Page 2 of 2 FirstFirst 12
Results 21 to 30 of 30

Thread: Yeti Airlines DHC6 at Lukla, on October 8th, 2008, crashed on runway

  1. #21
    Senior Member Gabriel's Avatar
    Join Date
    Jan 2008
    Location
    Buenos Aires - Argentina
    Posts
    5,783

    Default

    Quote Originally Posted by elaw View Post
    You wrote above that the only way to gauge skills is from another seat in the cockpit. In some cases, that's absolutely true.
    Not so much. Pilots not following checklist, not honoring sterile cockpit, and busting minimums, won;t do all that when they are being observed and evaluated.
    Only whistle blowers and, to some extreme, FOQUA, works for that. But that only in the context of a good culture where the rogue pilot is the exception and not the norm (especially not the expected norm).

    But there are a lot of skills that might be needed in extreme circumstances, that don't come into play in routine flying. So the hypothetical cockpit observer could spend many hours with someone flying fat dumb and happy, and have no idea they'd react badly when the s**t hits the fan.
    Sim helps. You can observe people in the sim. True: you never know how a person will react when facing a REAL emergency. A person can master an emergency in the sim and then freak out when his life is at stake. But what studies have shown is that the chances that a person will react correctly to a crisis or emergency increase markedly with the number of times that the person was exposed to that scenario in drills.

    --- Judge what is said by the merits of what is said, not by the credentials of who said it. ---
    --- Defend what you say with arguments, not by imposing your credentials ---

  2. #22
    Member
    Join Date
    Jan 2008
    Location
    MA, USA
    Posts
    672

    Default

    On the "observation factor", I completely agree - when a pilot would knowingly be doing things wrong. I think observation can be helpful when someone is doing things wrong but they're not aware of it.

    I don't think there's any doubt that sims help, but they have limitations. The biggest being then when a pilot does a sim session, they know things are going to go wrong.

    The human brain is a fantastic pattern-recognition engine. A pilot's brain will quickly identify a pattern where every time you sit in a sim, things go wrong left and right. But it will also identify the pattern that when flying on the line, nothing ever goes wrong*. It takes a certain amount of mental fortitude to fight that voice inside your head that says you can let your guard down because there's nothing to worry about in your current situation. Especially when 99.99% of the time there really *is* nothing to worry about in your current situation. It's the other 0.01% that gets ya.

    * I'm talking serious things that put a pilot's skills to the test, not the coffee pot in the galley springing a leak.
    Be alert! America needs more lerts.

    Eric Law

  3. #23
    Senior Member Gabriel's Avatar
    Join Date
    Jan 2008
    Location
    Buenos Aires - Argentina
    Posts
    5,783

    Default

    Quote Originally Posted by elaw View Post
    The human brain is a fantastic pattern-recognition engine. A pilot's brain will quickly identify a pattern where every time you sit in a sim, things go wrong left and right. But it will also identify the pattern that when flying on the line, nothing ever goes wrong*. It takes a certain amount of mental fortitude to fight that voice inside your head that says you can let your guard down because there's nothing to worry about in your current situation. Especially when 99.99% of the time there really *is* nothing to worry about in your current situation. It's the other 0.01% that gets ya.
    Good point. The pilot mindset should be "always work for the best, always prepare for the worse". That is something that I used to do. For example, I would take the walkaround seriously, as well as perform all the checklist and before take-off checks, trying to do them reading each item and looking and touching each control or indicator as if it was the first time (this sounds easy but is something amazingly hard to do). Then I would do my own take-off briefing in my head: "Now I will accelerate, lift off and the engine will fail (except if by chance it doesn't), so when it fails I will do this and that". This included some instances where I was consciously assuming a risk that I would die. You'll see: in my home airport, immediately after the threshold and at the sides there was a town. Nowhere to put it down in case of emergency. So my briefing was, if I am low, point down, full flaps, land on the runway and break as much as possible before running off the end of the runway with the least possible speed, if I am above 500ft, do the impossible turn, if I am in the middle, I am dead, just aim to a backyard or a tree and try no to kill anybody else in the process". This is something that I taught myself. No instructor told me or used it. And it's true: when from the last 1000 times that you did it, in all 1000 times nothing happens, taking it as if it WILL go wrong this time is hard.

    --- Judge what is said by the merits of what is said, not by the credentials of who said it. ---
    --- Defend what you say with arguments, not by imposing your credentials ---

  4. #24
    Senior Member Evan's Avatar
    Join Date
    Jan 2008
    Posts
    5,294

    Default

    Quote Originally Posted by elaw View Post
    And just to expand on that point, something that regulators and educators absolutely hate to admit: the number of hours required to become proficient and reliable varies depending on the person. Sometimes dramatically. That throws a real wrench in the works for training/testing programs because hours are very easy to measure while competence sometimes is not. Never mind all the other intangibles like how different people react differently in emergencies, etc.
    Competence is something we need to establish well BEFORE the first hour of revenue flight time. I don't want pilots establishing competence with me in seat 32C.

    It can also make the incompetent more relaxed with incompetence. I think a shining example is the accident a while back at SFO where you had a pilot who apparently couldn't hand-fly an approach but it took thousands of hours and a severely bent airplane for that fact to come to light.
    That was non-precision but it wasn't hand-flown. I don't think that was general incompetence. I see that one as a shocking lack of on-type training and thus ignorance of the automation behaviors combined with complacent, undisciplined and thus reckless piloting under automation (and a sick cockpit gradient culture).

    You wrote above that the only way to gauge skills is from another seat in the cockpit. In some cases, that's absolutely true. But there are a lot of skills that might be needed in extreme circumstances, that don't come into play in routine flying. So the hypothetical cockpit observer could spend many hours with someone flying fat dumb and happy, and have no idea they'd react badly when the s**t hits the fan.
    I think a check pilot can tell a lot about how reliably a pilot will react to abnormal situations by the presence or absence of observable habits. Things like having a hand on the thrust levers on final... verifying a checklist item by actually looking at the lever/switch/indicator... readbacks... crosschecks... respecting the sterile cockpit rule. Also, I said from ANY other seat in the cockpit, meaning the other pilot on a non-checkride flight.

  5. #25
    Senior Member Evan's Avatar
    Join Date
    Jan 2008
    Posts
    5,294

    Default

    Quote Originally Posted by elaw View Post
    And just to expand on that point, something that regulators and educators absolutely hate to admit: the number of hours required to become proficient and reliable varies depending on the person. Sometimes dramatically. That throws a real wrench in the works for training/testing programs because hours are very easy to measure while competence sometimes is not. Never mind all the other intangibles like how different people react differently in emergencies, etc.

    It can also make the incompetent more relaxed with incompetence. I think a shining example is the accident a while back at SFO where you had a pilot who apparently couldn't hand-fly an approach but it took thousands of hours and a severely bent airplane for that fact to come to light.

    You wrote above that the only way to gauge skills is from another seat in the cockpit. In some cases, that's absolutely true. But there are a lot of skills that might be needed in extreme circumstances, that don't come into play in routine flying. So the hypothetical cockpit observer could spend many hours with someone flying fat dumb and happy, and have no idea they'd react badly when the s**t hits the fan.
    Here's a beauty...

    Bagan F100 performing an NDB approach to Heho's runway 36, the first officer (29, CPL, 849 hours total, 486 hours on type) was pilot flying, the captain (49, ATPL, 5,937 hours total, 2,547 hours on type) was pilot monitoring.

    Fog, broken clouds. IMC on initial approach. CAPT announced visual contact at 660', but did not confirm visual at MDA, descent continued anyway.

    At 108', CAPT 5,937 hrs suddenly announced "Not okay!" and PUSHED THE ALT HOLD BUTTON!!

    NO GO AROUND call or action initiated.

    F/O, as PF, was apparently not doing much either.

    Airplane continued to descend of course. EGPWS callouts 100...50...40...30...(crunch!)

    MIraculously, only one pax killed (+ one poor mf on a motorcycle). Aircraft torn up and scattered about.

    What do those 5,937 hours tell you about this pilot?


    http://avherald.com/h?article=45b1221e/0000&opt=0

  6. #26
    Member
    Join Date
    Jan 2008
    Location
    MA, USA
    Posts
    672

    Default

    Quote Originally Posted by Evan View Post
    What do those 5,937 hours tell you about this pilot?
    Absolutely nothing?

    His actions during the event tell us that a) he was somehow impaired, b) he suffered mental overload (sort of like "a"), c) he was incompetent, or d) any combination of a, b, and c.
    Be alert! America needs more lerts.

    Eric Law

  7. #27
    Senior Member 3WE's Avatar
    Join Date
    Jan 2008
    Posts
    3,907

    Default

    Quote Originally Posted by elaw View Post
    His actions during the event tell us that a) he was somehow impaired, b) he suffered mental overload (sort of like "a"), c) he was incompetent, or d) any combination of a, b, and c.
    This! I concur, and more.

    Evan presents the case that he was experienced at breaking rules.

    Maybe he was. The violations seem extreme and eye-rolling.

    Conversely...

    ...the number of hours have no bearing that he wasn't a super, by-the-book pilot and skilled airman, but showed up with a brain tumor, stroke, just learned that his wife had cancer, dealing with a complicated approach...you name it, and that CRM simply broke down.

    Some combination of a, b, c, d, e, f, g and who knows how many permutations.
    Les règles de l'aviation de base découragent de longues périodes de dur tirer vers le haut.

  8. #28
    Senior Member Evan's Avatar
    Join Date
    Jan 2008
    Posts
    5,294

    Default

    Final report out on DL-1086. Capt 15,200 hours (11,000 on the MD-80) had apparently developed an ingrained habit of applying high reverse thrust, which results in rudder blanking, which is inconsequential on dry runways due to tire friction but a recipe for ugliness on contaminated runways. Despite both Delta and the MD-80 FCOM instructing pilots to limit EPR to 1.3 in such conditions, this veteran pilot had come to either forget that or to develop other instincts through experience.

    Quote Originally Posted by DL-1086 Final Report
    It is possible that the captain had developed a habit of applying more reverse thrust than 1.3 EPR.
    On the other hand, F/O 11,000 hours (3000 on the MD-80) detected the condition right away and alerted the captain three times to get out of reverse before he did so (“out of reverse,” “come out of reverse,” and then in a louder voice “come out of reverse.”), albeit too late...

    What do hours tell us again?

  9. #29
    Member ATLcrew's Avatar
    Join Date
    Sep 2013
    Posts
    567

    Default

    Quote Originally Posted by Evan View Post
    Final report out on DL-1086. Capt 15,200 hours (11,000 on the MD-80) had apparently developed an ingrained habit of applying high reverse thrust, which results in rudder blanking, which is inconsequential on dry runways due to tire friction but a recipe for ugliness on contaminated runways. Despite both Delta and the MD-80 FCOM instructing pilots to limit EPR to 1.3 in such conditions, this veteran pilot had come to either forget that or to develop other instincts through experience.



    On the other hand, F/O 11,000 hours (3000 on the MD-80) detected the condition right away and alerted the captain three times to get out of reverse before he did so (“out of reverse,” “come out of reverse,” and then in a louder voice “come out of reverse.”), albeit too late...

    What do hours tell us again?
    There are some who advocate that in situations such as what DL1086 faced it is more advisable to have the LESS experienced crewmember act as PF and have the more veteran pilot act as PM precisely because the latter's higher experience will help him/her monitor those "multiple distractions" better without actually manipulating the controls. In fact, in the early days of Cat II/Cat III it was strongly recommended to do just that.

  10. #30
    Senior Member Evan's Avatar
    Join Date
    Jan 2008
    Posts
    5,294

    Default

    Here's another gem. Final report on Jazz DH8A at Sault Ste Marie on Feb 24th 2015, touched down short of runway.

    Captain, 12,000 hours total, 9,000 hours on type was pilot flying. First officer 6630 hours total, 1,300 hours on type, was pilot monitoring.

    Lots of hours.

    Findings:

    - The company standard operating procedures require an approach speed of Vref + 5 knots; however, this is being interpreted by flight crews as a target to which they should decelerate, from 120 knots, once the aircraft is below 500 feet. As a result, the majority of examined approaches, including the occurrence approach, were unstable, due to this deceleration.

    - If guidance provided to flight crews allows for large tolerance windows, and crews are not trained to recognize an unstable condition, then there is a continued risk that flights that are unstable will be continued to a landing.
    [I would say an elevated risk]

    - If approaches that require excessive deceleration below established stabilization heights are routinely flown, then there is a continued risk of an approach or landing accident. [Again, elevated risk]

    So, great testimonial for Jazz there. But also a rather clear depiction of a very experienced flight crew unable to recognize an unstable approach.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •