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The introduction of drugs and bears Several physicians, including David the liver of a recently slaughtered pig M. Gaba of Stanford University and with circulating (artificial) blood. the late Hans-Gerhard Schaefer of During the operation itself, various the University of Basel/Kantonsspital crises may be introduced by the comin Switzerland, have recognized parputer—a hemorrhage, collapsed lung allels between interpersonal commuor cardiac arrest—that increase the nications problems in the cockpit need for joint decision making.

Bursts of Predmore classified what social conversation—prothe crew said to one anoth0 viding emotional support er into “thought units” that COCKPIT VOICE RECORDER TIME, IN MINUTES or inquiring about the level quantified a single thought, COMMAND INQUIRY ACKNOWLEDGMENT of anxiety being experiintent or action. OBSERVATION INCOMPLETE THOUGHT enced by others—were inThe crew had to deal terspersed throughout the with controlling the aircraft, MINUTE-BY-MINUTE analysis of the cockpit voice recorder transcript; these asides assessing damage, choosshowed intensive communication among crew members before proved to be an effective ing a landing site and prethe DC-10 crashed in Sioux City, Iowa, in 1989.

Accidents are also the basis for many of the scenarios that pilots confront in flight simulators. Sessions in a simulator are part of the annual training to reinforce basic CRM concepts. igh-fidelity simulators consist of a cockpit with working instruments and controls, the sensation of motion and a visual representation of the environment outside the cockpit windows. CRM has expanded the use of the simulator as a training tool. Initially simulators were employed only to teach and evaluate pilots’ flying skills (“stick and rudder” techniques).

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