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Evidence for an Issue 21 pieces of evidence for this issue.

crew coordination problems may occur (Issue #84) - The use of automation may adversely affect crew coordination, possibly leading to unsafe conditions.

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  2. Evidence Type: Excerpt from Survey
    Evidence: In response to the question: "If you feel that crew coordination/communication is impacted by the new technologies, do you see it as improved or reduced?" 11 pilots [22%] responded that crew coordination/communication is "Reduced", 16 pilots [31%] responded that crew coordination/communication is"Improved", 5 pilots [10%] responded that there is "More" crew coordination/communication on a flightdeck with the new technologies, the remaining 19 pilots [37%] did not respond to the question.
    Strength: +1
    Aircraft: B737
    Equipment: automation
    Source: Braune, R.J. (1989). Boeing/Deutsche Lufthansa Mixed Fleet Study 737-200/ -300 (EFIS). See Resource details

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  4. Evidence Type: Excerpt from Survey
    Evidence: In response to the question: "If you feel that crew coordination/communication is impacted by the new technologies, do you see it as improved or reduced?" 11 pilots [22%] responded that crew coordination/communication is "Reduced", 16 pilots [31%] responded that crew coordination/communication is"Improved", 5 pilots [10%] responded that there is "More" crew coordination/communication on a flightdeck with the new technologies, the remaining 19 pilots [37%] did not respond to the question.
    Strength: -2
    Aircraft: B737
    Equipment: automation
    Source: Braune, R.J. (1989). Boeing/Deutsche Lufthansa Mixed Fleet Study 737-200/ -300 (EFIS). See Resource details

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  6. Evidence Type: Excerpt from Incident Study
    Evidence: "4.1.2.5 Multiple FMC Page Monitoring Requirements The organization of information within the FMC/CDU appears to be an issue for some pilots. Monitoring the overall status and performance of the aircraft includes being aware of fuel status, lateral path, position, vertical path, and so on. To adequately monitor aircraft status by means of the FMC, the crew must review the information that is presented on a number of different pages which are accessed by means of a number of mode and/or line select keys. Extensive monitoring of the FMC/CDU diminishes the crew's ability to monitor the data in the mode control panel at the same time, thus creating the possibility for missing important information about the status of the aircraft. [ASRS incident report #119836] 'Approach DEN from the east on J80 the captain (pilot flying) asked copilot (pilot not flying) to request FL390 due to building thunderstorms over the Rocky Mountains. I (copilot) put FL390 in the right FMS computer to check aircraft capability for FL390. After entering and executing FL390 in 1 L on FMS, I verified that the altitude window on the mode control panel was at 35,000 feet and that the autothrottles did not add power for the climb. At this point, the mode control panel altitude window was holding the aircraft at current cruise altitude of 35,000 feet. This has been an accepted procedure in this situation. After checking altitude capability in the FMC, I mentioned to the captain that we could make FL390 and would save approximately one percent of fuel with the climb. This whole check took probably less than 20-30 seconds. I then called DEN ATC and was advised to expect FL390 in approximately two minutes due to traffic. Anticipating the higher altitude, I left FL390 in the FMC active cruise page, once again checking to make sure the window read 35,000 feet. I continued to prepare the ACARS position report to be transmitted over DEN. We were approximately three minutes east of DEN. I remember checking the ETA for SLC and entering the fuel over DEN as 22.5. Since I was preparing the position report I changed from the Cruise page in view with the FL390 Cruise active page on it. During the minute or minute and a half of preparing the ACARS position report and waiting for the ATC clearance to FL390 the captain (pilot flying) changed the mode control panel altitude window to 39,000 feet, anticipating the climb. Of course, the FMC not being constrained at 35,000 feet any longer started to slow climb to FL390. The captain also began a passenger announcement to the passengers about DEN and the turbulence, and that we expected to climb to a higher altitude shortly. The center called, 'Maintain FL350.' Without even hesitating, I responded 'Roger maintain 350.' By this time the captain (pilot flying) had already started a push-over. The aircraft had reached an altitude of approximately FL357. After the aircraft was returned to FL350, I checked the mode control panel altitude window and was surprised to see 39,000 feet. We returned to 35,000 feet, our cleared altitude. Within a few minutes, Center cleared to FL390. Crew coordination and lack of communication may have contributed to the altitude excursion and conflict. The mode control panel window is, in my judgment, the last step in the altitude change process, to be changed after the clearance has been received. The autoflight system will not depart the mode control panel altitude, even it the FMC is programmed for a different altitude.' " (page 4.12-4.13)
    Strength: +1
    Aircraft: unspecified
    Equipment: autoflight: autopilot
    Source: Eldredge, D., Mangold, S., & Dodd, R.S. (1992). A Review and Discussion of Flight Management System Incidents Reported to the Aviation Safety Reporting System. Final Report DOT/FAA/RD-92/2. Washington, DC: U.S. Department of Transportation, Federal Aviation Administration. See Resource details

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  8. Evidence Type: Excerpt from Survey
    Evidence: 4 of the 30 (13%) respondents reported a 4 (= agree) or 5 (= strongly agree) with pc84 crew coordination problems may occur
    Strength: +1
    Aircraft: unspecified
    Equipment: automation
    Source: Lyall, E., Niemczyk, M. & Lyall, R. (1996). Evidence for flightdeck automation problems: A survey of experts. See Resource details

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  10. Evidence Type: Excerpt from Survey
    Evidence: 12 of the 30 (40%) respondents reported a 1 (=strongly disagree) or a 2 (=disagree) with pc84 crew coordination problems may occur
    Strength: -2
    Aircraft: unspecified
    Equipment: automation
    Source: Lyall, E., Niemczyk, M. & Lyall, R. (1996). Evidence for flightdeck automation problems: A survey of experts. See Resource details

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  12. Evidence Type: Excerpt from Survey
    Evidence: "III. Transition Training Issues ... B. Sensitivity to Varying Pilot Needs ... a. Is training sensitive to the needs of pilot population that varies widely in such areas as total flight experience, airline experience, recency of last transition training, computer literacy, etc.? ... v 2 PC vs. 3PC Differences [One pilot in Orlady study made the following comment:] " 'Crew oordination is about the same as in any two-man crew.' " (page 14-18)
    Strength: -1
    Aircraft: unspecified
    Equipment: automation
    Source: Orlady, H.W. & Wheeler, W.A. (1989). Training for Advanced Cockpit Technology Aircraft. Moffett Field, CA: NASA Aviation Safety Reporting System. See Resource details

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  14. Evidence Type: Excerpt from Incident Study
    Evidence: In our review of 282 automation-related ASRS incident reports, we found 2 reports (1%) supporting issue084 (crew coordination problems may occur).
    Strength: +1
    Aircraft: various
    Equipment: automation
    Source: Owen, G. & Funk, K. (1997). Flight Deck Automation Issues: Incident Report Analysis. http://www.flightdeckautomation.com/incidentstudy/incident-analysis.aspx. Corvallis, OR: Oregon State University, Department of Industrial and Manufacturing Engineering. See Resource details

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  16. Evidence Type: Excerpt from Survey
    Evidence: Question 24 asked pilots if they agreed that the visual displays/instruments promoted good crew coordination…Among the AH-64D pilots, 51% of the responses were on the agree side of the scale… (page 11)
    Strength: +3
    Aircraft: AH-64D
    Equipment: automation
    Source: Rash, C.E., Adam, G.E., LeDuc, P.A., & Francis, G. (May 6-8, 2003). Pilot Attitudes on Glass and Traditional Cockpits in the U.S. Army's AH-64 Apache Helicopter. Presented at the American Helicopter Society 59th Annual Forum, Phoenix, AZ. American Helicopter Society International, Inc. See Resource details

  17.  
  18. Evidence Type: Excerpt from Survey
    Evidence: Question 20 asked pilots if they agreed that the visual displays/instruments contributed to positive crew relationships… Among the AH-64D pilots, 49% of the responses were on the agree side of the scale… (page 9)
    Strength: +2
    Aircraft: AH-64D
    Equipment: automation
    Source: Rash, C.E., Adam, G.E., LeDuc, P.A., & Francis, G. (May 6-8, 2003). Pilot Attitudes on Glass and Traditional Cockpits in the U.S. Army's AH-64 Apache Helicopter. Presented at the American Helicopter Society 59th Annual Forum, Phoenix, AZ. American Helicopter Society International, Inc. See Resource details

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  20. Evidence Type: Excerpt from Survey
    Evidence: Many AH-64D pilots reported that an ability see what the other crewmember was looking at on the MFD would help improve crew coordination. Another common comment was that the impetus for good crew coordination was on the crewmembers and not related to the instruments. On the other hand, several pilots commented that the visual displays/instruments in the AH-64D made crew coordination more important than ever because different crewmembers could do very different things at the same time. Representative comments of the AH-64D pilots were: … Crew coordination is made more difficult because the front seat pilot must devote much time to setting up the battlefield properly, the pilot in the back seat does not see changes as they are happening. (page 11)
    Strength: +1
    Aircraft: AH-64D
    Equipment: automation
    Source: Rash, C.E., Adam, G.E., LeDuc, P.A., & Francis, G. (May 6-8, 2003). Pilot Attitudes on Glass and Traditional Cockpits in the U.S. Army's AH-64 Apache Helicopter. Presented at the American Helicopter Society 59th Annual Forum, Phoenix, AZ. American Helicopter Society International, Inc. See Resource details

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  22. Evidence Type: Excerpt from Survey
    Evidence: Many AH-64D pilots reported that an ability see what the other crewmember was looking at on the MFD would help improve crew coordination. Another common comment was that the impetus for good crew coordination was on the crewmembers and not related to the instruments. On the other hand, several pilots commented that the visual displays/instruments in the AH-64D made crew coordination more important than ever because different crewmembers could do very different things at the same time. Representative comments of the AH-64D pilots were: … The designs do not promote crew coordination. The crewmembers must initiate crew coordination. (page 11)
    Strength: +1
    Aircraft: AH-64D
    Equipment: automation
    Source: Rash, C.E., Adam, G.E., LeDuc, P.A., & Francis, G. (May 6-8, 2003). Pilot Attitudes on Glass and Traditional Cockpits in the U.S. Army's AH-64 Apache Helicopter. Presented at the American Helicopter Society 59th Annual Forum, Phoenix, AZ. American Helicopter Society International, Inc. See Resource details

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  24. Evidence Type: Excerpt from Survey
    Evidence: "In order to identify what kinds of problems occur in automated aircraft, a review of accident and incident reports from a number of European and US sources was completed. Reports were selected on the basis of keyword searches for terms relating to human factors, training and automation, and were then classified using a taxonomy developed in ECOTTRIS to identify various operational, behavioural, design contributory and general automation factors. Analysis of frequency of factors and linkages between factors was carried out and yielded the following results: deficiency in CRM was a contributory factor in incidents and accidents (identified in 39% of all reports) and this could be linked with incorrect settings, monitoring and vigilance, inadequate knowledge of aircraft systems, experience and flight handling. Furthermore, complacency was found in 13% of reports and improper use of systems occurred in 15% of reports. In this part of the study, mode awareness was identified as a factor in only 6% of reports."
    Strength: +2
    Aircraft: various
    Equipment: automation
    Source: Sherman, P.J., Helmreich, R.L., & Merritt, A. (1997). National culture and flight deck automation: Results of a multination survey. International Journal of Aviation Psychology, 7(4), 311-329. Lawrence Erlbaum Associates. See Resource details

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  26. Evidence Type: Excerpt from Survey
    Evidence: Statement 20: "Crew coordination is more difficult in the B-757." From the histograph of the responses in Phase 1 of the study, 25% of the pilots agreed or strongly agreed with the statement and in Phase 2 of the study, 26% of the pilots agreed or strongly agreed with the statement while 56% disagreed or strongly disagreed in Phase 1, and 62% disagreed or strongly disagreed in Phase 2. The neutral responses were 19% in Phase 1 and 12% in Phase 2. (page 120)
    Strength: +2
    Aircraft: B757
    Equipment: automation
    Source: Wiener, E.L. (1989). Human Factors of Advanced Technology ("Glass Cockpit") Transport Aircraft. NASA Contractor Report 177528. Moffett Field, CA: NASA Ames Research Center. See Resource details

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  28. Evidence Type: Excerpt from Survey
    Evidence: "VIII. Cockpit Errors And Error Reduction ... B. Reports Of Cockpit Errors [Pilots were asked to respond to the following question:] 3. Describe in detail an error which you made, or observed, in operating the automatic features of the 757 that could have led to an incident or violation. How could it have been avoided? (equipment design? Training? Crew? Coordination?) Please describe specifically what was done." ... One pilot responded, "Trying to copy takeoff load advice via company radio because ACARS was inop. As a result one pilot was talking to and receiveing instructions from ground control while the other pilot was off the air. Consequently there was a mix-up and we missed a taxi clearance and taxied onto the wrong runway. Solution: the automated stuff has to work or you are worse [emphasized] off than the two pilot planes. 4054" (page 100, 107)
    Strength: +1
    Aircraft: B757
    Equipment: automation
    Source: Wiener, E.L. (1989). Human Factors of Advanced Technology ("Glass Cockpit") Transport Aircraft. NASA Contractor Report 177528. Moffett Field, CA: NASA Ames Research Center. See Resource details

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  30. Evidence Type: Excerpt from Observational Study
    Evidence: "The ASRS reports below are illustrative of some of the problems of autoflight. Narrative: We were cleared to cross 40 nm west of LINDEN VOR to maintain FL270. The Captain and I began [to] discuss the best methods to program the CDU to allow the performance management system to descend the aircraft. We had a difference of opinion on how to best accomplish this task (since we are trained to use all possible on-board performance systems). We wanted to use the aircraft's capabilities to its fullest. As a result, a late descent was started using conventional autopilot capabilities (vert spd, max indicated Mach/airspeed, and spd brakes). Near the end of descent, the aircraft was descending at 340 KIAS and 6000 FPM rate of descent. The aircraft crossed the fix approximately 250-500 feet high. Unfortunately we made no call to ATC to advise them of the possibility of not meeting the require [in sic] alt/fix. This possible altitude excursion resulted because: 1) The captain. [in sic] and the F/O had differences of opinion on how best to program the descent; A) Both thought their method was the best, the captain's of programming (fooling) the computer to believe anti-ice would be used during descent, which starts the descent earlier. The F/O's of subtracting 5 miles from the nav fix and programming the computer to cross 5 miles prior to LINDEN at FL270. B) A minor personality clash between the captain and the F/O brought about by differences of opinion on general discipline. C) Time wasted by both captain and F/O (especially F/O) in incorrectly programming CDU and FMS for descent, which obviously wasted time at level flight, which should have been used for descent. Observation: as a pilot for a large commercial carrier at its largest base, we seldom fly with the same cockpit crew member. This normally does not create a problem. I do, however, feel that with approximately 6 years, which can cause a bit more difficult transition than, say month to month cockpit crew change on a 727 or pre-EFIS DC-9. I have flown commercially for 10 years, and have flown 2-man crew for 8 of those 10. The toughest transition for me is to determine who shares the PF and PNF duties. This historically (3 years) has been the most difficult when the other crew member has transferred from a 3-man cockpit to a 2-man 'glass cockpit.' This is especially pertinent when the crew member has been on a 3-man crew for a number of years. As F/O, when you are the PNF, you accomplish your normal duties. However, often times when one is the PF, the F/O also has to do the PNF duties because the other crew member has not been used to doing the PNF duties to the extent that is required on 2-man cockpits, whether they be conventional or EFIS. This obviously can lead to a myriad of problems. Add weather or an airport such as Washington National, LaGuardia, or Orange County, and such problems can accelerate with alarming rapidity. (ASRS No. 122778)" (page 5-6)
    Strength: +1
    Aircraft: unspecified
    Equipment: FMS
    Source: Wiener, E.L. (1993). Intervention Strategies for the Management of Human Error. NASA Contractor Report NCA2-441. Moffett Field, CA: NASA Ames Research Center. See Resource details

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  32. Evidence Type: Excerpt from Observational Study
    Evidence: "The problems of crew interaction with keyboard data entry can be seen in the following ASRS report. Narrative: while preparing for departure, the captain loaded incorrect position coordinates in the IRS pos. Instead of a correct position of approximately N 50 deg 15 mins, E 00 deg 01 mins, he loaded N 50 deg 15 mins W 00 deg 01 mins. Contributing factors. Rushing to beat a noise curfew; short layover; lack of crew coordination and cross check. This resulted in a NAV map shift of approximately 30 mi. The problem was discovered on initial departure when radar told us we weren't proceeding on the proper course. The problem was discovered quickly and no conflict occurred. We switched to manual nav. However, we couldn't continue our ocean crossing and diverted to Shannon, Ireland, where we made an overweight landing. Human performance considerations: although the captain was supposed to be giving me a nav check he rapidly and without asking for verification programmed the computers himself. We had sufficient time to do the job right but didn't take it. I should have cross checked our position. But didn't. (It isn't in our nav checklist to do so). (ASRS No. 150785)" (page 30-31)
    Strength: +1
    Aircraft: unspecified
    Equipment: autoflight
    Source: Wiener, E.L. (1993). Intervention Strategies for the Management of Human Error. NASA Contractor Report NCA2-441. Moffett Field, CA: NASA Ames Research Center. See Resource details

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  34. Evidence Type: Excerpt from Survey
    Evidence: "VII. Cockpit Resource Management, Crew Coordination And Communication ... B. Cockpit Resource Management, Supervision, and Coordination ... [Pilots were asked to respond to the following question:] 1-4. What would you say about crew coordination on the 757 (compared to other aircraft?" The responses were analyzed to determine the pilot's overall evaluation of crew coordination on the 757. Out of a total of 105 responses, 71 pilots' [68%] responses were classified as either "Excellent, much better" or "Good, better, easier", while only 17 pilots' [16%] responses were classified as either " Fair, more difficult" or "Poor, much more difficult". 17 pilots' [16%] responses were classified as "Same, adequate, OK" (page 123-124)
    Strength: +1
    Aircraft: B757
    Equipment: automation
    Source: Wiener, E.L. (1989). Human Factors of Advanced Technology ("Glass Cockpit") Transport Aircraft. NASA Contractor Report 177528. Moffett Field, CA: NASA Ames Research Center. See Resource details

  35.  
  36. Evidence Type: Excerpt from Survey
    Evidence: Statement 20: "Crew coordination is more difficult in the B-757." From the histograph of the responses in Phase 1 of the study, only 25% of the pilots agreed or strongly agreed with the statement and in Phase 2 of the study, only 26% of the pilots agreed or strongly agreed with the statement while 56% disagreed or strongly disagreed in Phase 1, and 62% disagreed or strongly disagreed in Phase 2. The neutral responses were 19% in Phase 1 and 12% in Phase 2. (page 120)
    Strength: -3
    Aircraft: B757
    Equipment: automation
    Source: Wiener, E.L. (1989). Human Factors of Advanced Technology ("Glass Cockpit") Transport Aircraft. NASA Contractor Report 177528. Moffett Field, CA: NASA Ames Research Center. See Resource details

  37.  
  38. Evidence Type: Excerpt from Survey
    Evidence: "VII. Cockpit Resource Management, Crew Coordination And Communication ... B. Cockpit Resource Management, Supervision, and Coordination ... [Pilots were asked to respond to the following question:] 1-4. What would you say about crew coordination on the 757 (compared to other aircraft?" The responses were analyzed to determine the pilot's overall evaluation of crew coordination on the 757. Out of a total of 105 responses, 71 pilots' [68%] responses were classified as either "Excellent, much better" or "Good, better, easier", while only 17 pilots' [16%] responses were classified as either " Fair, more difficult" or "Poor, much more difficult". 17 pilots' [16%] responses were classified as "Same, adequate, OK" (page 123-124)
    Strength: -3
    Aircraft: B757
    Equipment: automation
    Source: Wiener, E.L. (1989). Human Factors of Advanced Technology ("Glass Cockpit") Transport Aircraft. NASA Contractor Report 177528. Moffett Field, CA: NASA Ames Research Center. See Resource details

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  40. Evidence Type: Excerpt from Survey
    Evidence: Pilots responded to "Open-Ended Question 5B. How has automation affected your crew coordination?" Out of a total of 104 pilots responding to this questions, 35 [34%] "emphasized the need or requirement for good crew coordination in the automated cockpit" and 8 [8%] responded that "they thought their crew coordination has somewhat decreased" [35+8 = 43 pilots, 41%], while 32 pilots responded "that automation has improved or made crew coordination much easier when used properly" and 23 responded "that automation has made no change in their crew coordination" [32+23=55 pilots, 53%]. The remaining 5 pilots [5%] responded "Other". (page 186)
    Strength: +1
    Aircraft: unspecified
    Equipment: automation
    Source: Wise, J.A., Abbott, D.W., Tilden, D., Dyck, J.L., Guide, P.C., & Ryan, L. (1993). Automation in Corporate Aviation: Human Factors Issues. CAAR-15406-93-1. Daytona Beach, FL: Center for Aviation/Aerospace Research, Embry-Riddle Aeronautical University. See Resource details

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  42. Evidence Type: Excerpt from Survey
    Evidence: Pilots responded to "Open-Ended Question 5B. How has automation affected your crew coordination?" Out of a total of 104 pilots responding to this questions, 35 "emphasized the need or requirement for good crew coordination in the automated cockpit" and 8 responded that "they thought their crew coordination has somewhat decreased" [35+8 = 43 pilots, 41%], while 32 pilots responded "that automation has improved or made crew coordination much easier when used properly" and 23 responded "that automation has made no change in their crew coordination" [32+23=55 pilots, 53%]. The remaining 5 pilots [5%] responded "Other". (page 186)
    Strength: -3
    Aircraft: unspecified
    Equipment: automation
    Source: Wise, J.A., Abbott, D.W., Tilden, D., Dyck, J.L., Guide, P.C., & Ryan, L. (1993). Automation in Corporate Aviation: Human Factors Issues. CAAR-15406-93-1. Daytona Beach, FL: Center for Aviation/Aerospace Research, Embry-Riddle Aeronautical University. See Resource details
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