The following NASA ASRS report (#1667101) by a CRJ-900 FO highlights the type of problem that can occur when both pilots become mutually distracted by a common problem.
[We experienced] a slow speed event in which the autopilot disconnected at approximately 170 knots. The aircraft did not enter a stall as both the Captain and I were able to correct and maintain the airspeed above stall margins.
During enroute transit ATIS and gate information was unavailable through the FMS due to NO ACARS COMM status message that remained until approximately 9 mins prior to arrival. At this time the Captain and I had already made the decision to use ILS XXR approach and had briefed and set up the cockpit as such. At this time the weather was OVC 600 2SM/MIST. While on the Initial Approach to ILS XXR, Approach informed us of the ATIS and runway change to the Visual YYL or RNAV/LOC YYL. At this time the updated weather reported was OVC 900 just above the airport but with visibility 10SM. We then decided to accept the RNAV YYL approach and entered a hold for traffic separation and to program the FMS for continued descent via vectors.
Prior to reaching Intermediate Approach Fix I was unable to program the FMS to show either the hold at Intermediate Fix or the runway on the FMS. Neither myself nor the Captain had ever had any issue with loading an approach into FMS and not having the correct waypoints show. The Captain and I both verified with Approach the correct waypoint at IAF and again could not get the FMS to show the approach and runway. It was at this time that the autopilot kicked off while in the hold due to speed loss and the Captain immediately took corrective action to prevent a stall. No altitude was lost in the hold and the Captain decided to keep the autopilot off and hand fly the remainder of the approach. We then accepted the Visual YYL and proceeded to continue via the Initial Approach via the Visual for Runway YYL.
After review and analysis of the situation from my perspective, as the PM (Pilot Monitoring) I should have been more attentive to ALL of the instruments/indications in the cockpit and should have told the Captain to maintain flying while I troubleshoot the FMS when he tried to assist in programming the FMS which caused temporary loss of situational awareness while on Initial Approach. Had I done so, I would’ve noticed the speed reduction well in advance of the autopilot kicking off. Also, although we were on the Initial Approach prior to turning base, it would’ve been more prudent to just accept the Visual for XXL and hand fly the approach rather than to continue trying to program the FMS.
This event is rather instructive when paired with Topic 23-4: The Importance of Staying Out-of-Synch. Here was a situation where the FO/PM encountered difficulty reprogramming the FMS during a last-minute approach/runway change. Clearly, both pilots became deeply concerned with the problem and devoted most of their attention toward solving it. The CA/PF diverted their attention from flying the aircraft to assisting the FO/PM with solving the FMC problem. Soon, they encountered a slow-speed event that automatically disconnected the autopilot. The Captain reacted quickly to add thrust and restore airspeed.
Some questions to consider:
- It is interesting that the FO filed a report, but the Captain didn’t. What are some reasons why this commonly happens?
- Most airlines direct the PM to attend to complex FMC reprogramming while the PF retains operational control of the aircraft and flightpath. We rarely see problems when the FO is the PF and the Captain is the PM. Why do we see more problems when the roles are reversed?
- This event seems to describe an environment where crews favor full FMS automation for STAR and approach guidance (and, frankly, who doesn’t). Unfortunately, we can’t freeze the aircraft in midair. It keeps moving forward. This often promotes a rising sense of urgency to resolve the programming problem as quickly as possible. Should the crew have reverted to a lower level of automation to keep moving toward their Intermediate Approach Fix – then to work on the following approach routing while the aircraft is enroute? Is this a skill that is practiced or supported by your airline?
- The FO states that, “I should have been more attentive to ALL of the instruments/indications in the cockpit…” As an assigned role, the PF is responsible for remaining attentive to the flightpath. Generally, we assume that the PM is only responsible for monitoring the quality of the PF’s flightpath management – not the fine details. The FO’s statement implies that they should have split their attention between solving their difficult FMC problem and monitoring the PF’s performance. Is this reasonable? What are some strategies for dividing workload with situations like this?
- The FO states that they, “…should have told the Captain to maintain flying while I troubleshoot the FMS when he tried to assist in programming the FMS…” Let’s dig deeper into this thought. It implies that the PM, regardless of their workload, needs to monitor the quality of the PF’s flying. We don’t know whether the FO detected the Captain’s distraction into the FMS issue or whether they drew this conclusion via hindsight. What measures could the FO have employed to ensure that the crew maintained effective role discipline?
For discussion, I have added my analysis of the questions from the previous post.
- It is interesting that the FO filed a report, but the Captain didn’t. What are some reasons why this commonly happens?
There are fundamental differences between pilot perspectives regarding the filing of NASA reports. Many pilots believe that you only file if you have an event that can be investigated for possible violation. While NASA ASRS reports do offer this benefit, this narrow interpretation causes us to lose vital information that can improve industry safety. Personally, I filed far more “safety” reports than I filed “error” reports.
NASA reports (or the equivalents within airlines with alternate reporting options) are avenues for us to highlight problems and potential safety vulnerabilities before they cause mishap events. For example, they provide excellent options for reporting signage issues at particular airports, confusing or faded taxi line painting, or error-prone local procedures. In this event, the report highlights a problem with maintaining flightdeck role integrity during a time-consuming inside-the-flightdeck problem.
The Captain could have rationalized that the event never fully progressed to a stall warning or altitude deviation, so it didn’t require a report. Imagine how much more we could learn about this slow-speed event if we had the Captain’s story in addition to the one reported by the FO.
Bottom line – these reports feed the proactive safety management system of our airline industry. Everything we can do to contribute to this process is worthwhile.
- Most airlines direct the PM to attend to complex FMC reprogramming while the PF retains operational control of the aircraft and flightpath. We rarely see problems when the FO is the PF and the Captain is the PM. Why do we see more problems when the roles are reversed?
As Captains, we maintain overall flight responsibility. We fulfill our particular role each flight (either PF or PM), but we are always the pilot in charge of the overall flight. Consequently, we feel a strong urge to intervene when obstacles arise. We can envision this Captain torn between the urgency of preparing for the runway/approach change and their frustration with the FO’s inability to program the change into the FMC. They probably rationalized that they would be able to resolve the programming problem quickly while effectively controlling the aircraft. Indeed, had the Captain successfully accomplished this, it would have reinforced doing the same thing in the future during a different event. The line between events where we successfully intervene to keep the flight moving and events where we fail is indistinguishable. Both situations look the same while we are engaged in them. It is only in hindsight that we discern the difference. The better option is preserve role integrity (addressed in the following questions) and not try to do everyone else’s jobs.
- This event seems to describe an environment where crews favor full FMS automation for STAR and approach guidance (and, frankly, who doesn’t). Unfortunately, we can’t freeze the aircraft in midair. It keeps moving forward. This often promotes a rising sense of urgency to resolve the programming problem as quickly as possible. Should the crew have reverted to a lower level of automation to keep moving toward their Intermediate Approach Fix – then to work on the following approach routing while the aircraft is enroute? Is this a skill that is practiced or supported by your airline?
In my book, I write about the importance of employing the optimal level of automation for the phase of flight and workload. Just as important, I also address the importance of smoothly transitioning between levels of automation as needs arise. This event occurred because the crew couldn’t achieve the FMS programming required for the level of automation that they were using within the time available. In an effort to preserve that level of automation, they both became fixated on the FMC programming problem. Imagine how much better this would have gone if they had reverted to a lower level of automation, allowed the autopilot to handle navigation to the next route fix, and spent the remaining time populating the remaining fixes of the new instrument approach.
- The FO states that, “I should have been more attentive to ALL of the instruments/indications in the cockpit…” As an assigned role, the PF is responsible for remaining attentive to the flightpath. Generally, we assume that the PM is only responsible for monitoring the quality of the PF’s flightpath management – not the fine details. The FO’s statement implies that they should have split their attention between solving their difficult FMC problem and monitoring the PF’s performance. Is this reasonable? What are some strategies for dividing workload with situations like this?
We have a sense from the FO’s report that they recognized that the Captain was abandoning their PF duties to assist with the FMC programming. They also recognized the need to monitor the quality of the flightpath management – and that the Captain was not adequately monitoring the flightpath.
The FO’s first option would be to suggest switching roles to allow the Captain to focus their attention on the FMC while the FO managed the aircraft. This is a highly reliable option that is, unfortunately, rarely used. It ensures role integrity and effectiveness while allowing the PM to focus their full attention on the FMC problem.
Assuming that the FO detected the adverse aircraft management trend (of the Captain “diving inside the box” instead of monitoring the aircraft), another option would be to make a callout alerting the PF of the adverse trend. This would inform the PF/Captain of their error and redirect them back toward their PF role.
- The FO states that they, “…should have told the Captain to maintain flying while I troubleshoot the FMS when he tried to assist in programming the FMS…” Let’s dig deeper into this thought. It implies that the PM, regardless of their workload, needs to monitor the quality of the PF’s flying. We don’t know whether the FO detected the Captain’s distraction into the FMS issue or whether they drew this conclusion via hindsight. What measures could the FO have employed to ensure that the crew maintained effective role discipline?
This sounds reasonable in hindsight, but proves to be rather difficult to perform while line-flying in-the-moment. I don’t see many FOs telling “the Captain to maintain flying while I troubleshoot the FMS.” This is a rather difficult CRM undertaking which proves to be highly variable depending on the perceived dynamics between the two pilots. This makes it a poor technique. Perhaps they could voice this as a strong suggestion. “Give me another minute to stay head-down solving this FMC problem while you remain head-up to monitor the flightpath. If I can’t solve it quickly, we can switch roles and let you reprogram the approach.”
Another option is to voice concern, “I’m concerned that we are both focused on this inside problem. There is too much going on outside to have us both working on reprogramming this approach.”
