In the 1970's investigators discovered that more than 70% of air crashes involve human error rather than failures of equipment or weather. A NASA workshop examining the role of human error in air crashes found that the majority of crew errors consist of failures in leadership, team coordination, and decision-making.

That training focuses on group dynamics, leadership, interpersonal communications, and decision-making. The training is now known as Crew Resource Management (CRM). Dr. Lauber, a member of the National Transportation Safety Board, defined CRM as “using all available sources – information, equipment, and people – to achieve safe and efficient flight operations.� More specifically, it is the active process employed by crew members to identify existing and potential threats and to develop, communicate, and implement plans and actions to avoid or mitigate perceived threats. CRM supports the avoidance, management, and mitigating of human errors. The secondary benefits of effective CRM programs are improved morale and enhanced efficiency of operations.

Significance

CRM alerted the aviation industry to the human-to-human interactions that are an integral part of any team performance. This training has the potential to save lives and money, and prevent accidents and lawsuits as well.

While no one can assess how many lives have been saved or crashes averted as a result of CRM training or safety initiatives based on data from LOSA, the impact has certainly been significant. LOSA (Line Operations Safety Audit) data demonstrate that 98% of all flights face one or more threats, with an average of 4 per flight. Errors are also observed on 82% of all flights with an average of 2.8 per flight. Consistent with the outstanding safety record of commercial aviation, the great majority of errors are well managed and inconsequential, certainly due in large measure to effective CRM practices by crews. LOSA provides organizations and regulators with a valid means of monitoring normal operations. By understanding what crews do successfully as well as where things go wrong, training and safety initiatives can be made more effective.

A real-world example of how CRM may have saved lives can be found in psychologist David Myers’ Social Psychology textbook, comparing two airline crashes in the 1980’s:

Helmrich (1997)…notes that flawed group dynamics were evident when an Air Florida plane lifted off from Washington's National Airport on a winter day in 1982. Ice in a sensor caused the speed indicators to read too high, leading the captain to apply too little power as the plane ascended:

First Officer: Ah, that's not right.

Captain: Yes, it is, there's 80 [referring to speed].

First Officer: Nah, I don't think it's right. Ah, maybe it is.

Captain: Hundred and twenty.

First Officer: I don't know.

It wasn't right, and the First Officer's muting his concerns led to the plane's stalling and crashing into a Potomac River bridge, killing all but five people on board.

But in 1989, the three-person crew flying a United Airlines DC-10 flight from Denver to Chicago responded as a model team to imminent disaster. The crew, which had been trained in crew resource management, faced the disintegration of the center engine, severing lines to the rudder and ailerons needed to maneuver the plane. In the 34 minutes before crash landing just short of the Sioux City airport runway, the crew had to devise a strategy for bringing the plane under control, assessing damage, choosing a landing site, and preparing the crew and passengers for the crash. Minute-by-minute analysis of the cockpit conversation revealed intense interaction—31 communications per minute (one per second at its peak). In these minutes the crew members recruited a fourth pilot who was flying as a passenger, prioritized their work, and kept one another aware of unfolding events and decisions. Junior crew members freely suggested alternatives and the captain responded with appropriate commands. Bursts of social conversation provided emotional support, enabling the crew to cope with the extreme stress, and to save the lives of 185 of the 296 people on board.

Practical Application

Crew Resource Management training is now required for airlines in 185 countries by the International Civil Aviation Organization (ICAO), the regulatory component of the United Nations.

Attitudes are another indicator of effect as they reflect the cognitive aspects of the concepts espoused in training. While attitudes are not perfect predictors of behavior, it is a truism that those whose attitudes show rejection of CRM are unlikely to follow its precepts behaviorally. The attitudes that have been measured to assess the impact of CRM were ones identified as playing a role in air accidents and incidents (Helmreich & Foushee, 1993; Helmreich, Merritt, Sherman, Gregorich, & Wiener, 1993). Data from a number of organizations show that attitudes about flight deck management also change in a positive direction (Helmreich & Wilhelm, 1991). CRM does not reach everyone. From the earliest courses to the present, a small subset of pilots have rejected the concepts of CRM (Helmreich & Wilhelm, 1991). These CRM failures are found in every airline and are known to their peers and to management. Any chief pilot can identify these individuals, who have come to be known by a variety of names – Boomerangs, Cowboys, and Drongos to mention a few. Efforts at remedial training for these pilots have not proved particularly effective. While CRM is endorsed by the majority of pilots, not all of its precepts have moved from the classroom to the line. For example, a number of airlines have introduced CRM modules to address "The Drongo label", comes from Australia and is perhaps the most appealing. A Drongo is a small bird that flies around and defecates on the heads of unsuspecting passersby.

This view comes from informal interviews of crews asked “What is CRM?� A typical response is “Training to make us work together better.� While this is certainly true, it only represents part of the story. It seems that in the process of teaching people how to work together we may have lost sight of why working together well is important. The overarching rationale for CRM, reducing the frequency and severity of errors that are crew-based has been lost. CRM did not export well. As first and second generation CRM training programs began to proliferate, many airlines in the U.S. and around the world began to purchase courses from other airlines or training organizations. Even in the U.S., courses imported from other organizations had less impact than those that were developed to reflect the organizational culture and operational issues of the receiving carrier. The situation was much worse when training from the U.S. was delivered in other nations. In many cases, the concepts presented were incongruent with the national culture of the pilots. The data are also interesting in showing the impact of initial training. The airlines from which data are shown did not stress the effects of stress on behavior and the scores stayed relatively flat across the measurement period. We strongly endorse joint training as a means of enhancing overall performance. Our concern is with the dilution of meaning. This is not a criticism of proceduralizing CRM, which can aid in making the practices part of the culture.

The Dutch scientist, Geert Hofstede (1980) has defined dimensions of national culture, several of which are relevant to the acceptance of CRM training. High Power Distance cultures, such as China and many Latin American countries, stress the absolute authority of leaders. Subordinates in these cultures are reluctant to question the decisions and actions of their superiors because they do not want to show disrespect. Exhortations to junior crewmembers to be more assertive in questioning their captains may fall on deaf ears in these cultures. Many cultures which are high in Power Distance are also collectivist. In collectivist cultures where emphasis is on interdependence and priority for group goals, the concept of teamwork and training which stresses the need for effective group behavior may be readily accepted. In contrast, highly individualistic cultures such as the U.S. stress independence from the group and priority for personal goals. Individualists may cling to the stereotype of the lone pilot braving the elements and be less attuned to the group aspects of flight deck management. A third dimension, Uncertainty Avoidance, refers to the need for rule-governed behavior and clearly defined procedures (Merritt, 1996). High Uncertainty Avoidance cultures such as Greece, Korea, and many Latin American countries, may be much more accepting of CRM concepts that are defined in terms of required behaviors. The U.S. is low in Uncertainty Avoidance, which is reflected operationally in greater behavioral flexibility, but also weaker adherence to Standard Operating Procedures (Helmreich, Hines, & Wilhelm, 1996). Management of cockpit automation is also influenced by national culture. Pilots from high Power distance and/or Uncertainty Avoidance cultures show more unquestioning usage of automation while those from cultures low in Power Distance and/or Uncertainty Avoidance show a greater willingness to disengage (Sherman, Helmreich, & Merritt, in press). The low Uncertainty Avoidance of U.S. pilots may account, in part, for frequent failure to complete checklists and the imperfect acceptance of proceduralized CRM in this country. There is a growing trend for carriers outside the U.S. to include national culture as part of CRM training and to customize their programs to achieve harmony with their own culture.

Evolution of CRM

an important development that should enhance the impact of CRM in those organizations. Malaysian Airlines, for example, has made national culture a part of its program (Helmreich & Merritt, in press). Considering both the observed limitations of CRM in the United States and the differing reactions to the training in other cultures, let us now turn to the fifth generation of CRM training --one which we believe addresses the shortcomings of earlier training approaches.

FIFTH GENERATION CRM – SEARCH FOR A UNIVERSAL RATIONALE

We have been searching for a rationale for CRM training that could be endorsed by pilots of all nations--including the Drongos. Returning to the original concept of CRM as a way to avoid error, we concluded that the overarching justification for CRM should be error management(Helmreich & Merritt, in press; Merritt & Helmreich, 1997). In reaching this position, we were much influenced by the work of Professor James Reason (1990, 1997). While human error was the original impetus for even the first generation of CRM, the realization and communication of this was imperfect. Even when the training advocated specific behaviors, the reason for utilizing them was not always explicit. What we advocate is a more sharply defined justification that is accompanied by proactive organizational support. CRM as error management. Underlying the fifth generation of CRM is the premise that human error is ubiquitous and inevitable--and a valuable source of information. If error is inevitable, CRM can be seen as a set of error counter-measures with three lines of defense. The first, naturally, is the avoidance of error. The second is trapping incipient errors before they are committed. The third and last is mitigating the consequences of those errors which occur and are not trapped. The same set of CRM counter-measures apply to each situation, the difference being in the time of detection. For example, consider an advanced technology aircraft which experiences a controlled flight intoterrain (CFIT) because an improper waypoint is entered into the Flight Management Computer (FMC). A careful briefing on approach procedures and possible pitfalls, combined with communication and verification of FMC entries would probably avoid the error. Cross-checking entries before execution and monitoring of position should trap erroneous entries. Finally, as the last defense, inquiry and monitoring of the position should result in mitigating the consequences of an erroneously executed command before CFIT. To gain acceptance of the error management approach, organizations must communicate their formal understanding that errors will occur, and should adopt a non-punitive approach to error. (This does not imply that any organization should accept willful violation of its rules or procedures.) In addition to normalizing error, organizations need to take steps to identify the nature and sources of error in their operations. The U.S. Federal Aviation Administration has announced a new initiative, Aviation Safety Action Programs, to encourage incident reporting within organizations to deal with safety issues proactively (FAA, 1997). For example, American Airlines is participating in the program with the cooperation of the pilots’ union and the FAA. This confidential, non-jeopardy reporting system allows pilots to report safety concerns and errors. The program has proved to be a resounding success, with nearly six thousand reports received in a two year period. Data generated by this system allow the company to take steps to prevent or minimize the recurrence of incidents.
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This attitude of personal invulnerability is a negative component of the professional culture of pilots and physicians (Helmreich & Merritt, in press).Training that demonstrates that these are erroneous or over-confident beliefs and that every individual is subject to stress can foster more realistic attitudes by reducing the onus attached to personal vulnerability. In turn, pilots who recognize the performance degradation associated with stress should more readily embrace CRM training as an essential counter-measure. In theory, the error management approach should provide a more compelling justification for CRM and human factors training, but the impact remains to be evaluated empirically. Continental Airlines has refocused both the basic awareness and recurrent components of CRM as error management. As part of their commitment to this approach, all pilots were given the new basic course. Data on the outcomes of this program should help determine the effectiveness of the fifth generation approach. At the same time that error management became the primary focus of CRM training, Continental introduced a new program to train instructors and There are many positive aspects of pilots’ professional culture such as pride in job and motivation that contribute strongly to safety.

THE VIEWS AND REPORTS EXPRESSED HERE ARE SOLELY FOR INFORMATION AND SHOULD BE TAKEN AS A GENERAL DESCRIPTION OF CRM AND NOT OTHERWISE - ADMINISTRATOR. Basecrew.com makes no guarantees, express or implied regarding the validity of information found in any or all the pages of basecrew.com. - administrator