Without trawling through the complete thread I thought that the RA failure had triggered 5 warnings to the crew. After all, wasn't this the reason they had configured to take all navigation information from the "B" system (for want of a better word). What was unknown was that the system would still take its height information from the right radar altimeter.

To play devil's advocate here, the crew had a very limited time to come to the realisation that something was wrong. For a considerable time after the aircraft had intercepted the ILS the speed was reducing to VREF so the thrust levers were at idle. When the crew did realise that the speed was decreasing below that speed the thrust levers were advanced (by the captain, I think) but he then took his hands off them and, of course, they retarded to idle.

Limited time, reconfiguring the aircraft, instrument conditions, a FO under some pressure and a trap lurking in the aircraft system..........the holes were lining up.

I have inadvertently, I think, confused the picture on RADALT u/s - certainly the 'collar' was in force, but the 'old' MEL required

"Approach Minimums or operating
procedures do not require its use"

and this obviously did not 'flag up' the trap that awaited, since detailed knowledge of the role of RADALT 1 is required to see that coming. In that respect I reckon Boeing were 'at fault' as they did not differentiate between RADALT 1 and 2 failure except in the effect on GPWS, and certainly an OPS note about the effect on the A/T 'RETARD' would not have gone amiss.

However, as we know the No 1 RADALT was not 'U/S' and therefore not MEL'd, so this is actually incidental to the accident which was primarily caused by 3 pairs of eyes looking the wrong way.

I find Dekker's report most informative but cannot agree with all his conclusions.

For example he maintains that the crew were not rushed although they were vectored in above the glide, descended with gear down flaps 15 to 1000 and then configured straight to flaps 40 and then apparently only at the prompt of the training captain.

The trainee, who is pilot flying, leaves the autopilot in till 400 feet and is obviously behind the aircraft as he fails completely to notice the drop in speed.

Dekker plays down the concept of gates and appears to be saying that unstabilised approaches are quite a regular event. I did however like the idea of safety pilots rewarding crews for performing go-arounds with a bottle of wine or something similar.

He provides a balanced view but one which is extremely, some might say excessively fair to Turkish Airlines. He stresses many positive aspects about their training for example, but plays down that they are regularly well down the safety rankings. He lists the facts; very experienced captain, new copilot who is transitioning from fighters and safety pilot with 700 hours on the 737. The captain is refered to by an honorific. But then he concludes there is no evidence that CRM is a factor.

I really like the idea of no blame culture and there is no question that there were a number of contributory factors, not least poor vectoring, a technical glitch and an inexperienced pilot flying. But I think this really was avoidable. There were at least four points where the crew could have regained the initiative.

On the intercept heading they could have pointed out to the controller that they would prefer a less agressive heading, particularly given the visibility.

Once established they could have slowed down and full configured giving themselves more time, before capturing from above.

At 1000 feet in imc they should have performed a mandatory go-around due to not being fully configured, spooled up or anywhere near vref.

At 400 feet and stall warning more precise actions which we practice regularly in the sim should have prevented ground contact.

I find the report well written and thought provoking. But to me this accident is like Handy's frog anecdote. If you throw a frog in boiling water it will jump out. If you put it in cold water and slowly heat it up the frog will boil to death. In other words an insidious trail of small factors added up to a major and very avoidable accident.

I have to disagree with many of the points being made. Life is actually quite simple if you just follow a few basic rules.

The MEL is clear in as far as what constitutes a failure. The rad alt was u/s as per the mel description of a faulty system, had been detected as u/s on previous legs, but had been ignored.

The procedure is simple, enter the fault in the tech log and the CB will be collared.

The reason for doing this is that the manufacturer Boeing are/were well aware of the consequences of a failure with this system. Boeing are not responsible for informing pilots how to bypass procedures in order to keep flying.

Had that one simple action been followed we would have no discussion. This viewpoint does not detract from the discussion about unexpected anomalies following failures.

And before you all launch into attacking this viewpoint lets just go back to the Spanair accident.

Pliots are human and make genuine mistakes. It cannot be avoided. They are supposed to select flaps before take off but there is a history of forgetting. As its important a take off warning system is installed in order not to get caught when that forgetful day comes.

If you now do not handle a fault correctly that appeared over 20 times in the days/weeks preceding Madrid then forgetting to select flaps turns into a tragedy.

You can talk all you want about modern aircraft and their capabilities and weaknesses but once again the biggest single weakness here was getting around the regulations.

XL test flight not in accordance with recommendations
easyjet near accident, not entering problems in the tech log
spanair repeated fault not dealt with properly
turkish repeat fault not dealt with properly
korean 747 stansted fault not dealt with properly

you are licensed to fly and are not engineers
engineers are licensed to fix, let them do it at the first opportunity

you never know, it may save your butt

dekker has inadvertently set back safety with this report because it ignores the true root cause (not following procedures) as mentioned in earlier posts here.

Help me out chaps, in which page/s or which report/s does it categorically say that this crew were aware of the Rad.Alt. fault before flight. And where does it categorically state that the crew fully understood the implications of this failure. Also, which numpty designs a system with the same name for two functions - the same one that calls a relic (all be it a pretty reliable one) from the sixties "modern" and "new generation?" Would the current 737-800 pass current certification tests? And why not?

PM

The Dekker report ignores these facts from the accident report.

Whilst agreeing with Safety Concerns assertations, Rad Alt snagged then fixed = no crash, it is NOT the primary cause.

The primary cause is simply that none of 3 experienced aviators monitored the airspeed from 1000ft until the stick shaker. PF had 4000hrs even if low hrs on type, and all fixed wing aircraft requires speed and normally thrust to maintain it on an approach. The 3rd set of eyes on the jumseat called SPEED at 100kts, 44kts less than the commanded speed, he was therefore asleep or felt inhibited to speak up. The Human Factors report emphasises VERY strongly the understanding nature of the LTC, so are we supposed to assume that the safety pilot was also fixated on checklist completion ?

Reading the rather pro THY pro LTC report can perhaps lead one to understand why they fouled up. It WAS however by any reasonable definition a rushed approach. PF was maxed out, didnt call for flap40, PNF suggested /accomplished, didnt call for checklist ,PNF likewise prompted, responded incorrectly. . Landing Gear? please. . . Oh down three greens
PNF in an effort to slow down the action suggested 1 at a time , and tried to allow the checklist to be completed normally.

Rushed approaches like these can and are flown safely very day. To do so however requires ALL crew members to be on the ball.

Whether due to authority gradient, denied in the report but subtly present I would suggest, fatigue, or whatever, these guys quite simply were NOT.

The Rad Alt was the mousetrap, the rushed approach the cheese, the choice to stick their fingers in to retreive it was the choice of the crew.

again, pilots are human and make mistakes. That part is normal and unavoidable.
It is due to numerous accidents over the years that many onboard systems are just that, onboard.

Accepting you are going to make a genuine error one day is half the battle. Thats why we have procedures, thats why we need to stick to them.

You can continuously question the skills of this crew or any other crew but they placed their faith in the technology bringing them safely to a point in time. It was misplaced faith as the aircraft was not serviceable and there was no indication in the log book despite numerous failings on previous days and during take off.

The accident reports I listed were all avoidable if one single common action had been followed, stick to procedures.

Many of you here posting about the qualities of the crew would have done exactly the same in their shoes and you do so everyday. You place your trust in the equipment working properly. Therefore snag it, when it doesn't do what it should.

If you did that we would have less accidents to discuss.

Again this is not taking anything away from other cockpit issues out there. But don't dump on a crew when you do exactly the same as them, you just got lucky.

I agree wholeheartedly about everyone making mistakes. One of the most useful aspects of Pprune for me is reading about and trying to learn from those that other people have made. However I simply cannot agree that most people would have 'done exactly the same in their shoes and do so everyday'.

In this case they captured from above, happens occasionally no big deal.

Failed to slow down configure and complete checklist by vmc gate when they were in imc conditions, definitely a big deal.

Left both autopilots engaged below 400 feet with nobody minding the shop, absolute no no.

If you fly the 737 and think this is normal or know many people who do then I am genuinely shocked.

I thought the HF report was very well written and covered many points, sometimes looking from different/unusual directions. The section on FMA use (or not!) was interesting and warrants much greater exposure.

What I don't really accept, in common with other posters, is that there was much degree of stability in the the approach. To me, it was a classic rush job: turned in early, too high and fast, went through 1,000' in IMC a) with idle thrust, b) not fully configured, c) way above Vref and d) landing checks not even started.

Quoting from the report: "There is, of course, no generic set of criteria that would make an approach “rushed.”" - I'm afraid I'm going to disagree there, too - most reputable airlines plus ICAO, EASA et. al. use 1,000'R, some allow 500R in VMC (not applicable here). The fact that they were so distracted by executing the landing checklist below 1,000' that basic monitoring was lost, speaks volumes.

There was a long discussion of the technical aspects of why the autothrottle behaved as it did but is that really relevant? At the end of the day, the crew were faced with a failure of the A/T system, i.e. it didn't advance the thrust levers when required. At that instant it is simply "a failure": if at that moment any other sort of technical problem had rendered the A/T U/S, the end result would have been the same...

Overall, though, I found it a very good read with some excellent background material and liked the author's style.

Although we here have only just found the Dekker report, I believe it predates the accident report, and therefore can be excused from not knowing its conclusions. In fact, I think parts of the Dekker report are actually in the accident report (haven't verified, but got definite "I've read that bit before" feeling).


Another point where Dekker differs from the final report, is that he states (as a finding) that the aircraft was irrecoverable at stick shaker, (there is little attention paid to the recovery effort, possibly as consequence of this assumption). Dekker also points to the Bournemouth 737 incident, and seems to be saying that a 737 at stick shaker, with pitch-up trim, is so difficult to recover that the crash is pretty much certain.

In contrast, the final report states that the a/c was recoverable at stick shaker, and recommends approach-to-stall procedure and training changes.


Also, there seems to be a, possibly very significant, factual discrepancy between the reports as regards timelines, which may lead to the differing conclusions above:

Dekker has this:

While final report has (my emphasis):

Quote:

---

Once the captain had taken over control, the autothrottle
was disconnected, but no thrust was selected at that point. Nine seconds after the commencement
of the first approach to stall warning, the throttle levers were pushed fully forward

---

Which look quite different to me - anyone got any better insight ?

The bit I did like from Dekker's report was his hindsight diagram. Most posters here are commenting with hindsight. To avoid getting into the pre event situation, follow procedures.

Of course any event can crop up at any time and catch people out. The point I am making is that there is a definite trend creeping up on us and that is complacency and non adherence to procedures.

The whole point of procedures is to reduce risk. We cannot cover every possibility but following procedures should cover most.

XL test flight not in accordance with recommendations
(no accident if test flight procedures followed)

easyjet near accident, not entering problems in the tech log
(no incident if problem entered in tech log)

spanair repeated fault not dealt with properly
(no accident if repeat item repaired even if flap setting forgotten)

turkish repeat fault not dealt with properly
(no accident if enterd in tech log and follow MEL procedure, pull cb ra 1 inop no influence on A/T)

korean 747 stansted ADI fault not dealt with properly captain crashed aircraft following defective adi
(no accident if repair before flight or set inop if MEL allows)

So yes, you could try and find excuses/explanations for all these happenings or you could just emphasize that procedures must be followed to the letter.

Or you could properly investigate why so many are overlooking procedures. The common thread linking all these accidents is not flying skills as such, it is human behaviour.

A few posts back, I came up with my own recommendations and suggested three. I'll now add another two. Get Boeing to change the FCC software so that the autopilot disconnects as Vss is approached. To have an autopilot that will fly an aircraft into a stall and bloody well trim it there is not acceptable in the 21st century. So the last one has to be to prevent nose-up trim being applied by the A/P when flying at less than selected speed. Make the bugger pull a bit. In this way at least the nose will drop when the A/P is disconnected - and you'll have a flyable aircraft.

Safety Concerns may be right about writing stuff in the tech. log but he has to be speaking about his own company, it's not a trend in all. I'll guarantee that when I fly tomorrow there will be entries in my tech. log regarding door noise and others about worn erosion tapes. We are working on eradicating these as quickly as we can. As for other posters, gates, rushed approaches, checklists and guff like that were not the important things in this incident. What I believe happened was that at aircraft failed in such a way, partly through poor design and partly through component failure that a bunch of useful people were not aware that they had passed the point where recovery was possible - in an allegedly modern aircraft.

Yes, extra margins probably would have helped as would have being stabilised by 1,000' but unless we have more information about how the crew was operating and what was going on in the mind of the Training Captain, we'll never know. For all I know, maybe he was going to use this approach as a "This is not how we do it at THY" exercise for both of the F/O's. To say that this is the way Turks operate, as some have implied, is insulting.

As for changing the way aircraft are flown, would we be better off if all approaches flown on 737s commenced above the glide were performed A/T Off? And would it be worthwhile having having recurrent "A/P On" stall awareness and recovery training, both level flight and approach regimes?

Over...

And wouldn't we be better off if the airlines insisted that their pilots keep in regular hand flying practice without the extra baggage of flight directors and autothrottles? All these loss of control accidents stem from one main cause. And that is lack of pure flying competency brought upon by blind reliance on button pushing.

One only has to read the Kenya Airways Boeing 737 accident report where the captain crashed the aircraft vertically while applying totally confused control inputs. And that was less than two minutes after take off. And all because he was unable to engage the automatic pilot in IMC. This accident and many others similar - is deadly proof of what is inevitable because of lack of today's pilots basic flying skills.

Despite numerous high class research papers warning of the dangers of automation dependancy, regulators and airlines are turning a blind eye. Of course this is a generalisation. But Blind Freddy could see why loss of control is now the primary reason for crashes.

PM
Deja vue... it's the same one that uses one horn for two functions (Helios!)

I can't totally agree with this, but you are probably not far off. I'm sure that there are many people who can remember flying hand-flown approaches to minimums on a regular basis into places like Jersey and Guernsey. Not only was the visibility poor, but the air was normally very rough and it always appeared to be close to crosswind limits - all on (sharp pencilled) minimum fuel. So no stress then! This was done with neither FD, A/P nor A/T. You got the knack in the end and got rather good at it but it was no safer for the passengers, especially if something went 'twang' or if there was problem elsewhere. Later on, having a "full house" so to speak, meant that you could monitor the aeroplane and interfere only to land (or go-around). As flight crew what we might not do enough is to practice visual, hand-flown, non-precision (unless you fly for RYR, that is) approaches and automatic landings each with and without A/T with enough regularity. By doing this you get to push all the knobs and buttons and get used to the aircraft "speaking to you." But this guy was just learning and the inbuilt traps got the two "minders." As for my airline, on the fleet I fly, if we have a problem it's getting your colleagues to use the autopilot.

keep thy airspeed up
 

While the Dekker report certainly points out a lot of relevant human factors, it ignores a most important fact in the last episode of the drama.

The stickshaker goes off and one of the crew members shouts "speed". The throttles are advanced, but the spool-up is not really monitored. Now, whatever may have happened beforehand, false ra sensor, glide capture from above, automation surprise and possibly a rushed approach, an impending and recognized stall was not really triggering the survival mode of any the three pilots in the cockpit.

A stall warning and consequently the need to get back airspeed places itself on top of all flying priorities regardless of the kind airplane you fly, from ultralight to heavy.

Get the power on, make sure the engines produce what they were built for and have an eye on the angle of attac/trim before even considering any other possible issues is just pure flying basics. Mr Dekker gives us reasons why the speed could decay without recognition, but not why an experienced (on stall-prone military jets) and well trained crew failed to recover properly from the impending stall. Could it have something to do with the intention of smooth flying with a load of passengers and possibly hiding the fact to the other crew members that something went terribly wrong?

Idle Thoughts
 

I was reading on another thread regarding engine accel times and noted a discussion regarding engine flight idle/ground idle being different throttle settings on the 738.
Would a RADALT indicating the aircraft on the ground also cause ground idle to be selected instead of flight idle?
I'd think not, because it would foul up potential for a GA, but it doesn't hurt to ask.

Signalled by flaps, gear and WOW. As far as I know, no signal from either RadAlt and no MEL note.

Thanks BOAC.

That report was deleted from that host.

What report from which host? :confused:

The final report can still be found at the dutch safety board!
Take a look here:
Crashed during approach, Boeing 737-800, Amsterdam Schiphol AIrport - De Onderzoeksraad voor veiligheid

I meant this one. Sorry for misunderstanding.

"Here's the TK1951 Human Factors Report, written by Sidney Dekker for the Dutch Safety Board. Very interesting!"

THYHFreport3


You can find it here

I read the report, and made notes. It lacked. Nowhere did the author distinguish between the gravity of an annunciated failure, and an undetected error, which was the case with the radalt.

Engineers designing Cat III autoland systems go to great lengths to assure there are no undetected failures that could kill people in umpteen fleet lifetimes. Annunciated errors and failures are expected and accommodated by the airplane systems.

If you look at this accident, and others, with annunciated vs. undetected failures in mind, the shading is quite different.

WTF...

They goofed it, no more!

Granted that humans are known to do a better job when "in the loop" than when monitoring another human, or monitoring the automation...

But when capturing the glideslope, whether from below or above, shouldn't ONE pair of eyes observe and confirm actual capture (track, power, airspeed)? To me it's as elementary as confirming flaps or gear.

fly a 146 in the LTMA for a few years .. you learn fast !

I started to refuse ATC instructions after many screw ups on the line. These people bring you in too fast, too close to the airport, and sometimes too high. The electronics can not capture a glide slope from above, and the ACT approach controllers should be aware of that limitation. Pilots have to learn to say "NO" to these people when they screw up. Far better to extend the downwind leg than to try to salvage poor vectoring and end up dead.
A quick calculation one can do (if above the GS) is to add one to the ground speed for the rate of descent i.e. GS 150 kts, add one to the 15 and that becomes 1600 FPM. This gives you a 6 degree slope to capture the 3 degree glide slope. So: 140 = 1500, 150=1600, 160=1700 etc. Do NOT exceed 2000 fpm. Don't let them fly your airplane. That's not their job. Their job is to separate little dots on the screen.

ATC do this because they unaware of the limitations of your aircraft and what you operationally need and want.
Sadly communication meetings between active line pilots and active ATC controllers are a thing of the past...everyone works flat out these days and under pressure and are trying to fit a quart into a pint pot and as rapidly as possible.
I do not blame you for flying very much with your guard up and sometimes refusing being suckered into a bad situation...this is old fashioned airman-ship and pilot in command responsibility...it also keeps your sorry bottom out of the non flying chief pilots office on your day off.

Cockpit crisis

In five years, over 50 commercial airplanes crashed in loss-of-control accidents. What’s going on?



With low clouds and a fine mist hanging in the morning air, the pilots of Turkish Airlines Flight 1951 anticipated a routine approach to Amsterdam’s busy Schiphol Airport on Feb. 25, 2009. But instead of touching down gently on the runway, the white and red Boeing 737 dropped out of the sky and slammed into a muddy field just short of the airport, smashing into three pieces. Nine people died, including all three pilots. Another 84 were injured.


Investigators attributed the crash to a faulty radio altimeter, aggravated by pilot errors and oversights. Radio altimeters use radio waves to measure a plane’s altitude—a key piece of equipment, which is why a 737 is equipped with two of them. But what nobody in the cockpit of Flight 1951 realized was that the malfunctioning altimeter happened to control the 737’s auto-thrust systems. So while the co-pilot was busy monitoring the autopilot (which used data from a different altimeter), and Capt. Hasan Tahsin Arisan was watching the co-pilot as part of a training exercise, and a third “safety” officer was supposed to be watching everyone to make sure nothing got missed, the auto-thrust erroneously engaged its “retard” mode, thinking it was just above the runway. The throttles were cut and the plane’s nose pitched up, causing the plane to drift into an aerodynamic stall. The flight crew tried to recover by returning the throttles to full power, but their initial efforts were thwarted by the confused auto-thrust system, which they forgot to disengage. There was no time for a second try.

Statistically speaking, modern avionics have made flying safer than ever. But the crash of Flight 1951 is just one of several recent, high-profile reminders that minor problems can quickly snowball into horrific disasters when pilots don’t understand the increasingly complex systems in the cockpit, or don’t use them properly. The point was hammered home later that year when Air France Flight 447 stalled at nearly 38,000 feet and ended up crashing into the Atlantic, killing all 228 on board. Investigators recently released transcripts from the Airbus A330’s cockpit voice recorder. It reveals a flight crew gripped by confusion as they tried to diagnose and respond to what should have been a manageable mid-air emergency, but instead resulted in a terrifying 3½-minute plunge in total darkness. “I don’t have control of the airplane anymore,” the co-pilot at the controls said at one point. “Now I don’t have control of the airplane at all.”..........more at link below


Cockpit crisis - World - Macleans.ca

Altimeter of Boeing 737 was repaired 16 times
 

Today some news on the Turkish Airlines Boeing 737 crash on short final at Schiphol airport in 2009

google translation used.

Article - Luchtvaartnieuws

THE HAGUE - The altimeter of the Boeing 737-800 Turkish Airlines on February 25, 2009 crash at Schiphol was in the period from January 2008 to February 2009, 16 malfunctioned. That said Wilma Mansveld Secretary for Infrastructure Monday to questions from Labour MP Attje Kuiken.

It is not true, writes the Secretary, that the defects are not repaired. "In all cases, action such as restarting the system and replacing the antenna,'' she wrote to the House.

The Turkish Airlines Boeing 737 had 135 people aboard. The plane crashed 25 February 2009 during the landing down to a field near Schiphol. Nine people were killed and 120 others were injured.

The Public Prosecutor (OM) decided in April last year, no criminal prosecution because of the accident. The prosecution examined whether someone had done something criminal perch in the crash. This was the case for the pilots, Boeing and the air traffic control.

On the role of the pilots important information is missing in the study because they are deceased and therefore could no longer be heard, said the OM then. The technical problem with the altimeter of the Boeing was known to the pilots, who had to solve. It was not a safety problem.

How wrong this statement is!

More a question of pilots not being trained and/or practised in the basics of flight control.

@fireflybob

Read the quote again....and you will understand!

hetfield, am aware of the entirety of the quote and the circumstances around this accident not to mention the various arguments on pprune.

@fireflybob

Do you agree, about several examples of incidents/accidents at well known carriers besides THY, like AF/LH/TAM and others, where the crew lost track due to "complexity" of their ship?

I agree it is a factor, of course.

Okay, and I agree about adequate pilots training !

Some airlines are doing that, others don't.

And there is a change in manufactores philosophy, even at Airbus...;)

"Don't touch anything"
"Fully automatique"
"All by Puesh buetton"

Now, they know different.

Payed with blood!

"Do you agree, about several examples of incidents/accidents at well known carriers besides THY, like AF/LH/TAM and others, where the crew lost track due to "complexity" of their ship?"

I disagree, slightly. I am giving a Type qualification course at the moment. As with many airlines it is self-funded by the student and thus is kept to a minimum number of sessions. As with other airlines the type rating is combined with an OPC. A few decades ago, in my early life entering the airlines, we were taught to fly the a/c in the TQ course, with SOP's attached. The line operation and SOP's were refined during line training. The initial emphasis was knowing how the a/c worked, how the systems worked and how to fly it. The line training refined these skills and expanded how to operate it within the airways system and a multitude of busy airports and small visual airfields. Understanding the complexities of the systems came with our 'apprenticeship', which had started in the sim.
Nowadays the TQ course seems to shift the emphasis more towards SOP's during the manoeuvres, some of which are with normal & non-normal scenarios. Some of the non-normals scenarios are box-ticking on the LST form, very few are in depth training of the gotchas and pitfalls. The handling emphasis is aimed at the LST items.
Thus IMHO it was not the 'complexity of their ship' which sucked them into trouble, it was the lack of training = understanding of those systems. This ignorance created a complex system when in fact with proper training it would have been quite simple.
One wonders if the policy of many airlines to use relatively (2 years experience) inexperienced F/O's as SFI's is correct. They have followed the self same course of knowing what to do, but not the how & the why. They then pass on this diluted knowledge to the next generation of cadets who will become the next generation of SFI's and so the downward spiral of knowledge continues. SOP's are so intense that the first thought of a pilot in a less than ideal situation is to ask, "what does the book say?" Second, if at all, comes "what is the most sensible airmanship thing to do?" By the time you arrive at the 2nd option it might be too ate as the a/c was still travelling very fast during the first phase of questioning confusion. It is noticeable that I've been told by newish F/O's that flying with the old farts is usually more relaxing than with the newbie captains. The oldies do what is best instinctively, and within the book boundaries, but are not afraid to bend the SOP's; the newbies are terrified to even blow at the boundaries and thus delay making some decisions and then have to race to catch up. All old farts were newbies once, but mostly with a longer and deeper apprenticeship than today.
IMHO, if the industry is gong to continue making captains with relatively low hours then the training of manual skills, and especially systems knowledge and understanding of all their possibilities, needs to be more in depth to compensate for the shorter apprenticeship. Too many commands can be given to those whose prof checks are above average and SOP knowledge is perfect. SOP's can not cover all eventualities. Most incidents and accidents started quite subtly and the human intervention, or lack of it, caused a can of worms to develop, when it was preventable. And that's a whole other discussion about a good crew being preventative rather than reactive. Slavishly following SOP's is not always preventative, but that was touched upon in an earlier thread.

Knowledge is power: ignorance can be painful in the extreme.

Not sure about the 'LH' quoted, but all the others were accidents which SHOULD have been avoided by BASIC flying skills. Why they were not exercised is a discussion point. There was certainly enough 'experience' in the three examples to have avoided the crashes. Was it that over-reliance on the 'systems' (aka 'complexity') caused the lack of attention to the basics?