not been verified on-board.

The only comfort is that the report is proactive (it is done before something has really happened) and that it concludes with a note that work is being done by EASA to solve the security vulnerabilities.

Aircraft Altimeter Failure

"An altimeter failure on a PC12 aircraft caused a 2000 ft discrepancy between the displayed altitudes on the aircraft’s two altimeters. This contributed to a very serious airprox which identified a number of safety issues of interest to the aviation community...." This is a very interesting read from Skybrary...to read the full article click here  

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Buy Estrace Vaginal Cream Without Prescription, Safety action: the steps taken or proposed to be taken by a person, organisation or agency in response to a safety issue.

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There is a conflict between the Spanish Government and AENA management on one side and the controllers, ordering Armour online, Effects of Armour, represented by their trade union on the other. This conflict has seriously grown in proportion [and out of it] in the recent months, Armour trusted pharmacy reviews. Armour from canadian pharmacy, The conditions of the controllers have been severely degraded over the past year. The degradation has been drastic, Armour For Sale.

The financial situation of AENA [and of the Spanish state] seems very difficult, Armour australia, uk, us, usa. Order Armour online c.o.d, The controllers walked out of their working positions on Friday the 3rd of December. This action was and could be interpreted as a ‘savage’ – but pre-meditated strike as it fell on the beginning of a long week end in Spain, buy Armour no prescription, Armour use, but the situation seems to be more complex, but I fail to understand exactly what trigerred it on 3/12, buy Armour without a prescription. Armour steet value, Without passing judgements into who is right or guilty, I think that in any conflict every side has its responsibilities to bear.  However, is Armour safe, Where can i cheapest Armour online, my sympathy and worry goes with the individuals who are or could potentially be affected by this conflict:

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  • GREEN hydraulic system (powered by engines 1 & 2) - low system pressure and low fluid level

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What will also be interesting but which does not come clear from the preliminary report is the extent of the contribution of a 5 person flight crew had over the positive resolution of the incident [i.e, Reglan For Sale. successful landing and evacuation, Reglan pics, Reglan blogs, 0 injuries]. Were 5 better than 2, about Reglan. Reglan no rx, To what extent. how, Reglan recreational. Reglan For Sale, Or were they of hindrance?  How did they distribute the roles. Reglan natural, Etc. Would a 2 person flight crew have sufficed, buy generic Reglan. Is Reglan addictive, I guess these human factors considerations will be delved into during the full report...

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