Revision Flashcards
What are the components of the SHELL model? Describe them
Software (Programs, procedures and checklists) Hardware (Physical bits) Environment (Environment around human) Liveware (Human at centre of model) Liveware (other humans)
What is the SHELL Model?
- A model of human factors
- Model assists in identifying human factors between liveware (human) centred and the other interfaces that the human interacts with
Who was the SHELL Model proposed by and when?
Edwards 1972
Where do the errors occur in the SHELL Model?
Errors occur at the interfaces. If things aren’t right between human and other interfaces, that is when things can go wrong.
What is threat and error management?
A safety philosophy which encourages safety behaviour
Briefly describe the TEM concept?
- For most flights, threats will always occur and errors can and will be made.
- Threats that are undetected or mismanaged will lead to errors. Errors that are undetected or mismanaged will lead to undesired aircraft states
What was TEM originally a tool for?
Originally a tool for line audits
Where do threats and errors come at/from?
Threats come at the crew
Errors come from the crew
What does LOSA stand for?
Line orientated safety audit
What is LOSA?
- Line orientated safety audit
- Audit to check for safe operations in the ‘real world’
How do LOSA’s work?
- Trained observers sit in the jump seat to observe if what is taught in CRM is being implemented
- Guaranteed confidentiality and no jeopardy for crew involved
What is the objective of LOSA?
To identify threats to operational safety and minimise risk presented by those threats.
What does LOSA enable operators to do?
To assess their level of resistance to systematic operational threats, risks and front line crew error
What are the four types of memory?
Sensory
Long term
Working
Procedural
What is sensory memory?
- Where it records all the raw data and sensory information (sight, sounds, smells, etc) while it is being perceived
- Has a very high capacity but very short term
What is long term memory?
- Essentially the ‘hard drive’
- Sensory info must be stored long term to be abele to help current situation
What is working memory?
- Buffer when processing and comparing perceptions and long term memories
What is procedural memory?
Sub routines or things that we do automatically
What is the visual sub component in working memory?
Visuospatial Sketchpad
What is the audio sub component in working memory?
Phonological loop
Is attention conscious or unconscious?
Can be both.
Conscious so can be deliberately focused on task.
Can be unconsciously and involuntarily diverted or captured by environment (i.e. bright flashing light
Which part of the information processing unit always required attention?
Central Processing
What does attention lead to?
Awareness
What is the attention mechanism filter?
Filter which ‘blocks’ and lets through stimuli.
What does attention mechanism filter vary with?
Varies with skill and psycho-emotive state.
What happens if we become more stressed with the attention mechanism filter?
The more stressed we are, the more resistant the barrier is. More info gets blocked and less gets through.
What is the ‘spotlight’ theory?
Attention like a spot light can only be consciously focused on certain area at certain time but can be shifted
With regards to the spot light theory, what does the size of the spot light depend on?
Linked to workload.
If the work load is heavy, the field shrinks and more stimuli is excluded to avoid distraction and to give full capacity to task.
With regards to the spot light theory, what may happen in a unfamiliar environment?
It may filter out important things
What is vigilance?
Sustained application of attention to task. Usually in order to noticed an abnormal event that occurs rarely
What is vigilance often referred to in aviation?
Monitoring
What is vigilance decrement?
Degradation of ability to maintain focused attention in order to detect critical signals over time. NOT just a function of fatigue
What are mental models?
The representation we have built to understand world around us. People may react differently to same situation because they have different mental representation of it
How/why can mental models differ?
Differ depending on:
- What we filter out
- Past experiences
- Personalities
What is the quality of mental representation determined by?
- Relevance
- Conformity
- Stability
What is Endsley’s model of situational awareness?
Level 1 - Perception
Level 2 - Comprehension
Level 3 - Projection
The higher level you are the better your decision making and responsiveness it
What are some situational awareness red flags?
Uncertainty Fixation on task Confusion Unexplained discrepancies Falling behind schedule Disregarding checklists Poor communication Complacency Unresolved warnings
Is workload the same as task load?
NO!
What is workload?
Nature of tasks to be completed such as mental and physical demands of work.
Workload is the output of information processing
Describe some ‘circumstances’ for workload?
Circumstances:
- standard required
- Time demands
- Context
- Environment
Describe some ‘individual’ factors for workload?
Individual:
- Effort demands
- Performance capabilities
- Emotional state
- Skills/experience
- Health/fitness
True or false, perceived workload varies on different tasks?
True
Will two different people doing the same task experience the same work load?
Not always, varies depending on many different factors such as past experiences, skills/experience, health/fitness/emotional state etc
What is task load?
The objective measurable quantity of what you are doing
What is the Yeaks Dodson Curve?
Graph showing performance compared to workload and arousal.
Performance generally increases to optimal then decreases rapidly.
Shows that the availability of attention changes with arousal
With regards to the Yeaks Dodson curve, what is the margin of safety?
Difference between the maximum capacity and workload
Is there a easy way to measure workload?
No, workload is perceived differently by each individual so it is difficult to measure.
How can we measure workload?
Can measure workload in two ways, objective physiological responses such as pupil dilation, heart rate variability and Galvanic skin responses. However these are not 100% precise.
You can also measure them subjectively using rating scales such as the Bedford Workload scale (using 0-10 rating system) or NASA task load index. The questions must be asked in a structured way to get best results
What are the three stages of Fitts and Posner Three Stage Model
Cognitive
Associative
Autonomous
Describe the first stage of Fitts and Posner Three stage model?
Cognitive stage.
- Very conscious of the processes and tasks are all completed through working memory
Describe the second stage of Fitts and Posner Three Stage model.
Associative stage.
-Still conscious, you have built a set of simple rules for frame work. i.e. if this happens, do this
Describe the third stage of Fitts and Posner Three Stage model.
Autonomous
- No longer conscious, you completely bypass the working memory
How can you move from novice to expert in the Fitts and Posner Three stage model?
Only through experience. The more cycles you do the higher up the continuum you go.
What is the Rasmussen SKR?
A human error classification system
Skill, Rules or knowledge based behaviours leading to unsafe acts.
How does Rasmussen describe unsafe acts?
Can be unintentional or intentional.
Unintentional includes slips, lapses and mistakes
Intentional is violations.
Under Rasmussen, define the SKR?
Skill - autonomous
Knowledge - Cognitive
Rule - Associative
What are slips and lapses when it comes to Rasmussen’s SKR?
Slips and lapses occur under the skill or autonomous stage.
It is when your plan of action is correct however the execution was wrong (i.e. selected wrong button)
What are mistakes when it comes to Rasmussen’s SKR?
Mistakes occur in the rule (associative) or knowledge (cognitive) stages.
It is when you intended on doing the right thing however your plan was flawed. It could even be that you executed your plan perfectly.
What are intentional behavioural errors when it comes to Rasmussen’s SKR?
Violations.
Most often done with good intentions to save time or to try and benefit the company, not always malicious.
What are intentional behavioural errors broken down to when it comes to Rasmussen’s SKR?
Routine - Good intention, everyone is doing it because ‘that’s how things work here’
Exceptional - exceptional circumstances such as running two hours behind, all engines fail etc
Malicious - some one trying to break the system and make things go wrong
What is the decision making model?
The scale which uses mental effort/time taken for decision making. The less time taken, decision may be intuitive, more time taken means most likely rational decision
What is a rational decision?
- Stacking up all the option
- Slowly sifting through all the options
- Putting value on all different options
- Process optimisation
What does a quicker decision mechanism depend on?
How skilled we are
What are some bias in decision making?
Conformation (look for info that supports theory and ignoring info that doesn’t)
Saliency (picking the option that’s the clearest)
Recency (pick the decision that was right last time)
What is parallel vs serial decision making?
Parallel - weighs up all options and select best task
Serial - see first good option and go with it (satisficing)
What is assertiveness?
Using clear and persuasive communication techniques to state, restate and defend what you consider is right whilst supporting CRM and without being aggressive.
What is the assertiveness model?
Focus on own needs and no put downs = assertive
Focus on others needs and no put downs = supportive
Focus on own needs and put downs = aggressive
Focus on others need and put downs = submissive
How did assertiveness training for CRM come about?
Came from ‘back in the day’ when there was a very steep cockpit gradient and captain was always considered right and first officer was their ‘assistant’.
What is the support process for assertiveness training?
Balance between conserving CRM and getting message across. If time permits go through 3 phases, guidance, procedural and emergency phases.
What is the first phase in the support process for assertiveness training?
Guiding phase.
- Offering info the other person may not be aware off.
- Subtly question understanding so they go searching for information
- Express concern that you don’t thing something is right
What is the second phase in the support process for assertiveness training?
Procedural phase
- Offer solution you think will help situaion
What is the third phase in the support process for assertiveness training?
Emergency phase
- If nothing has happened during the first two phases enter the emergency statement as agreed by the airline to act to recover situation
What is ‘personality’?
Relatively stable and enduring aspects of individual making them unique. Accounts for consistency in behaviour
What are personality traits?
Distinguished characteristics or qualities measured on continuum that guide behaviour
What are personality types?
Cluster of traits that distinguish one group of individuals from another
What is personality inventory?
Groups of questions (questionnaire) that measures dimensions of personalities and groups you into particular type
What are some examples of personality inventory questionnaires?
MBTI (Myer Briggs Test Index)
16PF
EPI
What are the five factory theory of personality?
O - Openness to experience C - Conscientiousness E - Extraversion vs Introversion A - Agreeableness N - Neuroticism / emotional stability
What are the elements of a safety culture?
Commitment, informed awareness, just, flexible, learning, wary
What is a just culture?
One where you are responsible for your actions
Define a leader.
Someone who efficiently balances the requirements of task and team members.
They look after the needs of the team, cohesion and the task
What is cockpit authority gradient?
Describes the perceived difference in level of authority between member of flight crew
What are the three different leadership types?
Autocratic (steep cockpit gradient)
Laissez Faire (flat cockpit gradient)
Synergistic (shallow cockpit gradient
What is the ideal cockpit gradient?
A Shallow but positive cockpit gradient where there is a clear leader
What are some group phenomena that occurs in some teams?
Group think (where individuals go along with group to preserve group harmony) Risky shift (tendency to err towards high risk strategies because its a team, no one has sole responsibility) Conformity (members conform to other members of the group)
What is does CRM stand for and what is it?
Crew resource management.
- Effective utilisation of ALL available resources (information, equipment and people) to achieve safe and efficient flight operations.
How many generations of CRM have there been?
6
What other groups has CRM expanded to include recently?
To include cabin crew, maintenance, ATC, dispatch etc
What is proactive interference and when is it likely to occur?
Tendency for old learnt behaviour to interfere with newly learnt behaviour.
Likely to occur under high workload/stress
What is retroactive interference and when is it likely to occur?
Tendency for newly learnt behaviour to interfere with old learnt behaviour.
Likely to occur under high workload/stress
What does LOFT stand for?
Line orientated flight training
What is LOFT?
Line orientate flight training.
Training through full mission simulation rather than brief part tasks. Fly as crew to develop CRM
What is Reason’s Accident Causation (SWISS CHEESE) Model?
- For an accident to happen, lots of things need to fail in succession.
- Model breaks it down to active failures, latent conditions and failed/missed defences
What are some of the categories in Reason’s Accident Causation (SWISS CHEESE) model?
- Organisational (management, decisions, organisational procedures)
- Local conditions (Resources, ergonomics, working conditions, moral)
- People (Errors, violations, Personality, attitude)
- Defences (Regulations, Procedures, Technology)
How do failures occur according the Reason’s Accident Causation (SWISS CHEESE) model?
Failure occurs when latent conditions fail and trigger is in place. Generally pilot is the active error that ‘pulls the trigger’ for accident
Who is generally involved in investigating an accident?
Pilots Engineers Medical officers Human factors specialists Flight data specialists Other specialists (meteorologist etc) Admin (IT, photographers etc)
What is the rough process for accident investigation?`
Investigate Factual data collection (SHELL) Reconstruct events Systemic Analysis (REASON Swiss cheese model) Findings (Final Report) Safety Reporting
What are the different generations of CRM?
1st Cockpit Resource Management (management operated)
2nd Move to Crew Resource Management (Team orientated, SA etc)
3rd Still CRM but now included cockpit and cabin
4th CRM introduced LOFT
5th CRM back to original error management
6th CRM now with TEM
