NTSB update on Asiana 214
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Originally Posted by Cool Guys
In my opinion, with good automation many of these problems should not occur. Good automation does not have traps, it is simple, the auto pilot mimics manual control pretty close
Testing automation on the ground is much easier than doing it on airliners in the sky at 500 kt. In any case "good automation" requests to stop modifications and to product total description of every detail of the system BEFORE operational use. It seems that aviation industry does not respect these quality minimum rules.
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increases pilot workload and therefore reduces spare mental capacity and situational awareness.
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I've found that the MORE you exercise your mind and eye / hand flying, you get better and stronger and have more capacity to handle things
using automation all the time is like using an escalator instead of taking the stairs. and the day the escalator goes Tango Uniform, you will be out of breath and have NO spare capacity.
one pilot friend of mine said: you really aren't ready to be an instrument pilot or ATP until you can hand fly an ILS to minimums while eating a hamburger and getting the phone number of a DARN good looking Female Flight Attendant.
All while doing your logbook.
using automation all the time is like using an escalator instead of taking the stairs. and the day the escalator goes Tango Uniform, you will be out of breath and have NO spare capacity.
one pilot friend of mine said: you really aren't ready to be an instrument pilot or ATP until you can hand fly an ILS to minimums while eating a hamburger and getting the phone number of a DARN good looking Female Flight Attendant.
All while doing your logbook.
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Bubbers is just stating the bloody obvious minus the self aggrandizing anecdotes at Toncontin! Sure had they remember to fly blah blah blah...but they didn't because they were fools or fooled into thinking the automation will take care of the shop. With newer generations of planes and manufacturers taking the road to greater autoomation, new pilots have to cope with automation traps because their SOPs predicated full use of automation.
We will never be going to have new generation of planes behaving like the DC3sc, F-27s or B747 classics that we enjoyed years ago. Present airline SOPs, airport architecture and system, ATC, TRACON, PRNAV, arrivals and departures are full of automatics with their inherent concomitant traps. If pilots are not made aware of such traps and only taught to click off everything automatic, we will only have a short term solution. Fine by me as a pilot, but what about future progress.
I don't want to be an old fart reliving and regurgitating my glory days telling everyone to use quill pens and parchment everytime the wireless keyboard runs out of battery ( of course some are not battery powered ). Sigh...........
We will never be going to have new generation of planes behaving like the DC3sc, F-27s or B747 classics that we enjoyed years ago. Present airline SOPs, airport architecture and system, ATC, TRACON, PRNAV, arrivals and departures are full of automatics with their inherent concomitant traps. If pilots are not made aware of such traps and only taught to click off everything automatic, we will only have a short term solution. Fine by me as a pilot, but what about future progress.
I don't want to be an old fart reliving and regurgitating my glory days telling everyone to use quill pens and parchment everytime the wireless keyboard runs out of battery ( of course some are not battery powered ). Sigh...........
And I think that this is what Bubbers was trying to say. The single trap is - believing that total trust can be placed in automation, leading the pilot to ignore what the aircraft is doing.
Automation should only be trusted as much as the PNF trusts the PF - PNF should continually monitor the safety fundamentals.
This may upset those who believe that automation is to be fully trusted but that is the trap. If automation could be fully trusted there would be no need to have a flight crew there in the first place.
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We will never be going to have new generation of planes behaving like the DC3sc, F-27s or B747 classics that we enjoyed years ago. Present airline SOPs, airport architecture and system, ATC, TRACON, PRNAV, arrivals and departures are full of automatics with their inherent concomitant traps. If pilots are not made aware of such traps and only taught to click off everything automatic, we will only have a short term solution.
This may upset those who believe that automation is to be fully trusted but that is the trap.
Reflecting on the sentiments above I think we need to consider a couple of points. Regarding the old types of a/c we used to fly... and therein lies a clue..'fly'.. Sure we had to operate them as well, but we knew how to fly them, often had to fly them e.g. Greek islands, and knew their foibles. They had basic automatics and we knew how to operate and monitor those because we knew more about what the a/c should be doing. Did the automatics do what we would do manually? Yes; then watch it carefully, and even we might learn something at the same time. This idea of 'clicking off everything automatic' means they first have to realise there is a problem and then be able to take over manually. Much debate has been made about the lack of ability of modern pilots in that latter regard. We need to be aware when the automatics start to go AWOL and perhaps correct it via the automatics: then, if that proves unsatisfactory takeover ourselves.
I saw over the past 20 years a generation of pilots who did not know the foibles and the basic envelope and thus didn't realise when things were starting to go awry. Their monitoring skills were 'knowledge and understanding deficient'. They trusted too much and fell into traps. Some they had induced by
mis-management of the FMC/AFDS, some had crept up on them via the FMC having a mind if its own. Sometimes they noticed, sometimes not. Sometimes they knew how to correct it or startedg playing the piano in hope.
I now see a new generation who, by their training, is even more removed from the a/c and therefore the understanding of the dark art. The basic flight school training is so diluted from days gone by it's scary. 150hrs and no aeros. The basic jet TQ syllabus is not orientated to learning how to control the beast manually, but how to operate it. There are lots of boxes to be ticked with systems failures and monkey reading QRH's. There are so many back ups that the QRH will always get you home. Many crashes I've read about were not mis- handling of QRH's, but caused by things which did not fit the index of the QRH, and the crew was found deficient.
If you don't fully understand what the a/c should be doing and how you would control it during various phases of flight, how can you be an effective monitor? You are suckered into the TRUST attitude. The SOP's are written so comprehensively that if you stick rigidly to them you might survive your 40 year career. That is what is being drummed into the cadets at TQ school. But still we see serviceable a/c being pranged. You can't write an SOP or QRH for all scenarios. Mother nature is waiting to bite, and that includes human factors from all links in the chain.
Without the basic knowledge and skills we can not be effective monitors, because we don't realise when it's creeping away from us; and we won't be effective last chance saloon when necessary. Those of us who came up the ladder via those basic a/c an onto the LNAV/VNAV/GPS a/c should not have forgotten the basics of earlier lives. The 150hr cadets going straight onto the new wizz-bang all bells & whistles a/c never had, and likely never will have, those in-depth basics.
I still believe TQ school should teach, in depth, how to fly the a/c, avoid the known traps of manual and automatic flight and afterwards learn how to operate the a/c. Given that guys now can get command after 4 years of trained monkey flying the foundations need to be more solid. Otherwise there will be a 'lot of trusting' going on, and hoping reliability, back-ups & SOP's will avoid any piloting skills being needed. The human factors people keep telling us that we are very bad monitors. We make very weak ones if we don't fully understand what we are monitoring, and yet I see technology & SOP's moving ever greater towards the alter of monitoring pilots. The PF is only a button pusher being PM to the automatics, and PM is the monitor to ensure PF pushes the correct buttons. What a life.
This may upset those who believe that automation is to be fully trusted but that is the trap.
Reflecting on the sentiments above I think we need to consider a couple of points. Regarding the old types of a/c we used to fly... and therein lies a clue..'fly'.. Sure we had to operate them as well, but we knew how to fly them, often had to fly them e.g. Greek islands, and knew their foibles. They had basic automatics and we knew how to operate and monitor those because we knew more about what the a/c should be doing. Did the automatics do what we would do manually? Yes; then watch it carefully, and even we might learn something at the same time. This idea of 'clicking off everything automatic' means they first have to realise there is a problem and then be able to take over manually. Much debate has been made about the lack of ability of modern pilots in that latter regard. We need to be aware when the automatics start to go AWOL and perhaps correct it via the automatics: then, if that proves unsatisfactory takeover ourselves.
I saw over the past 20 years a generation of pilots who did not know the foibles and the basic envelope and thus didn't realise when things were starting to go awry. Their monitoring skills were 'knowledge and understanding deficient'. They trusted too much and fell into traps. Some they had induced by
mis-management of the FMC/AFDS, some had crept up on them via the FMC having a mind if its own. Sometimes they noticed, sometimes not. Sometimes they knew how to correct it or startedg playing the piano in hope.
I now see a new generation who, by their training, is even more removed from the a/c and therefore the understanding of the dark art. The basic flight school training is so diluted from days gone by it's scary. 150hrs and no aeros. The basic jet TQ syllabus is not orientated to learning how to control the beast manually, but how to operate it. There are lots of boxes to be ticked with systems failures and monkey reading QRH's. There are so many back ups that the QRH will always get you home. Many crashes I've read about were not mis- handling of QRH's, but caused by things which did not fit the index of the QRH, and the crew was found deficient.
If you don't fully understand what the a/c should be doing and how you would control it during various phases of flight, how can you be an effective monitor? You are suckered into the TRUST attitude. The SOP's are written so comprehensively that if you stick rigidly to them you might survive your 40 year career. That is what is being drummed into the cadets at TQ school. But still we see serviceable a/c being pranged. You can't write an SOP or QRH for all scenarios. Mother nature is waiting to bite, and that includes human factors from all links in the chain.
Without the basic knowledge and skills we can not be effective monitors, because we don't realise when it's creeping away from us; and we won't be effective last chance saloon when necessary. Those of us who came up the ladder via those basic a/c an onto the LNAV/VNAV/GPS a/c should not have forgotten the basics of earlier lives. The 150hr cadets going straight onto the new wizz-bang all bells & whistles a/c never had, and likely never will have, those in-depth basics.
I still believe TQ school should teach, in depth, how to fly the a/c, avoid the known traps of manual and automatic flight and afterwards learn how to operate the a/c. Given that guys now can get command after 4 years of trained monkey flying the foundations need to be more solid. Otherwise there will be a 'lot of trusting' going on, and hoping reliability, back-ups & SOP's will avoid any piloting skills being needed. The human factors people keep telling us that we are very bad monitors. We make very weak ones if we don't fully understand what we are monitoring, and yet I see technology & SOP's moving ever greater towards the alter of monitoring pilots. The PF is only a button pusher being PM to the automatics, and PM is the monitor to ensure PF pushes the correct buttons. What a life.
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the Trap
as others have said, is complete trust in the automation without verify.
Is not the recurring issue here not so much that the airplane misbehaved but that no one was monitoring the basic flight instruments?
Is not the recurring issue here not so much that the airplane misbehaved but that no one was monitoring the basic flight instruments?
Doors
Nice effort. The scenario you described and that I opined on wasn't evident during the Asiana crash. Stay on task, stick to facts, don't stray.
You must be something, I ask we avoid rambling, non pertinent stories and you draw conclusions as to my level of knowledge.
There's lessons to be learned from Asiana, there I was stories do nothing only water it down, distracting from the narrative.
Nice effort. The scenario you described and that I opined on wasn't evident during the Asiana crash. Stay on task, stick to facts, don't stray.
You must be something, I ask we avoid rambling, non pertinent stories and you draw conclusions as to my level of knowledge.
There's lessons to be learned from Asiana, there I was stories do nothing only water it down, distracting from the narrative.
Rat 5 is bang on the money..
I'll give a practical example of one of his points.
Many of the younger/newer pilots that I have flown with don't run a 3x profile in their head during descent. To those of us who used to have to run it constantly all the way to touch down this seems absurd. But they have never had to, and nobody ever trains them to do it, so they don't, they just check that the VNAV pip is in the right place and then feel comfortable.
So, as Rat pointed out, when the profile is wrong, when do they pick it up? Passing 20,000ft when they expect to have 70nm to run but only have 55? No, they don't even notice because they have never been controlling it manually. Scary I know but it's true in many cases.
I'll give a practical example of one of his points.
Many of the younger/newer pilots that I have flown with don't run a 3x profile in their head during descent. To those of us who used to have to run it constantly all the way to touch down this seems absurd. But they have never had to, and nobody ever trains them to do it, so they don't, they just check that the VNAV pip is in the right place and then feel comfortable.
So, as Rat pointed out, when the profile is wrong, when do they pick it up? Passing 20,000ft when they expect to have 70nm to run but only have 55? No, they don't even notice because they have never been controlling it manually. Scary I know but it's true in many cases.
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Its not their race
Its not their airline
Its simply this...pilots allowed a plane to get low and slow...and not just a sloppy five knots.
I had an uncle...he never flew a plane in his life...anytime he saw me he said: don't get low and slow. He said this to me for over 30 years.
so someone who doesn't have a pilot's lic. knows it.
don't blame fatigue, the only excuse is that everyone ate the fish, or they were not doing their jobs
Its not their airline
Its simply this...pilots allowed a plane to get low and slow...and not just a sloppy five knots.
I had an uncle...he never flew a plane in his life...anytime he saw me he said: don't get low and slow. He said this to me for over 30 years.
so someone who doesn't have a pilot's lic. knows it.
don't blame fatigue, the only excuse is that everyone ate the fish, or they were not doing their jobs
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A viewpoint from Les Abend, current 777 captain, and author "Flying" magazine.
Jumpseat: Speculation Fascination with the Asiana 214 Crash | Flying Magazine
Jumpseat: Speculation Fascination with the Asiana 214 Crash | Flying Magazine
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So, theoretically with a pilots license should in my opinion never get low and slow. One of my favorite FO's when I was on vacation flew with a captain that got low and slow into TGU and took out the fence at the 70 ft cliff landing south.
There is no excuse for that if you are a real pilot and not a button pusher fresh out of school or who never progressed past that. I was in Europe when I read this in the newspaper. Later, I found out it was my friend who was the FO. I thought everybody knew if you are approaching a runway with a cliff on the approach end the air has to spill over the cliff downward if you have a head wind so you get a down draft. He didn't. Stupidity sometimes can not be fixed.
There is no excuse for that if you are a real pilot and not a button pusher fresh out of school or who never progressed past that. I was in Europe when I read this in the newspaper. Later, I found out it was my friend who was the FO. I thought everybody knew if you are approaching a runway with a cliff on the approach end the air has to spill over the cliff downward if you have a head wind so you get a down draft. He didn't. Stupidity sometimes can not be fixed.
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Les Abend :
How true .
This accident is almost a carbon copy of TK / AMS . This time the crew survived so we might know what went inside their heads and why no-one saw the speed decay. Some good might come out of this in the end.
The NTSB, in Chairman Deborah Hersman’s words, has been very transparent with the factual data of Asiana Flight 214.(....) It’s bad because the release of information allows the misinformed to reach biased conclusions without all the factual data.
This accident is almost a carbon copy of TK / AMS . This time the crew survived so we might know what went inside their heads and why no-one saw the speed decay. Some good might come out of this in the end.
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But they have never had to, and nobody ever trains them to do it, so they don't, they just check that the VNAV pip is in the right place and then feel comfortable.
So, as Rat pointed out, when the profile is wrong, when do they pick it up?
Even worse reliance on automatics and VNAV: when adjusting the route during arrival; perhaps with an extended centre line when still flying towards the downwind and needing to make a 180 to the runway, the VNAV vertical error might give >2000' high. What happens is the new generation yanks out the speed brake and dives the a/c to attain 'the path'.
Ask them to look at the ILS DME = direct track miles to the airfield; now add 15nm for the downwind, base turn and finals from 2000'. Are you high or low? Very often the answer is LOW. There is an ah ha moment, the speed brake is retracted and now the question. "How can VNAV show that error?" "It doesn't matter, but it did. Now do you understand that you are in charge and the FMC is a tool to help you, but you have to decide if you trust the info it's giving you and whether to use that info." Your brain needs to be further ahead than the nose of the CDU.
It's like the guys who punch numbers into a calculator with no gross error cross check of the answer expected. They too have some surprises.
So, as Rat pointed out, when the profile is wrong, when do they pick it up?
Even worse reliance on automatics and VNAV: when adjusting the route during arrival; perhaps with an extended centre line when still flying towards the downwind and needing to make a 180 to the runway, the VNAV vertical error might give >2000' high. What happens is the new generation yanks out the speed brake and dives the a/c to attain 'the path'.
Ask them to look at the ILS DME = direct track miles to the airfield; now add 15nm for the downwind, base turn and finals from 2000'. Are you high or low? Very often the answer is LOW. There is an ah ha moment, the speed brake is retracted and now the question. "How can VNAV show that error?" "It doesn't matter, but it did. Now do you understand that you are in charge and the FMC is a tool to help you, but you have to decide if you trust the info it's giving you and whether to use that info." Your brain needs to be further ahead than the nose of the CDU.
It's like the guys who punch numbers into a calculator with no gross error cross check of the answer expected. They too have some surprises.
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This accident is almost a carbon copy of TK / AMS . This time the crew survived so we might know what went inside their heads and why no-one saw the speed decay.
-A crew incapable of manual flight- is a phenomenon that we have to blame on ourselves. The whole airline industry is culpable of having allowed this to creep into existence.
We -the airline industry- must do something about it. NOW.
We -the airline industry- must do something about it. NOW.
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'HOLD' mode means just that, HOLD the thrust levers as your rate of descent, speed and distance to the selected level is under your right hand.
By selecting the thrust you wish (the autothrottles being 'clutch' disengaged to prevent the autothrust messing about with your pilot selected thrust) you have the ability to control your speed and descent thus achieving clearances as requested by ATC. Pretty nice system if you wish to play with it.
The autothrottle will wake up at ALT capture and re-engage, if you disconnect BOTH flight directors the auto throttle will wake up in SPD mode. If you deselect only ONE FD and then level the aircraft before ALT capture mode then you're in trouble of your own making.
It's not a 'trap' per se, it's a 'feature' that is useful as long as you are aware of the limitations and, as has been said here previously, it's not a mode you should be using close to the deck and on finals.
If in doubt, AP off, manual flying, both FD's off then back on again if they are giving you good info otherwise both off and fly the thing like an aeroplane!
By selecting the thrust you wish (the autothrottles being 'clutch' disengaged to prevent the autothrust messing about with your pilot selected thrust) you have the ability to control your speed and descent thus achieving clearances as requested by ATC. Pretty nice system if you wish to play with it.
The autothrottle will wake up at ALT capture and re-engage, if you disconnect BOTH flight directors the auto throttle will wake up in SPD mode. If you deselect only ONE FD and then level the aircraft before ALT capture mode then you're in trouble of your own making.
It's not a 'trap' per se, it's a 'feature' that is useful as long as you are aware of the limitations and, as has been said here previously, it's not a mode you should be using close to the deck and on finals.
If in doubt, AP off, manual flying, both FD's off then back on again if they are giving you good info otherwise both off and fly the thing like an aeroplane!
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Les Abend: The NTSB, in Chairman Deborah Hersman’s words, has been very transparent with the factual data of Asiana Flight 214.(....) It’s bad because the release of information allows the misinformed to reach biased conclusions without all the factual data. (ATC Watcher: "How true.")
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The underlying cause might be found in the answer to the following question:
What would have been the consequences for the PF if he had gone around earlier?
Obviously he would have avoided the crash but what would have happened to his training record, comand, promotion, etc? I have not flown in Korea but know some that have and acording to them the consequences of messing up (an approach during training for example) can be pretty harsh.
These are lessons that we learned long long ago. Why don't they sink in?
What would have been the consequences for the PF if he had gone around earlier?
Obviously he would have avoided the crash but what would have happened to his training record, comand, promotion, etc? I have not flown in Korea but know some that have and acording to them the consequences of messing up (an approach during training for example) can be pretty harsh.
These are lessons that we learned long long ago. Why don't they sink in?