[Error, stress and teamwork in medicine and aviation. A cross-sectional study]
No abstract available
Non-NASA Center↗
Engineering topics
Helmreich, R. L.
Publications and source records attributed to Helmreich, R. L..
Culture in the cockpit: do Hofstede's dimensions replicate?
Survey data collected from 9,400 male commercial airline pilots in 19 countries were used in a replication study of Hofstede's indexes of national culture. The analysis that removed the constraint of item equivalence proved superior, both conceptually and empirically, to the analysis using Hofstede's items and formulae as prescribed, and rendered significant replication correlations for all indexes (Individualism-Collectivism .96, Power Distance .87, Masculinity-Femininity .75, and Uncertainty Avoidance .68). The successful replication confirms that national culture exerts an influence on cockpit behavior over and above the professional culture of pilots, and that "one size fits all" training is inappropriate.
Non-NASA Center↗
Error, stress, and teamwork in medicine and aviation: cross sectional surveys
OBJECTIVES: To survey operating theatre and intensive care unit staff about attitudes concerning error, stress, and teamwork and to compare these attitudes with those of airline cockpit crew. DESIGN:: Cross sectional surveys. SETTING:: Urban teaching and non-teaching hospitals in the United States, Israel, Germany, Switzerland, and Italy. Major airlines around the world. PARTICIPANTS:: 1033 doctors, nurses, fellows, and residents working in operating theatres and intensive care units and over 30 000 cockpit crew members (captains, first officers, and second officers). MAIN OUTCOME MEASURES:: Perceptions of error, stress, and teamwork. RESULTS:: Pilots were least likely to deny the effects of fatigue on performance (26% v 70% of consultant surgeons and 47% of consultant anaesthetists). Most pilots (97%) and intensive care staff (94%) rejected steep hierarchies (in which senior team members are not open to input from junior members), but only 55% of consultant surgeons rejected such hierarchies. High levels of teamwork with consultant surgeons were reported by 73% of surgical residents, 64% of consultant surgeons, 39% of anaesthesia consultants, 28% of surgical nurses, 25% of anaesthetic nurses, and 10% of anaesthetic residents. Only a third of staff reported that errors are handled appropriately at their hospital. A third of intensive care staff did not acknowledge that they make errors. Over half of intensive care staff reported that they find it difficult to discuss mistakes. CONCLUSIONS: Medical staff reported that error is important but difficult to discuss and not handled well in their hospital. Barriers to discussing error are more important since medical staff seem to deny the effect of stress and fatigue on performance. Further problems include differing perceptions of teamwork among team members and reluctance of senior theatre staff to accept input from junior members.
Non-NASA Center↗
The evolution of Crew Resource Management training in commercial aviation
In this study, we describe changes in the nature of Crew Resource Management (CRM) training in commercial aviation, including its shift from cockpit to crew resource management. Validation of the impact of CRM is discussed. Limitations of CRM, including lack of cross-cultural generality are considered. An overarching framework that stresses error management to increase acceptance of CRM concepts is presented. The error management approach defines behavioral strategies taught in CRM as error countermeasures that are employed to avoid error, to trap errors committed, and to mitigate the consequences of error.
Non-NASA Center↗
Cross-cultural issues in CRM training
The author presents six stages of intercultural awareness and relates them to cockpit resource management training. A case study examines cultural differences between South American and United States flight crews and the problems that can occur when pilots minimize differences. Differences in leadership styles are highlighted and strategies for training South American pilots are provided.
NASA Discipline Space Human Factors↗
Safety in the operating theatre--part 1: interpersonal relationships and team performance
The authors examine the application of interpersonal human factors training on operating room (OR) personnel. Mortality studies of OR deaths and critical incident studies of anesthesia are examined to determine the role of human error in OR incidents. Theoretical models of system vulnerability to accidents are presented with emphasis on a systems approach to OR performance. Input, process, and outcome factors are discussed in detail.
Non-NASA Center↗
Human factors and safety in emergency medicine
A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.
Non-NASA Center↗
Validation of astronaut psychological select-in criteria
An optional astronaut selection strategy would select-in individuals on the basis of personality attributes associated with superior performance. Method: A test battery, the Astronaut Personal Characteristics Inventory (ASTROPCI) was developed which assesses positive and negative components of achievement, motivation, and interpersonal orientations and skills. The battery was administered to one hundred three astronaut candidates and sixty-six current U.S. Shuttle astronauts. To determine performance, a series of conceptual areas related to space flight performance were defined. Astronauts rated their peers on each of these dimensions. Ratings were obtained on all eighty-four current astronauts (excluding those selected in 1990). In addition to peer ratings, supervisor assessments of the same dimensions were obtained for each astronaut. Results: Cluster and factor analysis techniques were employed to isolate subgroups of astronauts. Those astronauts with both high achievement needs and interpersonal skills were most often rated among the top five by their peers and least often rated among the lowest five. A number of scales discriminated between astronauts rated high and low on one or more performance dimensions. Conclusions: The results parallel findings from the personality assessment of individuals in other demanding professions, including aircraft pilots and research scientists, suggesting that personality factors are significant determinants to performance in the space environment.
Rose, R. M.↗
Does CRM training work?
Formal cockpit resource management training in crew coordination concepts increases the percentage of crews rated as above average in performance and decreases the percentage of crews rated as below average.
NASA Discipline Space Human Factors↗
The structure of cockpit management attitudes
A revised version of the Cockpit Management Attitudes Questionnaire (CMAQ) is introduced. Factor analyses of responses from 3 different samples reveal comparable factor structure (previous attempts to factor analyze this measure had produced equivocal results). Implications for the measurement of attitudes and the assessment of attitude change are discussed. It is argued that the CMAQ will benefit both special training programs and efforts to explore attitude-performance linkages in air-transport operations.
NASA Program Space Human Factors↗
Making it without losing it: Type A, achievement motivation, and scientific attainment revisited
In a study by Matthews, Helmreich, Beane, and Lucker (1980), responses by academic psychologists to the Jenkins Activity Survey for Health Prediction (JAS), a measure of the Type A construct, were found to be significantly, positively correlated with two measures of attainment, citations by others to published work and number of publications. In the present study, JAS responses from the Matthews et al. sample were subjected to a factor analysis with oblique rotation and two new subscales were developed on the basis of this analysis. The first, Achievement Strivings (AS) was found to be significantly correlated with both the publication and citation measures. The second scale, Impatience and Irritability (I/I), was uncorrelated with the achievement criteria. Data from other samples indicate that I/I is related to a number of health symptoms. The results suggest that the current formulation of the Type A construct may contain two components, one associated with positive achievement and the other with poor health.
NASA Discipline Space Human Factors↗
Exploring flight crew behaviour
A programme of research into the determinants of flight crew performance in commercial and military aviation is described, along with limitations and advantages associated with the conduct of research in such settings. Preliminary results indicate significant relationships among personality factors, attitudes regarding flight operations, and crew performance. The potential theoretical and applied utility of the research and directions for further research are discussed.
NASA Discipline Space Human Factors↗
Cockpit resource management - Exploring the attitude-performance linkage
Measured attitudes regarding cockpit management were contrasted for pilots whose line flying performance was independently evaluated by check airmen as above or below average. A highly significant discriminant function was obtained indicating that these attitudes are significant predictors of behavior. The performance of 95.7 percent of the pilots was correctly classified by the analysis. Implications of the results for cockpit resource management training and pilot selection are discussed.
Helmreich, R. L.↗
Cockpit management attitudes
Distinctions are drawn between personality traits and attitudes. The stability of the personality and the malleability of attitudes are stressed. These concepts are related to pilot performance, especially in the areas of crew coordination and cockpit resource management. Airline pilots were administered a Cockpit Management Attitudes questionnaire; empirical data from that survey are reported and implications of the data for training in crew coordination are discussed.
Helmreich, R. L.↗
Social psychology on the flight deck
Social psychological and personality factors that can influence resource management on the flight deck are discussed. It is argued that personality and situational factors intersect to determine crew responses and that assessment of performance under full crew and mission conditions can provide the most valuable information about relevant factors. The possibility of training procedures to improve performance on these dimensions is discussed.
Helmreich, R. L.↗
Psychological considerations in future space missions
Issues affecting human psychological adjustments to long space missions are discussed. Noting that the Shuttle flight crewmembers will not have extensive flight qualification requirements, the effects of a more heterogeneous crew mixture than in early space flights is considered to create possibilities of social conflicts. Routine space flight will decrease the novelty of a formerly unique experience, and the necessity of providing personal space or other mechanisms for coping with crowded, permanently occupied space habitats is stressed. Women are noted to display more permeable personal space requirements. The desirability of planning leisure activities is reviewed, and psychological test results for female and male characteristics are cited to show that individuals with high scores in both traditionally male and female attributes are most capable of effective goal-oriented behavior and interpersonal relationships. Finally, it is shown that competitiveness is negatively correlated with the success of collaborative work and the social climate of an environment.
Helmreich, R. L.↗
Planning and managing future space facility projects
To learn how ground-based personnel of a space project plan and organize their work and how such planning and organizing relate to work outcomes, longitudinal study of the management and execution of the Space Lab Mission Development Test 3 (SMD 3) was performed at NASA Ames Research Center. A view of the problems likely to arise in organizations and some methods of coping with these problems are presented as well as the conclusions and recommendations that pertain strictly to SMD 3 management. Emphasis is placed on the broader context of future space facility projects and additional problems that may be anticipated. A model of management that may be used to facilitate problem solving and communication - management by objectives (MBO) is presented. Some problems of communication and emotion management that MBO does not address directly are considered. Models for promoting mature, constructive and satisfying emotional relationships among group members are discussed.
Sieber, J. E.↗
A critical review of the life sciences project management at Ames Research Center for the Spacelab Mission development test 3
A management study was initiated by ARC (Ames Research Center) to specify Spacelab Mission Development Test 3 activities and problems. This report documents the problems encountered and provides conclusions and recommendations to project management for current and future ARC life sciences projects. An executive summary of the conclusions and recommendations is provided. The report also addresses broader issues relevant to the conduct of future scientific missions under the constraints imposed by the space environment.
Helmreich, R. L.↗