\u00a0 \u201cThe problem with pilots today is that they\u2019re not doing enough hand flying!\u201d\u00a0 How often has this been said in recent years?\u00a0 It is a refrain that seems to be the current \u201chypothesis du jour\u201d by many in the aviation industry in an effort to explain many of the incidents and accidents that have occurred. It appears that the entire industry, regulators and the various alphabet organizations have jumped onto this bandwagon.\u00a0 \u201dAdvocate more hand flying\u201d and safety will be improved.\u00a0 Closely following this, and\u00a0 a bit curiously, is the concept that all pilots need to do is \u201cpay attention to detail\u201d more, that if the accident or incident is not a result of \u201cstick and rudder\u201d skills, it is a consequence of just not paying attention.\u00a0 Has anyone stopped to think about these things?<\/p>\n Stick and Rudder<\/strong><\/p>\n I have a bias. As can be seen in the photo I took over Hong Kong (above) I love hand flying.\u00a0 I have a love\/hate relationship with autopilots and autothrottles, in that they can be great but it is not nearly as fun for me.\u00a0 If conditions allow for it, I will hand-fly the airplane up to FL250 (25,000 feet) and I also turn off the automation fairly early during the arrival.\u00a0 I do it because flying the airplane is fun! There is no question that hand flying is good, and the more you do the better you will get at it.\u00a0 \u00a0However, how does this relate to the recent air carrier accidents?<\/p>\n A review of all of the accidents involving jet transports in the last five years fails to find any that would clearly have been averted if the pilots had done more hand-flying. \u00a0If the hand-flying aspect was present, it was not in isolation. \u00a0There are several where the aspect of hand-flying has been raised, but even those are missing the point.\u00a0 Most recently in the news highlighting the call for \u201cmore hand-flying\u201d have been Air France (AF) 447 and Asiana 214 in San Francisco. \u00a0However, a review of AF 447 and the preliminary data on Asiana, with the removal of hindsight bias, makes the \u201ceasy fix\u201d of more hand-flying much less clear.<\/p>\n Contrary to popular opinion, and based on the data that has been provided, the accidents themselves do not appear to be a lack of hand-flying skills per se.\u00a0 In other words, the accident could have happened to someone who handles the aircraft exceptionally well.\u00a0 What I am seeing in these accidents is not<\/em> a lack of flying skills, but rather a lack of understanding what the automation is providing for them.\u00a0 In other words, their expectations of the automation are different than what the automation will actually do.\u00a0 This aspect is not trained as well.\u00a0 While the pilots are trained in the basics of the automation, there are enough gaps in the training that the \u201cWhat\u2019s it doing now\u201d comment (typically stated in a humorous way, but meant seriously), is very common.<\/p>\n If a pilot does not know why the automation is doing something there is (of course) the possibility that the computer is doing something it should not be doing. \u00a0In reality\u00a0that is a very low probability \u2014 the rate of actual problems with the hardware and\/or software is very, very low.\u00a0 It is much more probable that the pilot does not understand the automation.\u00a0 Therefore, a statement (or even a thought) along the lines of \u201cWhat\u2019s it doing now?\u201d should serve as a red flag that the pilot does not fully understand the automated system.\u00a0 Perhaps they are operating at too high a level of automation for the situation.\u00a0 Regardless, if the disconnect continues for more than a moment or two, \u00a0they should seriously consider moving to a less automated mode until things are sorted out.<\/p>\n At all times, the pilot should be certain what to expect next.\u00a0 Unfortunately, absent significant system knowledge, most of the current systems installed in aircraft do not do a very good job of telegraphing to the flight crew what it is planning on doing after the current action.\u00a0 Sometimes it is not a large factor, such as the way the aircraft adjusts to a different-than-expected wind model when it transitions from one phase of flight to another, but other times it can be a major factor that can lead to, at the very least, a violation of a regulation or at worst, an accident when a crew expected the aircraft to capture a certain vertical path or airspeed.<\/p>\n Pilot Knowledge<\/strong><\/p>\n Putting the automation aside, let\u2019s take a look at the hand-flying aspects.\u00a0 In all the advocating of hand-flying there has not been much of an effort to ensure that\u00a0all pilots have reviewed or received recurrent training on the\u00a0fundamental aerodynamics.\u00a0 You may find that surprising.\u00a0 You might ask \u201cDon\u2019t pilots get trained for that early on?\u201d\u00a0 Well, the answer to that is a definite \u201cmaybe\u201d. \u00a0While most pilots might get it at some point early in their careers, there are some that have only learned enough to pass the written test, with their formal training being generally fairly superficial.\u00a0 Sure, they know how the aircraft responds to their inputs and a rudimentary concept of \u201cwhy\u201d, but that leaves out the concepts of what would happen in the more rare \u201ccorner-points\u201d that are often the scenario where accidents occur. \u00a0Regardless of their background, a comprehensive review of aerodynamics should be included in the training programs. \u00a0It is not expected that pilot skills will stay sharp in hand-flying or the flight procedures absent regular training, so why is a review of aerodynamics left out of the equation?<\/p>\n While it is\u00a0only rarely that a comprehensive\u00a0baseline understanding of aerodynamics is important, when it is important, it can be very <\/em>important! In addition, if we are to expect pilots to use their \u201chand-flying\u201d skills to get out of sticky situations, perhaps they should be allowed to practice those skills in situations where they might need them.\u00a0 AF 447\u2019s crew found themselves hand-flying the aircraft at an altitude regime where the full time use of the autopilot is required,<\/em> in a degrade flight control mode\u00a0rarely practiced or demonstrated at any <\/em>altitude.<\/p>\n The combination of the altitude and flight control regimes was something that they would never have seen in any training, even assuming the simulator could adequately replicate the conditions (a topic unto itself!). \u00a0Is it reasonable to assume that they would be able to have the skills to hand-fly the airplane with those issues, while flying at night through the upper levels of turbulent thunderstorms? \u00a0It is easy to judge them in hindsight, but the scenario was far different than the comfort of judging their actions after the fact from an\u00a0office chair.<\/p>\n Attention to Detail<\/strong><\/p>\n Thinking more on the combination of advocating hand-flying and \u201cattention to detail\u201d, one has to ask, \u201cHow can you pay attention to detail if you are hand-flying?\u201d\u00a0 The industry originally moved towards the idea of more automation to allow for better decision making with fewer pilots in the cockpit. The concept was that we could operate very large aircraft (which used to require crews of three or more pilots) with just two pilots, as the automation would free up the pilots from all that hand-flying, so they could concentrate on decision making.\u00a0 In that process, there is no question that the pendulum went pretty far to the point of mandating high levels of automation use, and that needed to be pulled back, but it now appears that we are trying to go the opposite way, while admonishing \u201cok, hand-fly, but you\u2019re still just as responsible to monitor!\u201d<\/p>\n More to the point, though, we simply cannot just command somebody to pay attention more.\u00a0 In the Just Culture algorithm, we divide actions that led to an adverse outcome into error, at-risk <\/em>and reckless.\u00a0 <\/em>We define an error <\/em>as something that is an unintentional act, and, by definition, if that leads to a bad outcome, it is a \u201csystem problem.\u201d By \u201csystem\u201d, we mean that we need to redesign the policies, procedures, equipment, displays, etc. to fix it.\u00a0 At-risk <\/em>is an action that is a result of a person intentionally not following a policy or procedure, but doing it to work-around something in order to facilitate getting the job done.\u00a0 This is a combination of an individual and system issue, but also still largely a system problem, as the system was not designed correctly if someone is having to \u201cbend the rules\u201d to get the job done. \u00a0\u00a0Reckless <\/em>is just a disregard of the rules for no justifiable reason.<\/p>\n Coming back to this issue of \u201cattention to detail\u201d, where would this fall in the Just Culture matrix?\u00a0 It would be hard to argue that any lapse due to lack of attention to detail would constitute an intentional act to just disregard procedures.\u00a0 Perhaps in some cases (but not many) it could fall into the at-risk<\/em> area, but most of the time, these would clearly be an error.\u00a0 <\/em>The fix for errors <\/em>is not to just tell someone \u201cdon\u2019t do that!\u201d \u00a0I am reminded of the Bob Newhart<\/a> video (linked here<\/a>) where he plays the role of a psychologist who tells his patient to \u201cjust stop it\u201d when she is expressing problems.\u00a0 If we are to correct these issues it will be through system and procedural design, not just telling someone to \u201cstop it\u201d.<\/p>\n The \u201csystem\u201d should be designed with the knowledge of human error and cognitive limitations by people who have an expertise in the field. \u00a0Too many times we see people put in positions and given titles with no real expertise. \u00a0A person who has a combination of formal academic training in human factors, coupled with\u00a0experience in the field, would be ideal, as that person could integrate the academic knowledge with the \u201creal world\u201d to truly create systems that could capture error. \u00a0As an alternative, two people, one with academic knowledge, and one with extensive operational experience, could be coupled together to attack these types of problems.<\/p>\n Relying on people who do not possess the knowledge and experience is how we created these flawed systems in the first place. \u00a0We, as an industry, can do better.<\/p>\n ======================================================<\/p>\n![\"inverted](\"https:\/\/airlinesafety.blog\/wp-content\/uploads\/2014\/05\/inverted-hkg-firefly.jpg\")
<\/a>\u00a0\u00a0The author shot this photo flying inverted over Hong Kong<\/p>\n<\/a><\/p>\n<\/a><\/p>\n