CRM Aspects in Accidents and Incidents
CRM Aspects in Accidents and Incidents
CRM Aspects in Accidents and Incidents
I Introduction
Visual illusions take place when conditions modify the pilot’s perception of
the environment relative to his / her expectations.
Visual illusions may result in landing short of the runway, hard landing or runway
overrun, but may also cause spatial disorientation and loss of control.
II Statistical Data
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Human Performance
Flight Operations Briefing Notes Visual Illusions Awareness
Night time 75 %
Low visibility 70 %
IMC 59 %
Darkness or twilight 53 %
Non-ILS approach 53 %
Visual approach 30 %
Absence of :
- letdown navaid
21 %
- approach / runway lighting
- VASI / PAPI
Table 1
“ Visual ” Factors in Approach-and-Landing Events
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Flight Operations Briefing Notes Visual Illusions Awareness
The following factors and conditions affect the flight crew ability to accurately perceive
the environment, resulting in visual illusions.
• Ceiling;
• Visibility (i.e., vertical visibility, slant visibility and horizontal visibility); and/or,
• Cloudiness (e.g., rain, fog or fog patches, haze, mist, smoke, snow, whiteout
effect).
Visual illusions result from the absence of or the alteration of visual references that
modifies the pilot perception of his / her position relative to the runway threshold.
Visual illusions affect perception of heights, distances and/or intercept angles.
Visual illusions are most critical when transitioning from IMC and instrument references
to VMC and visual references.
Visual illusions (such as the black-hole effect) affect the flight crew vertical and
horizontal situational awareness, particularly during the base leg and when turning final
(as applicable) and during the final approach.
Visual illusions usually induce crew inputs (corrections) that cause the aircraft to
deviate from the original and intended vertical or lateral flight path.
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Flight Operations Briefing Notes Visual Illusions Awareness
Visual illusions can affect the decision about when and how fast to descend from
the MDA(H).
The following paragraph provides an expanded overview of all the factors and
conditions creating visual illusions to discuss how each factor or condition may affect
the pilot perception of:
• The airport and runway environment;
• The terrain separation; and,
• The aircraft vertical or lateral deviation from the intended flight-path.
• Preventing the flight crew from detecting a too shallow flight path.
Figure 1
Effect of Terrain Up-hill Slope on Flight Path Perception
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Flight Operations Briefing Notes Visual Illusions Awareness
− A downhill slope in the approach zone creates an illusion of being too low
(i.e., impression of a shallow glide path, as shown on Figure 2), thus:
• Possibly inducing a correction placing the aircraft above the intended glide
path ; or,
• Preventing the flight crew from detecting a too steep flight path.
( Photo No.1 : 12 NM from touchdown – Photo No.2 : 2 NM from touchdown, on PAPI glide path )
Figure 2
Effect of Terrain Down-hill Slope on Flight Path Perception
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Flight Operations Briefing Notes Visual Illusions Awareness
• A wide or short runway (low aspect ratio) creates an impression of being too
low; and,
Figure 3
Center Photo : LFBO 14 R (3500 m x 45 m) / 3-degree glide slope / 200 ft RA
− Bright runway-lights create the impression of being closer to the runway (hence
on a steeper glide path);
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Flight Operations Briefing Notes Visual Illusions Awareness
− Low intensity lights create the impression of being farther away (hence on
a shallower glide path);
− If runway lighting is partially visible (e.g., during the downwind leg or during
the base leg of a visual or circling approach), the runway may appear being
farther away or at a different angle (i.e., the intercept angle is perceived as
smaller than actual).
The following runway approach-aids and conditions may increase the crew exposure to
visual illusions:
• Glide slope beam being unusable beyond a specific point because of terrain or below
a specific altitude/height because of approach over water;
• Offset localizer course; and/or,
• 2-bar VASI, if used below 300 ft height above touchdown (HAT) for glide path
corrections.
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Flight Operations Briefing Notes Visual Illusions Awareness
− Flying in haze creates the impression that the runway is farther away, inducing
a tendency to shallow the glide path and land long;
− Shallow fog (i.e., fog layer not exceeding 300 ft in thickness) results in a low
obscuration but also in low horizontal visibility:
• When on top of a shallow fog layer, the ground (or airport and runway,
if flying overhead) can be seen, but when entering the fog layer the forward
and slant visibility usually are lost;
• Entering a fog layer also creates the perception of a pitch up, thus inducing a
tendency to push over and place the aircraft below the desired glide path
and in a steeper-than-desired attitude;
− In light rain or moderate rain, the runway may also appear fuzzy because of rain
halo effect, increasing the risk of not perceiving a vertical deviation or lateral
deviation during the visual segment.
The visual segment is defined as the segment flown after full transition from
instruments to visual references;
• In night time conditions, rain increases the apparent brilliance of the ALS,
making the runway appears to be closer, inducing a pitch down input and the
risk of landing short of the runway threshold.
− When breaking out of the overcast at both ceiling and visibility minimums (DH
and RVR), the slant visibility may not allow sight of the farther bar(s) of
the VASI/PAPI, thus reducing the available visual clues for the visual segment in
reduced visibility;
− A snow-covered terrain together with a clouds overcast create a phenomenon
called “white-out” that eliminate perception of terrain features (slope) and
height above terrain.
• Crosswind:
− In crosswind conditions, the runway lights and environment will be angled with
the aircraft heading; flight crew should maintain the drift correction and resist
the tendency to align the aircraft heading with the runway centerline.
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Flight Operations Briefing Notes Visual Illusions Awareness
The following crew actions and their consequences often are cited in the analysis
of approach-and-landing incidents or accident resulting from visual illusions:
• Natural tendency to descend below the glide slope or the initial glide path
(i.e., “ducking under”);
• Inability to arrest the rate of descent after descending below the intended glide path
(i.e., late recognition of the flattening of runway and runway environment);
• Failure to monitor the instruments and the flight path, while both crew members are
involved in the identification of visual references.
The following table provides a summary of the various factors and conditions together
with their effects on the pilot’s perception and unintended actions that may result in
a hazardous situation:
Narrow / long runway Being too high Push Land short / Land hard
Wide or short runway Being too low Pull Land long / overrun
Runway or terrain
Being too high Push Land short / Land hard
uphill slope
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Flight Operations Briefing Notes Visual Illusions Awareness
Runway or terrain
Being too low Pull Land long / overrun
downhill slope
Heavy rain Being too close Push over Land short / Land hard
Entering fog
Increasing pitch Push over Steep glide path / CFIT
(shallow layer)
Drifting rain,
Aircraft drifting sideways Undue drift correction Off-runway landing
snow or sand
Table 1
Effects of Visual Illusions on Pilot’s Perception and Actions
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Flight Operations Briefing Notes Visual Illusions Awareness
Flight crews should be educated and trained on the factors and conditions creating
visual illusions and their effects on the perception of the environment and aircraft
position:
• Perception of heights / depth, distances, and angles;
• Assessment of aircraft lateral position and glide path.
Approach hazards – and any combination thereof - should be assessed for each
individual approach, during the approach and go-around briefing, by reviewing
the following elements:
• Ceiling and visibility conditions;
• Weather:
− Wind, turbulence;
− Rain showers;
− Fog or smoke patches;
− Drifting snow or sand;
− Snow-covered terrain / runway (white-out phenomenon); and/or,
− Sun height over horizon;
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Flight Operations Briefing Notes Visual Illusions Awareness
When requesting or accepting a visual approach, flight crew should be aware of the
surrounding terrain features and man-made obstacles.
At night, an unlighted hillside between a lighted area and the runway threshold may
prevent the flight crew from correctly perceiving the rising terrain.
Type of approach
To prevent going too early to visual references and descending prematurely below
the MDA(H), the PF should maintain reference to instruments until reaching the VDP.
This provides further protection against visual illusions in hazard conditions.
During a visual or circling approach, if the VASI / PAPI indicates below glide slope level
off or climb until the VASI/PAPI shows on-glide-path.
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Flight Operations Briefing Notes Visual Illusions Awareness
Resist the tendency to pitch down and “duck under”; this is the greatest challenge
during the visual segment of the approach, this includes:
• Pitching down into the approach light in an attempt to see the runway during
a precision approach; or,
• Ducking under because of the impression of being too high when affected by visual
illusions.
The following provides a summary of the techniques available to counter visual illusions
(and prevent from ducking under):
• Maintain instruments scan down to touchdown;
• Use VASI / PAPI, if available, down to runway threshold (only when using
a 3-bar VASI or a PAPI).
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Flight Operations Briefing Notes Visual Illusions Awareness
VI.5 Coordination
The defined task sharing ensures a continued monitoring of visual and instrument
references, throughout the transition to visual references and thereafter (i.e., during
a visual approach or during the visual segment of an instrument approach).
In known or anticipated hazard conditions, the PNF should reinforce his / her
monitoring of instrument references and of flight progress, for an effective cross-check
and back-up of the PF.
Altitude and excessive-parameter-deviation callouts should be the same for instrument
approaches and visual approaches, and should be continued during the visual segment
(i.e., including glide slope deviation during an ILS approach or vertical speed deviation
during a non-precision approach).
In case of a go-around, specific excessive-parameter-deviation callouts should be
considered (as indicated in SOPs).
The following Briefing Notes complement the above discussion on the acquisition of
visual references and on visual illusions:
• Standard Operating Procedures
• Conducting Effective Briefings
• Enhancing Terrain Awareness
• Acquisition of Visual References
• Flying Visual Approaches
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Flight Operations Briefing Notes Visual Illusions Awareness
IX Regulatory References
• FAR 91.175 – Takeoff and landing under IFR – Paragraph (b), Loss of visual
references.
http://www.cami.jccbi.gov/aam-400A/Brochures/SpatialD.htm
This Flight Operations Briefing Note (FOBN) has been adapted from the corresponding ALAR Briefing Note developed by
Airbus in the frame of the Approach-and-Landing Accident Reduction (ALAR) international task force led by the Flight Safety
Foundation.
This FOBN is part of a set of Flight Operations Briefing Notes that provide an overview of the applicable standards,
flying techniques and best practices, operational and human factors, suggested company prevention strategies and personal
lines-of-defense related to major threats and hazards to flight operations safety.
This FOBN is intended to enhance the reader's flight safety awareness but it shall not supersede the applicable regulations
and the Airbus or airline's operational documentation; should any deviation appear between this FOBN and the Airbus or
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