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Instrument Flying Handbook
Human factors
Aeronautical Decision Making (ADM)

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Instrument Flying


Table of Contents

Chapter 1. Human Factors
Chapter 2. Aerodynamic Factors
Chapter 3. Flight Instruments
Chapter 4. Section I
Airplane Attitude Instrument
Using Analog Instrumentation
Chapter 4. Section II
Airplane Attitude Instrument
Using an Electronic Flight

Chapter 5. Section I
Airplane Basic
Flight Maneuvers
Using Analog Instrumentation
Chapter 5. Section II
Airplane Basic
Flight Maneuvers
Using an Electronic Flight

Chapter 6. Helicopter
Attitude Instrument Flying

Chapter 7. Navigation Systems
Chapter 8. The National
Airspace System

Chapter 9. The Air Traffic
Control System

Chapter 10. IFR Flight
Chapter 11. Emergency

The ADM process addresses all aspects of decision making
in the flight deck and identifies the steps involved in good
decision making. While the ADM process will not eliminate
errors, it will help the pilot recognize errors, and in turn
enable the pilot to manage the error to minimize its effects.
The steps are:

  1. Identifying personal attitudes hazardous to safe
  2. Learning behavior modification techniques;
  3. Learning how to recognize and cope with stress;
  4. Developing risk assessment skills;
  5. Using all resources: and
  6. Evaluating the effectiveness of one's ADM skills.

Historically, the term "pilot error" has been used to describe
the causes of these accidents. Pilot error means that an action
or decision made by the pilot was the cause, or a contributing
factor that led to the accident. This definition also includes
the pilot's failure to make a decision or take action. From
a broader perspective, the phrase "human factors related"
more aptly describes these accidents since it is usually not a
single decision that leads to an accident, but a chain of events
triggered by a number of factors.

The prejudgment chain, sometimes referred to as the "error
chain," is a term used to describe this concept of contributing
factors in a human factors related accident. Breaking one link
in the chain normally is all that is necessary to change the
outcome of the sequence of events.

The Decision-Making Process
An understanding of the decision-making process provides
a pilot with a foundation for developing ADM skills.
Some situations, such as engine failures, require a pilot to
respond immediately using established procedures with a
little time for detailed analysis. This is termed automatic
decision-making and is based upon training, experience, and
recognition. Traditionally, pilots have been well trained to
react to emergencies, but are not as well prepared to make
decisions requiring a more reflective response where greater
analysis is required. Typically during a flight, there is time
to examine any damages that occur, gather information, and
assess risk before reaching a decision. The steps leading to
this conclusion constitute the decision-making process.

Defining the Problem
Problem definition is the first step in the decision-making
process. Defining the problem begins with recognizing that
a change has occurred or that an expected change did not
occur. A problem is perceived first by the senses, then is

distinguished through insight and experience. One critical
error that can be made during the decision-making process
is incorrectly defining the problem. For example, a low oil
pressure reading could indicate that the engine is about to
fail and an emergency landing should be planned, or it could
mean that the oil pressure sensor has failed. The actions to be
taken in each of these circumstances would be significantly
different. One requires an immediate decision based upon
training, experience, and evaluation of the situation; whereas
the latter decision is based upon an analysis. It should be
noted that the same indication could result in two different
actions depending upon other influences.

Choosing a Course of Action
After the problem has been identified, the pilot must evaluate
the need to react to it and determine the actions that may
be taken to resolve the situation in the time available.
The expected outcome of each possible action should be
considered and the risks assessed before deciding on a
response to the situation.

Implementing the Decision and Evaluating the

Although a decision may be reached and a course of action
implemented, the decision-making process is not complete.
it is important to think ahead and determine how the decision
could affect other phases of flight. As the flight progresses, the
pilot must continue to evaluate the outcome of the decision
to ensure that it is producing the desired result.

Improper Decision-Making Outcomes
Pilots sometimes get in trouble not because of deficient basic
skills or system knowledge, hut rather because of faulty
decision-making skills. Although aeronautical decisions
may appear to he simple or routine, each individual decision
in aviation often defines the options available for the next
decision the pilot must make and the options, good or
bad, they provide. Therefore, a poor decision early on in
a flight can compromise the safety of the flight at a later
time necessitating decisions that must be more accurate and
decisive, Conversely, good decision-making early on in an
emergency provide greater latitude for options later on.

FAA Advisory Circular (AC) 60-22, defines ADM as a
systematic approach to the mental process of evaluating a
given set of circumstances and determining the best course of
action. ADM thus builds upon the foundation of conventional
decision-making, but enhances the process to decrease
the probability of pilot error Specifically, ADM provides
a structure to help the pilot use all resources to develop
comprehensive situational awareness.