BSAS 330 Module 2.3 Discussion
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Embry-Riddle Aeronautical University *
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Course
330
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Health Science
Date
Dec 6, 2023
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docx
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Uploaded by fightswithnopants
Please read course materials about the details of these models and techniques before you respond to
this discussion:
5M Model and concept
Human Factors HFACS and SHELL Matrix
Critical human factor questions asked during an accident investigation.
Answer the following questions. Your response should contain what you learned from all your reading
material; keep it succinct, but apply as much knowledge as possible to answer the questions fully:
1.
Does the phrase "pilot error" truly define causation within the accident error chain?
2.
Compare and contrast the difference between cause or blame.
3.
Explain the value of the model concepts relative to detecting organizational factors or elements
of the error chain on accidents such as Zonk Air or other mishaps.
Pilot error as a phrase does not fully define causation within the accident error chain. While it can
identify a proximate cause, it oversimplifies the many factors contributing to accidents. Aviation
accidents are typically the result of a chain of events, including organizational, environmental, and
universal factors, with pilot error being just one link in that chain (Wiegmann & Shappell, 2003).
Cause and blame differ in many ways. Cause encompasses various interconnected factors leading to an
event, while blame assigns responsibility or accountability to individuals or parties. The cause can help
identify factors that may prevent another mishap. Blame can oversimplify real causes and divert
attention from issues in accident investigations.
Model concepts such as the 5M Model, HFACS (Human Factors Analysis and Classification System), and
SHELL Matrix are valuable tools for detecting organizational factors and elements of the error chain in
accidents. The 5M Model consists of Man, Machine, Medium, Mission, and Management and is a
framework that helps analyze accidents by considering the interactions of these five elements. It is
particularly useful in identifying how organizational factors influence accidents. It can highlight how
inadequate training (a "Man" factor) or flawed procedures (a "Management" factor) might contribute to
an accident.
HFACS is a structured approach for analyzing human factors in accidents. It categorizes errors into
categories like Unsafe Acts, Preconditions for Unsafe Acts, Organizational Influences, and Unsafe
Supervision. HFACS can help investigators go beyond blaming individuals and dives into organizational
and cultural factors that may be at play.
The SHELL Matrix is a framework that focuses on the interactions between software, hardware,
environment, and liveware (people) in complex systems. It is useful for identifying how these elements
interact within an organization and how they may lead to accidents. By examining each element in the
organization's culture and procedures, the SHELL Matrix helps detect weaknesses and conditions that
contribute to accidents.
References:
Wiegmann, D. A., & Shappell, S. A. (2003). Human error analysis of commercial aviation accidents:
Application of the human factors analysis and classification system. Aviation, Space, and Environmental
Medicine, 74(10), 1023-1033.
Bryant,
I agree with your post and the importance of adopting a solid approach to accident analysis. Pilot error
may play a role in accidents, but it is just one element in a complex web of contributing factors. I also
think the distinction between cause and blame is vital. Cause involves finding the reasons for underlying
reasons for events, while blame decides responsibility without considering the broader scope. Model
concepts such as 5M, HFACS, and SHELL provide valuable frameworks for identifying organizational
problems and elements in the error chain. My favorite model to use is HFACs because it categorizes
errors into categories like Unsafe Acts, Preconditions for Unsafe Acts, Organizational Influences, and
Unsafe Supervision. These categories can almost always be applied to scenarios like Zonk Air.
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