Altitude Deviations: Breakdowns of an Error Tolerant System

Palmer, Everett A.; Hutchins, Edwin L.; Ritter, Richard D.; vanCleemput, Inge

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Altitude Deviations: Breakdowns of an Error Tolerant System

1991-12-01
By Palmer, Everett A. ; Hutchins, Edwin L. ; Ritter, Richard D. ; ...

[PDF-3.40 MB]

English

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Details:

Creators:

Palmer, Everett A. ; Hutchins, Edwin L. ; Ritter, Richard D. ; vanCleemput, Inge

Palmer, Everett A. ; Hutchins, Edwin L. ; Ritter, Richard D. ; vanCleemput, Inge Less -
Corporate Contributors:

University of California, San Diego ; Wellesley College

University of California, San Diego ; Wellesley College Less -
Subject/TRT Terms:

[+]

Aircraft Pilotage Altitude Altitude Deviations Attention Automation-assisted Altitude-change Task Datalink Error Detection Flight Control Systems Human Error Human Factors Engineering Human Machine Systems Intelligent Feedback Pilot And Automatic-systems Interactions Primary Flight Displays Recommendations
Publication/ Report Number:

DOT/FAA/RD-92/7
Resource Type:

Tech Report
TRIS Online Accession Number:

00841843
Corporate Publisher:

Ames Research Center
NTL Classification:

NTL-AVIATION-Air Traffic Control;NTL-AVIATION-Aviation Human Factors;NTL-AVIATION-Aviation Safety/Airworthiness;NTL-SAFETY AND SECURITY-Human Factors;
Abstract:

Pilot reports of aviation incidents to the Aviation Safety Reporting System (ASRS) provide a window on the problems occurring in today's airline cockpits. The narratives of 10 pilot reports of errors made in the automation-assisted altitude-change task are used to illustrate some of the issues associated with pilot and automatic-systems interactions. These narratives are then used to construct a description of the cockpit as an information processing system. Describing the cockpit as a single information processing system is useful because the system behaviors of interest are not determined solely by the behavior of the humans in the system. Altitude deviations in transport aircraft are usually the result of several small problems. The information processing analysis also highlights the variety of languages and media used in the cockpit to describe the flight path as clearance information is processed by the cockpit system. The analysis concentrates on the error-tolerant properties of the system and on how breakdowns can occasionally occur. An error-tolerant system can detect and correct its internal processing errors. The cockpit system consists of two or three pilots supported by autoflight, flight-management, and alerting systems. These humans and machines have distributed access to clearance information and perform redundant processing of information. Errors can be detected as deviations from either expected behavior or as deviations from expected information. Breakdowns in this system can occur when the checking and cross-checking tasks that give the system its error-tolerant properties are not performed because of distractions or other task demands. The report concludes with recommendations based on the analysis for improving the error tolerance of the cockpit system.
Format:

PDF
Collection(s):

ITSJPO Digital Library US Transportation Collection
Main Document Checksum:

[+]

urn:sha256:1e87f97f2eb07a75b8b080771bb11bf3ae8c852941fd9ee252e87b4fd7d63bf6
Download URL:

https://rosap.ntl.bts.gov/view/dot/35168/dot_35168_DS1.pdf
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Altitude Deviations: Breakdowns of an Error Tolerant System

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