13. Human Error and Reliability Flashcards
Reliability and Decision Making
What is the term that describes a measure of the probability of a human committing an error
HUMAN RELIABILITY
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Reliability and Decision Making
Actively and consciously choosing between 2 or more options is what
A DECISION
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Reliability and Decision Making
What is the definition of a decision
ACTIVELY AND CONSCIOUSLY CHOOSING BETWEEN 2 OR MORE OPTIONS
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Reliability and Decision Making
What are the 2 basic types of rational reasoning
- REASONING - Work out what you must do to achieve a certain goal
- LOGICAL REASONING - solve an abstract problem of logic
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Reliability and Decision Making
Of the 2 basic types of rational reasoning, which one are humans typically good at
REASONING TO WORK OUT WHAT YOU MUST DO TO ACHIEVE A CERTAIN GOAL
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Reliability and Decision Making
Of the 2 basic types of rational reasoning, which one are most people poor at
SOLVING PURE LOGIC PROBLEMS
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Reliability and Decision Making
What are 3 common factors that the decision making process is influenced by;
- ____ : looking at the clock
- ____ : happy, sad, anxious
- ____ : looks dangerous
- TIME PRESSURE
- EMOTION
- ASSESSMENT OF RISK
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Reliability and Decision Making
Time pressure is likely to lead to what sort of decision being taken
RISKIER
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Reliability and Decision Making
Risk Assessment involves identifying ____, assessing the ____ of the threat occurring and then assessing the ____ of the threat
- POTENTIAL THREATS
- PROBABILITY
- SEVERITY
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Reliability and Decision Making
Deciding to do something without going through a conscious evaluation of the options is an example of what
ACTING ON IMPULSE
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Reliability and Decision Making
Decisions should ideally be what
Opposite to acting on impulse
RATIONAL
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Reliability and Decision Making
Decision making can be influenced by what 6 factors;
- ____ : nice bubbly person
- ____ : leaning to this decision
- ____ : something that happened a long time ago
- ____ : high pressure workload
- ____ : lack of knowledge
- ____ : other individuals
- PERSONALITY : nice bubbly person
- BIAS : leaning to this decision
- PAST EXPERIENCE : something that happened a long time ago
- STRESS : high pressure workload
- TRAINING : lack of knowledge
- GROUP OF PEOPLE : other individuals
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Reliability and Decision Making
What are the 9 complete stages of the decision making process;
- ____ : most important feature of the problem is identified along with the most desirable outcome
- ____ : gather as much of this as possible in the time available
- ____ : identify the degree of risk involved
- ____ : All options available
- ____ : weight up the consequences of options available
- ____ : which course of action to take
- ____ : execute
- ____ : observe
- ____ : was the decision valid
- DEFINE THE AIM : most important feature of the problem is identified along with the most desirable outcome
- COLLECT INFORMATION : gather as much of this as possible in the time available
- ASSESS THE RISK : identify the degree of risk involved
- DEVELOP OPTIONS : All options available
- EVALUATE THE OPTIONS : weight up the consequences of options available
- DECIDE : which course of action to take
- IMPLEMENT : execute
- MONITOR CONSEQUENCES : observe
- REVIEW : was the decision valid
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Reliability and Decision Making
Good decision making requires what, which closely matchin the real-world situation
MENTAL MODELS
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Reliability and Decision Making
When an incomplete mental model is formed, what is likely to occurr
ERRORS
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Reliability and Decision Making
Errors occur as a result of what
INCOMPLETE MENTAL MODELS
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Reliability and Decision Making
A mistake is a result of what
FAILED PLAN OF ACTION
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Reliability and Decision Making
A failed plan of action results in what
A MISTAKE
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Reliability and Decision Making
Faulty plans are a result of what
FAULTY DECISIONS
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Reliability and Decision Making
An extreme situation that occurs suddenly with little warning is likely to trigger what in a pilot
STARTLE RESPONSE
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Reliability and Decision Making
A startle response is associated with sudden what
As a result, individuals may suffer from significantly reduced ability to think effectively for how up to how long
- PHYSIOLOGICAL AROUSAL
- 60 SECONDS
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Reliability and Decision Making
The counter measure for a pilot flying (PF) to a startle response is to do what
DO NOTHING FOR A MOMENT
Fly the aircraft, take a deep breath, confirm stable flight path
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Reliability and Decision Making
If a pilot flying (PF) is suffering from startle response, what should the pilo monitoring (PM) do
COMMUNICATE IMMEDIATELY
start communciating with the PF immediately
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Reliability and Decision Making
There are 9 things which altogether are factors that influence and affect human reliability. Together, these are;
- ____ : roles defined and assigned to team members
- ____ : comfortablness of the flight deck
- ____ : organisation and layout of the cockpit
- ____ : well thought out SOPs
- ____ : workload
- ____ : the amount available affacts reliability
- ____ : Operating in the WOCL
- ____ : experience gained
- ____ : teamwork
- THE ORGANISATION : roles defined and assigned to team members
- WORKING CONDITIONS : comfortablness of the flight deck
- THE MAN-MACHINE INTERFACE : organisation and layout of the cockpit
- PROCEDURES AND PLANS : well thought out SOPs
- No. OF SIMULTANEOUS GOALS : workload
- AVAILABLE TIME : the amount available affacts reliability
- TIME OF DAY : Operating in the WOCL
- TRAINING and EXPERIENCE : experience gained
- CREW COLLABORATION : teamwork
- THE ORGANISATION : The quality of the roles defined and assigned to team members and sthe supporty given by the organisation
- WORKING CONDITIONS : The quality of the working conditions. For example, the comfortablness of the flight deck and the level of the noise or distraction
- THE MAN-MACHINE INTERFACE : A poorly designed or organised flight deck reduces the reliability of the crew
- PROCEDURES AND PLANS : Pre-determine, well thought out plans and procedures
- No. OF SIMULTANEOUS GOALS : The more tasks the individual must attend to, the less reliable they become
- AVAILABLE TIME :Amount of time available to execute the task
- TIME OF DAY : Operating in the WOCL
- TRAINING and EXPERIENCE : Training and experience improve human reliability
- CREW COLLABORATION : Effective team collaboration to reduce errors
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Other decision making issues
Most of the time, human decisions are based on a combination of what 3 things;
- ____ : instinct
- ____ : came to rational decision
- ____ : past experience
- INTUATION
- REASONING
- HUNCH
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Other decision making issues
What is the term known as where a professional makes a decision based on comparing the present situation with their past experience
RECOGNITION PRIMED DECISION MAKING
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Other decision making issues
What is the name given to a particular type of decision-making bias that strongly favours continuing with a plan to get on the ground as soon as possible rather than reviewing the situation.
PLAN CONTINUATION BIAS
(get-home-itis)
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Mental Models and Situation Awareness
What does the brain construct which are an approximate to reality
MENTAL MODELS
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Mental Models and Situation Awareness
Why is mental modelling important i.e. what does it allow a pilot to do
DEAL QUICKLY WITH LARGE AMOUNTS OF INFORMATION
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Mental Models and Situation Awareness
Mental model allows a pilot to better anticipate a situation. What is the advantage this brings
REDUCES WORKLOAD to AVOID MISTAKES
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Mental Models and Situation Awareness
What is the name given to modelling of a situation
SITUATIONAL AWARENESS
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Mental Models and Situation Awareness
What is situational awareness
MODELLING OF A SITUATION
situationl awareness is the process of creating and maintaining an accurate mental model of your situation
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Mental Models and Situation Awareness
On the occassions when the pilots situational awareness is good, what feeling will this give them
BEING IN CONTROL OF EVENTS
Thinking ahead of the aircraft
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Mental Models and Situation Awareness
When situational awareness is lost, you may feel like events are what
IN CONTROL OF YOU
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Mental Models and Situation Awareness
If a pilot feels that they are losing or have lost situational awareness, what are 5 things that they can do to regain it;
- ____ : burden of flying
- ____ : slow down
- ____ : understand where you are and where you will soon be
- ____ : think about the bigger picture
- ____ : make time to decide
- REDUCE YOUR WORKLOAD : burden of flying
- REDUCE THE PACE OF EVENTS : slow down
- REBUILD THE MENTAL PICTURE : understand where you are and where you will soon be
- STEP BACK : think about the bigger picture
- IMPROVE YOUR DECISION MAKING : make time to decide
- REDUCE YOUR WORKLOAD : Stabilise the flight path, engage autopilot to reduce burden of flying
- REDUCE THE PACE OF EVENTS : Increase track miles, alter course to slow down events before next essential event
- REBUILD THE MENTAL PICTURE : Use available aids to rebuild your mental picture
- STEP BACK : Mentally step back and try to think about the bigger picture
- IMPROVE YOUR DECISION MAKING : Take or make more time to decide. Resist temptation to take quick decisions
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Mental Models and Situation Awareness
In multi-crew situations, you must divide and apportion tasks, which means communication how with other crew members
CLEARLY and UNAMBIGUOUSLY
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Mental Models and Situation Awareness
when flying at night in very dark conditions, or in cloud, or both, your air picture is built up by what
ENTIRELY AND EXCLUSIVELY BY INTERPRETATION OF FLIGHT DISPLAYS
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Mental Models and Situation Awareness
Which 2 displays give a pilot their orientation in 3D space when flying in dark, cloud, or both
- ATTITUDE INDICATOR
- ATTITUDE STRIP
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Mental Models and Situation Awareness
Which 4 instruments give a pilot information about changes in state and energy level of the aircraft when flying in dark, cloud, or both
- SPEED STRIP
- ALTITUDE STRIP
- VERTICAL SPEED INDICATOR
- COMPASS
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Mental Models and Situation Awareness
Which instrument gives a pilot the ability to situate the aircraft position in 2D space when flying in dark, cloud, or both
NAVIGATION DISPLAY
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Mental Models and Situation Awareness
Which instruments gives a pilot information about the energy being given to, and used by, the aircraft when flying in dark, cloud, or both
THRUST INDICATORS
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Mental Models and Situation Awareness
When information is missing or faulty, what happens to situational awareness and what is the risk
- SEVERELY DEGRADED
- SAFETY COMPROMISED
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Mental Models and Situation Awareness
What are the 2 major threats to situational awareness
- MISLEADING INFORMATION
- NO INFORMATION
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Mental Models and Situation Awareness
When trying to rebuild situational awareness, a pilot needs sufficient information to do one or possible 2 things. These are what
- REGAIN CONTROL OF AIRCRAFT (if lost)
- STABILISE FLIGHT PATH
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