Controlled Flight Into Terrain — CFIT is the event that occurs when an airworthy aircraft, under the control of a qualified pilot, is flown into terrain (or water or obstacles) with inadequate awareness on the part of the pilot of the impending collision. The majority of CFIT fatalities involve large air carrier aircraft (because they carry more passengers), but the largest number of CFIT accidents involves small turboprop and jet aircraft engaged in part 135 operations. In general aviation, studies have shown that almost 5 percent of all accidents occur due to CFIT. This accounts for 17 percent of the GA fatalities. In this lesson we will examine the problem of controlled flight into terrain, and examine the root causes of several CFIT accidents. We will also look at the types of preventive measures the aviation industry is taking to reduce the number of CFIT accidents worldwide. The areas that we will explore in this lesson are: CFIT (Controlled Flight Into Terrain) ALA (Approach and Landing Accidents) Human Factors Distractions Situational awareness Environmental factors Intervention Strategies — Industry emphasis on CFIT prevention CRM (Crew Resource Management) Technology — Ground Proximity Warning System (GPWS), Enhanced Ground Proximity Warning System (EGPWS) The term CFIT describes a type of accident based on the outcome of the flight. Most CFIT accidents occur during the approach and landing phase of flight, thus the acronym ALA (Approach and Landing Accident). In the majority of aircraft accidents there are a number of factors leading to the crash. Together, these factors are called the accident chain. Links of the accident chain are commonly called causal factors; in some cases, a single factor may emerge and be identified as a primary causal factor. REVIEW: Causal Factors Through statistical analysis, investigators have determined five primary causal factors that account for over 70 percent of CFIT accidents: Omission of action or inappropriate action Lack of situational awareness/positional awareness Inadequate flight handling "Press-on-itis" (when a pilot is determined to get to a destination) Poor professional judgment/airmanship Primary causal factors are not mutually exclusive. For example, an accident that cites "omission of action or inappropriate action" as the primary causal factor may have been brought on by any combination of the other causal factors. As the number one primary causal factor, "Omission of action or inappropriate action" was usually exhibited by a pilot's failure to respond appropriately when arriving at decision altitude (DA) or the minimum descent altitude (MDA) without visual reference, or when visual reference was lost. Despite the regulatory requirements, the flights were continued below DA or MDA to disastrous conclusions. This single factor accounts for nearly 25 percent of the CFIT accidents studied. 14 CFR part 91, section 91.175 is very specific regarding what actions are required when DA or MDA is reached without visual contact with the airport or runway environment. Of the primary causal factors, a lack of situational awareness or a lack of positional awareness is at the heart of CFIT accidents. Generally it happens when pilots are unaware of high ground in the vicinity of an airport. CFIT accidents on approach don't normally occur because the pilots stray off the approach course into surrounding terrain. Rather, most of the pilots were right on course but didn't manage their descent properly. One of the more difficult CFIT causal factors to identify is flight handling. This factor is typified by the inability of a flight crew to control the aircraft to the desired parameters, such as airspeed, altitude, and rate of descent. Flight-handling difficulties occur in situations such as: Powerplant mismanagement Hurried approaches Inability of the flight crew to comply with and execute a demanding ATC clearance Unusual weather/wind conditions Stall during escape maneuver/go-around Improper use of cockpit automation Flight handling can be as simple as failure of the flight crew to put in the correct altimeter setting. "Poor professional judgment/airmanship" is a bit of a catchall of the top five causal factors, and is used when the cause of the accident cannot be directly attributed to any of the other causal factors. In reality, each of the previous four causal factors also contain a significant level of poor judgment and bad decision making on the part of the pilot or flight crew. Some examples of this factor include: Ignoring multiple Ground Proximity Warning System alerts Poor or inappropriate division of cockpit duties Failure to maintain a sterile cockpit on approach Inability on the part of the flying pilot to maintain glide slope and/or localizer within acceptable tolerances Incorrect or inappropriate use of aircraft equipment Stress affects all of us in one way or another. Some people, however, thrive on stress and actually seek out stressful situations. Recent studies show that some pilots fit that group. They are stimulated by the challenges associated with flight, and perform better because of those challenges. In this case, stress is positive as long as it doesn't become too great, and is controlled by the pilot to meet the rigors of a demanding situation. For most of us, however, stress can short circuit our positive attributes, and create situations where we are unable to perform adequately. It is important for your students to understand that almost anything can produce stress, and whether it affects them in a positive way or a negative way depends on how they handle it. To help identify stress and its origin, three broad categories have been identified. Work Work is perceived as either productive or unproductive. Productive work is thought of as having a valid goal or outcome, so stress is low in most cases. If the workload is high and the deadline is short, the stress level for productive work is higher than the converse. Your students need to know that how they perceive work is an important factor in how they handle stress. When it is perceived as unproductive, or is thought to have no relevant value or goal, stress is greater and may become a distraction if not managed properly. It can affect their physical well-being as well as their personal life. Physical Problems Physical problems or biological/health issues produce stress. Explain to your students that when combined with environmental factors such as excessive noise, vibration, heat, or cold, the effects are compounded, reducing tolerance to other types of stress. Environmental factors are an everyday occurrence, and adding health issues can make pilots less capable of coping with other forms of stress, and generally reduces overall efficiency. Personal Problems Personal problems are related to circumstances or events that are largely psychological. Like physical problems, personal problems can both produce stress and reduce a pilot's ability to cope with other forms of stress. It is important for your students to understand that stresses resulting from personal problems such as family difficulties or financial problems have a tendency to generate other problems, which may manifest themselves as depression, anxiety, irritability, and violent displays of anger. None of these have a place in the cockpit of an airplane. Fatigue is a part of aviation that every pilot will experience. It affects different people in different ways. The obvious and most dangerous outcome of fatigue is when a pilot falls asleep in the cockpit. You can suggest that your students pay close attention to how they feel after a particularly intense flight training session. Fatigue is aggravated by many contributing factors such as poor nutrition, illness, emotional stress, boredom, and personality. For pilots, time-zone changes, aircraft vibration, sleep deprivation, age, experience, and personality can interact to produce dangerous situations. Fatigue can lead to the inability to perform simple physical tasks, inattention to detail, and poor judgment. In the cockpit, fatigue can result in missing instruments in the scan, inappropriate fixation, or the lack of awareness of subtle changes on engine gauges and instruments. Fatigue is insidious, and performance decay is generally noticed before feeling tired. Fatigue is unavoidable, due to the operational nature of aviation. To remedy the possibility of fatigue when you fly, allow for adequate rest periods. In a single-pilot operation, plan fuel stops and meal breaks at regular intervals. The ability to recognize, manage, or eliminate cockpit distractions improves task management and situational awareness. Distractions can be put into three basic categories: Operational Distractions Non-Operational Distractions Physiological distractions Many indicators show that situational awareness has been lost and you may be able to think of others, but five stand out to warn of an accident chain in progress. Ambiguity — when the information from two or more sources doesn't agree Fixation — focusing on something to the exclusion of all else Confusion — uncertainty about a situation (may be linked and lead to fixation) Failure to recognize and resolve discrepancies Inability to effectively communicate a problem to others During training flights, you can help your students to understand how easy it is to fall into the trap of the accident chain by pointing out specific instances where situational awareness was lost. Studies indicate that the majority of CFIT accidents occur during the afternoon, twilight and nighttime hours. Of the accidents studied during these time periods, some 21 percent involved visual illusions. The result of these illusions is generally a false perception of altitude and/or attitude. Two such visual illusions are runway-slope effects and black-hole illusion. Runway-slope effects are most noticeable when approaching a sloped runway. The tendency is to position the airplane so the runway appears as it would for a normal, flat runway. On runways that slope uphill, it produces a dangerously low approach. For a downhill runway, it produces a high approach with the possibility of overshooting the runway. When poor light conditions or reduced visibility is added to either of these scenarios, you can find yourself in danger of becoming a CFIT statistic. By maintaining a high level of situational awareness, you may avoid the pitfalls of a runway-slope illusion. If you have an airport in your local area that has a sloping runway you can impress on your students how the slope creates this illusion. Black-hole illusion usually occurs during a night approach over unlighted terrain or water. The black in the foreground causes the runway lights in the distance to appear lower than they really are, giving the perception that the airplane is higher than it really is. Again, situational awareness can prevent most of these types of accidents. It is imperative to know where your airplane is in all three dimensions. This illusion can be demonstrated during night training but care should be exercised so that flight safety is not compromised. Did you know that approximately 75% of all aviation accidents are human factors related? As a CFI, you have the ability to potentially change this statistic by integrating the following subjects into your everyday lessons: Aeronautical Decision Making Judgment The DECIDE model Hazardous Attitudes Cockpit Resource Management REVIEW: Intervention Strategies There are basically three strategies for eliminating CFIT: Training Avoidance Technology In an effort to reduce the number of CFIT accidents, the airline industry has implemented extensive training programs, as well as deployed technological instrumentation that provides early warning of terrain proximity. The technology being used is ground proximity warning systems (GPWS), and enhanced ground proximity warning system (EGPWS). As a general aviation pilot and CFI, the airplanes that you fly may not have ground proximity warning system technology. You and your students have to rely on training and practice to avoid the situations that lead to CFIT accidents. However, as the technology improves and becomes less expensive, you may begin to see terrain awareness warning systems (TAWS) and in larger GA aircraft, EGPWS, which are designed specifically for GA aircraft One effective tool you and your students can use to evaluate the risk of CFIT on any given flight, is the CFIT Checklist, which was developed by the Flight Safety Foundation to provide a platform for risk assessment. The three-part risk assessment tool uses a numeric scoring system to determine your risk of controlled flight into terrain. The first part of the CFIT checklist calculates the risk for each flight, sector, or leg. The second part examines risk reduction factors by looking at company culture (training philosophy), flight standards, and type of aircraft, as well as hazard awareness and training. The third part of the checklist should be used to calculate the risk of a CFIT accident for a given flight. Since most CFIT accidents occur at airports with non-precision approaches, training procedures should emphasize standardization training for non-precision approaches, and an intense currency program. The FAA recommends the development of a training program that includes realistic flight training device or flight simulator exercises in a rigorous semiannual program. In keeping with the idea that non-precision approach procedures are a significant risk factor, the Airline Pilots Association (ALPA) suggested that non-precision approaches be outlawed for large transport-category aircraft, in an effort to remove one of the risk factors that lead to CFIT accidents.