AS332L2 Ditching off Shetland: 23rd August 2013
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They both make the same sort of noise if they hit something
and some of the military noise here sounds simply unprofessional for me as human errors can be easily corrected and avoided once understood.
If pilots have a problem with their own personality they maybe don't like to look at the human factor, scared to see their very own incompetence?
ps: their incompetence as 'humans', not necessary 'pilots'
Last edited by xlsky; 17th Nov 2013 at 10:42.
I'm not sure anybody is saying 'pilot error, end of', those days in the military ended with the Mull of Kintyre Chinook incident thankfully. The flight safety culture within the military has changed drastically over the last 20 years and is every bit as 'enlightened' as the civilian world. Only those who have been on both sides of the fence are fully qualified to comment.
It doesn't matter whether you call it pilot error and then look for the causes or look for the causes and then call it pilot error, it's the same beast. Nobody is accusing a professional flight crew of being wilfully negligent, it's just that some of the language used by a small minority on this forum is slightly more on the blunt side. It seems there are a number of sensitive souls who are easily offended.
Nice to see yet another good thread slowly descending into military v civilian handbag waving. There are some big chips on shoulders out there!
It doesn't matter whether you call it pilot error and then look for the causes or look for the causes and then call it pilot error, it's the same beast. Nobody is accusing a professional flight crew of being wilfully negligent, it's just that some of the language used by a small minority on this forum is slightly more on the blunt side. It seems there are a number of sensitive souls who are easily offended.
Nice to see yet another good thread slowly descending into military v civilian handbag waving. There are some big chips on shoulders out there!
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Not sure if it is good practice to assume the final cause and then look for the evidence.
Human error is a very wide field, no doubt it is the main contributor, but it can be everything from misapprehension to medical issues or factors from a workplace environment.
The crew are victims as well; they deserve some respect just as for them being humans. their live and that of their families are deeply affected too.
Human error is a very wide field, no doubt it is the main contributor, but it can be everything from misapprehension to medical issues or factors from a workplace environment.
The crew are victims as well; they deserve some respect just as for them being humans. their live and that of their families are deeply affected too.
Last edited by xlsky; 17th Nov 2013 at 11:32.
Llamaman, well said, I presume it is comments like this
you are referring to.
HC, get off your high horse, we have had a 'just culture' in military flight safety for many years. Your comments just make you look petty and insecure. A safety culture that won't recognise that people can actually be at fault (because they made a mistake) but constantly seeks to make excuses for that fault, isn't making anything safer at all, just denying the obvious (and often uncomfortable) truth.
No-one is saying these guys should be sacked, they may need some retraining and probably some lengthy therapy to get over what happened but having an accident shouldn't make anyone unemployable. God knows, it used to be said that the only way to get promoted in the military was to crash an aircraft!
Those who say "pilot error. End of." are incompetent to hold any role in flight safety, even if they may hold some (self) important elevated position in the military.
HC, get off your high horse, we have had a 'just culture' in military flight safety for many years. Your comments just make you look petty and insecure. A safety culture that won't recognise that people can actually be at fault (because they made a mistake) but constantly seeks to make excuses for that fault, isn't making anything safer at all, just denying the obvious (and often uncomfortable) truth.
No-one is saying these guys should be sacked, they may need some retraining and probably some lengthy therapy to get over what happened but having an accident shouldn't make anyone unemployable. God knows, it used to be said that the only way to get promoted in the military was to crash an aircraft!
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Crab - 27 accidents all with the same common theme!! Failure of the "human" to manage the flight path. There are military, military in civil role and of course full blown civvies all making these mistakes. No one appears exempt from these insidious mistakes.
The singular problem with categorising them as "Pilot Error" is that we fail to identify, assess and correct the environmental issues that lead to these errors.
One incident, where an S76 hit the sea then took off again was put down to the handling pilot having a tough session in the gym!!
Forget pilot error. That is just the bit at the end that all of us seem susceptible given the specific circumstances. If we are to make a serious effort to stop these events we need a more discerning approach to the problem.
CAA know tis and so do most of us at the pointy end of flight safety.
DB
The singular problem with categorising them as "Pilot Error" is that we fail to identify, assess and correct the environmental issues that lead to these errors.
One incident, where an S76 hit the sea then took off again was put down to the handling pilot having a tough session in the gym!!
Forget pilot error. That is just the bit at the end that all of us seem susceptible given the specific circumstances. If we are to make a serious effort to stop these events we need a more discerning approach to the problem.
CAA know tis and so do most of us at the pointy end of flight safety.
DB
DB - while you have a human in the cockpit who can choose to ignore procedures or forget checks or make cognitive errors, you will continue to have accidents.
Is it possible to select, train and ensure competency of pilots to the point where they don't make mistakes? Possibly, but how much will that cost and who will pay for it?
At the moment, just enough seems good enough for the employers, customers and regulators. As long as you have the perception of safety then people will keep getting on the aircraft and, after all, it is statistically much, much safer than riding a bicycle through London.
I am not saying we shouldn't keep on trying to minimise accidents since the same lessons need repeating constantly - like 'fly the aircraft' but if you don't accept the fundamental premise that the human in the cockpit will always be a weak link then you are likely to put all your effort into one direction. Concentrating on autopilot training for example, you might eradicate all bad practices in that area and then be horrified when someone manages to find a completely different way of crashing the aircraft.
The biggest error that keeps being made in flight safety is to identify a reason for the human error (in your example a tough session in the gym) and create a solution (no more pilots to use the gym before flying) to prevent that particular set of holes in the cheese lining up again (as they were never likely to do).
If you select your pilots well, train them well, motivate them well, vary their tasks to avoid the mundane and repetitive and ensure that they are not pressured to push on or take risks to get the job done - then you might have a chance of achieving aviation Nirvana but it will remain a Utopian dream because the realities of cost and competition will always drag everyone down to the lowest common denominator.
Is it possible to select, train and ensure competency of pilots to the point where they don't make mistakes? Possibly, but how much will that cost and who will pay for it?
At the moment, just enough seems good enough for the employers, customers and regulators. As long as you have the perception of safety then people will keep getting on the aircraft and, after all, it is statistically much, much safer than riding a bicycle through London.
I am not saying we shouldn't keep on trying to minimise accidents since the same lessons need repeating constantly - like 'fly the aircraft' but if you don't accept the fundamental premise that the human in the cockpit will always be a weak link then you are likely to put all your effort into one direction. Concentrating on autopilot training for example, you might eradicate all bad practices in that area and then be horrified when someone manages to find a completely different way of crashing the aircraft.
The biggest error that keeps being made in flight safety is to identify a reason for the human error (in your example a tough session in the gym) and create a solution (no more pilots to use the gym before flying) to prevent that particular set of holes in the cheese lining up again (as they were never likely to do).
If you select your pilots well, train them well, motivate them well, vary their tasks to avoid the mundane and repetitive and ensure that they are not pressured to push on or take risks to get the job done - then you might have a chance of achieving aviation Nirvana but it will remain a Utopian dream because the realities of cost and competition will always drag everyone down to the lowest common denominator.
Originally Posted by [email protected]
HC, get off your high horse,
I suspect that in reality, military attitudes have moved on, although it is only fairly recently that the Mull of Kintyre accident was properly sorted. But within the context of this thread, I can only go by the views of TC and to a lesser extent you, who seem to be suggesting that there is no point in talking about it further, being all fluffy etc, because it was "pilot error" and therefore the conversation is at an end.
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Good post Crab. And DB , agree that the real issue is trying to understand and address why errors are made. But you can't quite say "Forget pilot error"! Where it exists - and that's in most accidents, let's face it - it should be identified as such, partly so we all have heightened awareness of our fallibility as pilots, the need to concentrate 100% and not to just buck-pass personal responsibility to corporate culture etc, and particularly to trigger the process of understanding and addressing of the cause(s) of the pilot error.
Starting at the beginning, what, if any, academic qualifications are required to become a commercial pilot today? How bright do you need to be?
Starting at the beginning, what, if any, academic qualifications are required to become a commercial pilot today? How bright do you need to be?
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Starting at the beginning, what, if any, academic qualifications are required to become a commercial pilot today? How bright do you need to be?
Errrrrrrr.....Pardon? You do mean the British Army I hope!
Yes they have to pass some exams, but that seems to be as much about learning the answers to the questions as it is about actually understanding the subject. Yes they have to pass a test, but that is primarily all about manual flying.
We then maybe send them on a fixed duration type rating course, and hope that what comes out is a uniform level of understanding.
So then we put these guys into a modern sophisticated helicopter with very complex systems and software, these being the primary ways by which they interact with the aircraft, and expect them to fully grasp all the technical intricacies. How is that related to their selection and testing for a CPL(H)?
We then maybe send them on a fixed duration type rating course, and hope that what comes out is a uniform level of understanding.
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I think understanding the dangers of the more difficult parts of the flight envelope is key here.
As a result of this accident, during EC225 simulator training, We now force this error on the crew during SEMA approaches (SEMA only provide 3 Axis mixed mode with the pilot responsible for the collective vertical channel). Simply asking them to reduce speed in this condition to 60 KIAS is usually enough to destabilise the approach and create confusion as the helicopter flight path slides back up the power/airspeed curve.
This exercise helps the crew to recognise the dangers of low speeds in mixed mode operations and emphasise to them to avoid this.
We also apply a similar philosophy to OEI landings, deliberately flying an LDP at 1/2 speed at MLW, resulting in a crash into the lead in lights.
Simulator training is ideal for demonstrating areas of the envelope that we should try to avoid. It needs to be briefed beforehand to avoid negative training but the effects on crews is dramatic. After one crash into the lights they monitor there speed at LDP like hawks.
Consider the good pilot. You sit behind him and he meets all profile parameters accurately and appropriately. You tick all the little boxes on his form! However, does he really understand the dangers of the bits of the envelope you have not seen him explore??
Introducing "Exercises to Failure" into initial and recurrent training is a good step in the right direction. In fact some of the posters on this thread who feel that manual flying skills and intelligence will save them from these errors would probably fit in my "Above Average" category and paradoxically benefit from this type of training.
For the record, the Commander of the accident aircraft is a qualified Civil Engineer. I suspect had someone shown him the dangers of mixed mode flight in the Simulator one week before this accident it would never have happened. This is an opportunity for real change in the methods and content of initial and recurrent training. I have some good ideas but I am just one man.
Somehow we need a forum and opportunity to collate, evaluate and conclude better. More effective and more beneficial ways to train. The CAA I believe recognise this themselves but it is we, the industry SMEs that must stand up and lead the way.
ZDB
As a result of this accident, during EC225 simulator training, We now force this error on the crew during SEMA approaches (SEMA only provide 3 Axis mixed mode with the pilot responsible for the collective vertical channel). Simply asking them to reduce speed in this condition to 60 KIAS is usually enough to destabilise the approach and create confusion as the helicopter flight path slides back up the power/airspeed curve.
This exercise helps the crew to recognise the dangers of low speeds in mixed mode operations and emphasise to them to avoid this.
We also apply a similar philosophy to OEI landings, deliberately flying an LDP at 1/2 speed at MLW, resulting in a crash into the lead in lights.
Simulator training is ideal for demonstrating areas of the envelope that we should try to avoid. It needs to be briefed beforehand to avoid negative training but the effects on crews is dramatic. After one crash into the lights they monitor there speed at LDP like hawks.
Consider the good pilot. You sit behind him and he meets all profile parameters accurately and appropriately. You tick all the little boxes on his form! However, does he really understand the dangers of the bits of the envelope you have not seen him explore??
Introducing "Exercises to Failure" into initial and recurrent training is a good step in the right direction. In fact some of the posters on this thread who feel that manual flying skills and intelligence will save them from these errors would probably fit in my "Above Average" category and paradoxically benefit from this type of training.
For the record, the Commander of the accident aircraft is a qualified Civil Engineer. I suspect had someone shown him the dangers of mixed mode flight in the Simulator one week before this accident it would never have happened. This is an opportunity for real change in the methods and content of initial and recurrent training. I have some good ideas but I am just one man.
Somehow we need a forum and opportunity to collate, evaluate and conclude better. More effective and more beneficial ways to train. The CAA I believe recognise this themselves but it is we, the industry SMEs that must stand up and lead the way.
ZDB
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Consider the good pilot. You sit behind him and he meets all profile parameters accurately and appropriately. You tick all the little boxes on his form! However, does he really understand the dangers of the bits of the envelope you have not seen him explore??
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DB - I think you're absolutely right that training involving things going wrong - and I mean divergence from normal flight profiles rather than failures - is likely to be more valuable than just monitoring lots of properly done approaches. In fact I'm surprised this is isn't done more, by the sound of it. People can look very competent when they do things by rote, (eg accurately following a prescribed approach) but it's only when you hit them with something abnormal that you can see how much awareness they really have of all the crucial parameters, and skills to get them back on course if they are not right.
With regard to pilot competence, there have been a vast number of posts on this thread about training, quite reasonably, but virtually none about basic aptitude.
I do wonder whether the industry has sufficiently realised that, particularly with such increasing sophistication of aircraft and systems, a pretty high level of intelligence is necessary to be a good safe pilot. When everything is hunky dory yes, flying is not too challenging and a lot of people, trained, could do it. But when things get challenging, intelligence is required to make sensible rapid judgements and decisions.
It really worries me when I read of the occasional story of some kid being picked to have a free full CPL/ATPL training course, with no apparent selection process to ensure they are bright enough. You wouldn't want a surgeon operating on your kids, or a lawyer acting for you, who had only got 5 poor GSCEs! I'm not saying all pilots similarly need 3 or 4 Grade A A levels, but flying modern IFR twins well is a challenging job and I do think consideration should be given to ensuring commercial pilots are selected on some sort criteria to ensure they are sufficiently bright and quick thinking to be able to deal safely with the dramas they will inevitably encounter from time to time.
Can anyone shed any light on what academic qualifications are required by any commercial and military organisations to qualify for CPL/ATPL training?
Finally I must make it clear I am not suggesting this point applies to this Sumburgh accident - it is a general comment.
With regard to pilot competence, there have been a vast number of posts on this thread about training, quite reasonably, but virtually none about basic aptitude.
I do wonder whether the industry has sufficiently realised that, particularly with such increasing sophistication of aircraft and systems, a pretty high level of intelligence is necessary to be a good safe pilot. When everything is hunky dory yes, flying is not too challenging and a lot of people, trained, could do it. But when things get challenging, intelligence is required to make sensible rapid judgements and decisions.
It really worries me when I read of the occasional story of some kid being picked to have a free full CPL/ATPL training course, with no apparent selection process to ensure they are bright enough. You wouldn't want a surgeon operating on your kids, or a lawyer acting for you, who had only got 5 poor GSCEs! I'm not saying all pilots similarly need 3 or 4 Grade A A levels, but flying modern IFR twins well is a challenging job and I do think consideration should be given to ensuring commercial pilots are selected on some sort criteria to ensure they are sufficiently bright and quick thinking to be able to deal safely with the dramas they will inevitably encounter from time to time.
Can anyone shed any light on what academic qualifications are required by any commercial and military organisations to qualify for CPL/ATPL training?
Finally I must make it clear I am not suggesting this point applies to this Sumburgh accident - it is a general comment.
Last edited by rotorspeed; 18th Nov 2013 at 09:56.
Rotorspeed -
Commercial - zero if self funded. I believe the Bristow/Air League sponsorship from earlier this year specified at least an A/1 in GCSE/Standard Grade maths, which was the cause of some consternation at the time!
RAF - "2 A-levels (at grade A-C) or 3 Highers or equivalent, plus 5 GCSE/SCEs at Grade C/2 minimum or equivalent including English language and grade B/1 in maths."
Commercial - zero if self funded. I believe the Bristow/Air League sponsorship from earlier this year specified at least an A/1 in GCSE/Standard Grade maths, which was the cause of some consternation at the time!
RAF - "2 A-levels (at grade A-C) or 3 Highers or equivalent, plus 5 GCSE/SCEs at Grade C/2 minimum or equivalent including English language and grade B/1 in maths."
Lots of good ideas and valuable discussion here but the "how" word is still eluding us it seems. I don't have an easy solution.
Being mildly old, I was line trained on the S-61 which was not endowed with power although magnificent. "Never get below Vtoss (67kts if I remember) except when taking off or landing" said my LTC. In later years, shuttling S-61s on the SNS as a Captain at night in haze and still conditions, I never forgot his wise words.
We have had 332Ls, L2s and 225s now for 30+ years. Have we bred a generation of pilots not used to low power aircraft in the real working environment? Was the old "Command Course" using a Bell 206 a good thing and should we reconsider its merits?
Being below Vtoss in any helicopter without it being a deliberate action is not a good place to be. Are we preaching automation without reinforcing the basics?
Being mildly old, I was line trained on the S-61 which was not endowed with power although magnificent. "Never get below Vtoss (67kts if I remember) except when taking off or landing" said my LTC. In later years, shuttling S-61s on the SNS as a Captain at night in haze and still conditions, I never forgot his wise words.
We have had 332Ls, L2s and 225s now for 30+ years. Have we bred a generation of pilots not used to low power aircraft in the real working environment? Was the old "Command Course" using a Bell 206 a good thing and should we reconsider its merits?
Being below Vtoss in any helicopter without it being a deliberate action is not a good place to be. Are we preaching automation without reinforcing the basics?
DB,
Sounds like a perfectly good approach to learning.
I used to do something similar in the Bell 412 and S-76 Sim.
My favorite scenario was set up by the Students themselves.
If they failed to brief the Missed Approach when doing an ILS....I "disappeared" the airport so they would not see a thing when arriving at DH.
Immediately....confusion set in.
Almost invariably....they hit "Go Around" but did not think to raise the Collective (three Axis system only). Shortly, we saw the equivalent of what happened off Shetland.
Taking the video tape down to the classroom, grabbing a cup of coffee while they watched themselves on TV....usually got the point across they needed to listen and learn from the Instructor and Course of Instruction.
There were other ways as well.....set up the situation...get them "busy" and watch them make a mistake that resulted in a crash....and they started listening to what was being said.
Key point....once they "SAW" it could happen to them....there was a much better attitude shown re understanding how easy it is to be the cause of one's own demise.
If time was available I liked to take the crew out to the Aircraft Carrier....make it a very dark, very hazy night....no reference but the lights and wake of the carrier. Then ask them to perform an EOL to the Carrier from 5,000 feet MSL.
The teaching point was to get them to thinking about the "Basics" of helicopter flying....in this case....did the intended point of landing move up or down on the point of the windscreen....meaning are you going to make the spot or not. It was not about landing on the Carrier....but forcing them to revert to one of the first things we learn in flying helicopters after all the sophisticated and complex topics and maneuvers they had been dealing with for up to a week.
That was my way of ending the sim session reminding them that remembering the basics is something we need to do all the time we are flying the helicopter for at some point it might make the difference between going home to the Wife and Kids or not.
Sounds like a perfectly good approach to learning.
I used to do something similar in the Bell 412 and S-76 Sim.
My favorite scenario was set up by the Students themselves.
If they failed to brief the Missed Approach when doing an ILS....I "disappeared" the airport so they would not see a thing when arriving at DH.
Immediately....confusion set in.
Almost invariably....they hit "Go Around" but did not think to raise the Collective (three Axis system only). Shortly, we saw the equivalent of what happened off Shetland.
Taking the video tape down to the classroom, grabbing a cup of coffee while they watched themselves on TV....usually got the point across they needed to listen and learn from the Instructor and Course of Instruction.
There were other ways as well.....set up the situation...get them "busy" and watch them make a mistake that resulted in a crash....and they started listening to what was being said.
Key point....once they "SAW" it could happen to them....there was a much better attitude shown re understanding how easy it is to be the cause of one's own demise.
If time was available I liked to take the crew out to the Aircraft Carrier....make it a very dark, very hazy night....no reference but the lights and wake of the carrier. Then ask them to perform an EOL to the Carrier from 5,000 feet MSL.
The teaching point was to get them to thinking about the "Basics" of helicopter flying....in this case....did the intended point of landing move up or down on the point of the windscreen....meaning are you going to make the spot or not. It was not about landing on the Carrier....but forcing them to revert to one of the first things we learn in flying helicopters after all the sophisticated and complex topics and maneuvers they had been dealing with for up to a week.
That was my way of ending the sim session reminding them that remembering the basics is something we need to do all the time we are flying the helicopter for at some point it might make the difference between going home to the Wife and Kids or not.
I I, bizarrely, I find myself having to teach pilots to be comfortable in the low speed environment and how to handle the aircraft to maintain ETL when manoeuvring, especially with limited power - this as a result of exactly that type of thinking eg speed makes you safe.
But Crab.....your most important work is in that flight regime....so it is exactly right you would do so.
Offshore Oil Flying....other than SAR or Winching, some kinds of Shuttling and perhaps the extremely remote chance of some underslung work does not require Crews to operate in that flight regime so it is commonsense they would see things differently than you.
That is why the Cook Book method of flight training, the one size fits all concept, just doesn't work.
Box Ticking is just another way of describing that mindset that rejects the notion that training should impart or refresh some wisdom about our craft and trade.
Offshore Oil Flying....other than SAR or Winching, some kinds of Shuttling and perhaps the extremely remote chance of some underslung work does not require Crews to operate in that flight regime so it is commonsense they would see things differently than you.
That is why the Cook Book method of flight training, the one size fits all concept, just doesn't work.
Box Ticking is just another way of describing that mindset that rejects the notion that training should impart or refresh some wisdom about our craft and trade.