Yesterday the Australian Investigation Authorities, the ATSB released their final investigation report on an incident in which a SAAB 340B’s stick shaker (approach to stall warning) was activated. The report is available here.
The ATSB analysis concluded that the “Pilot Flying became task saturated due to high workload and did not notice the reducing speed which was also missed by the pilot monitoring due to a focus on other tasks”.
Sometime before the incident the anti-icing boot on the airplanes wing failed and due to the prevailing icing conditions, the crew decided to turn back and land at the takeoff airport.
The crew was working the checklist during the turnback and that is when the stick-shaker activated.
The FSF golden rules (found here) from the ALAR toolkit have some very simple rules for safe flying.
The first one being AVIATE NAVIGATE COMMUNICATE. And the third or fourth is “Always one head up” meaning one pilot is always monitoring managing and manipulating the flight path trajectory and managing the energy state of the airplane by monitoring the flight instruments.
This is acknowledging the human limitation of inability to multitask.
So if we acknowledge that multitasking is a computer term borrowed into human behavior, that is not really achievable, why do we more often than not tempted to think that we can do it. If the Aviation industry has concluded that multitasking is a myth, and should not be attempted why is it that we are often tempted to abandon this very basic principle of aviation?
The main reason is the reason the FSF has put this in the golden rules in the first place. Most of us believe that we CAN multitask. We confuse attention distribution with multitasking. While multitasking is a computer term wrongfully applied to humans, attention distribution is the craft of paying the correct amount of attention at the right time to the right spot. Correct attention distribution has a lot to do with SOP, experience, it has a lot to do with instruction, and management emphasis. These are all put in place to fight the very basic natural sometime wrongfully nurtured tendency of people, and more so pilots to mange everything, not to miss details, and think we can multitask.
And we sometimes can, the problem is that every now and then, when we turn our attention to a secondary task, there will be something over there grabbing our attention, causing us to spend more time than we can afford or planned and neglect the most important task of flying the airplane.
I tend to disagree with the ATSB’s analysis of task saturation. The report should look into the reasons why task saturation occured.
The industry has come up with non-technical skills attention after thirty or forty years of development ever since united 173 accident. (fuel exhaustion due to pilots task prioritization, loss of time perception and fuel status) the accident that changed aviation and piloting more than all others.
Workload management and task prioritizing is the trickiest one of them all.
It is hard because it requires overcoming basic instincts.
The good news is that the industry acknowledges this hardship and came up with solutions.
Easier said than done.
Please remember multitasking is a myth, attention distribution is the harsh reality stick to it.
Everything is embedded in our SOP. We just have to believe in them and follow them.