NOTECHS and Human Factor

Aviation-related industries are to be considered high-risk organizations where responsibilities and pressures are high, as well as the physical and psychological risks related to the incidence and probability of accidents (Dekker, 2010). The operative core of such organizations is represented by flight crews, which are usually small-sized command and control teams, in a certain way unique, since they are extremely exposed to both high-risk factors and a high degree of human interaction (Salas et al., 2001). For such reason, correct risk identification and an accurate accident analysis based on human interaction are fundamental to manage the safety levels of these teams. Moreover, this is the basis of the HR aviation culture where—given the nature of complex systems, characterized by human-machine interaction but also by teams’ human-human interaction—human error represents the cause of a considerable percentage of accidents (Flin et al., 2002; Shappell et al., 2017). 

Another aviation-related field, also extremely exposed to human errors, is the emergency sector, such as the HEMS (Helicopter Emergency Medical Service) field. The Helicopter Emergency Medical Service is an exceptional example of encapsulation of the medical and aviation sectors since professionals belonging to both these fields (e.g., physicians, pilots, flight technicians, etc.) are working together and undergo various kinds of pressures (e.g., time pressure, peer pressure, self-induced pressures, etc.) that could lead to human error. When carrying out HEMS operations, usually team members have to make difficult decisions in a very short time, and the consequences of a wrong decision may be extremely grave.

 In this sector, Cooperation and Leadership skills are fundamental, since during emergency operations the cohesion of the team members can be strongly tested. Communication and teamwork skills—together with the ability to make good decisions—have been addressed in a multitude of studies in this sector. This has led to the development of an assessment system called: Non-Technical Skills (NOTECHS). 

Following this applied research stream, the present project presents the development and the application of a new short-scale named “NOTECHS+” to measure the Non-Technical Skills (i.e., NOTECHS: Cooperation, Leadership and Managerial skills, Decision-Making, and Situational Awareness) plus Resilience and Emotion Regulation constructs, in a sector that comprises the aviation and the emergency personnel: the Helicopter Emergency Medical Service (HEMS). 

Considering practical aspects, besides assessment, due to its brevity, the NOTECHS+ developed in this research project could be used to measure the baseline and the effects of the intervention, where an intervention can be used to understand the strengths and limits of the three components considered and to then provide training to strengthen the non-technical components needed to deal with high-stress environments. This is especially important in fields, such as HEMS, that involve teams that endure high stress daily. The applicability of this scale can also be extended to other teams in the healthcare system and in the military, where unforeseen events happen regularly and where it is especially important to be trained to cope effectively and maintain situational awareness under stressful conditions. 

Bibliographic references:

Salas, E., Burke, C. S., and Samman, S. N. (2001). Understanding command and control teams operating in complex environments. Inf. Knowl. Syst. Manage. 2, 311–323. 
Flin, R., O’Connor, P., and Mearns, K. (2002). Crew resource management: improving team work in high reliability industries. Team Perform. Manag. Int. J. 8, 68–78. doi: 10.1108/13527590210433366 
Mitchell, L., and Flin, R. (2008). Non-technical skills of the operating theatre scrub nurse: literature review. J. Adv. Nurs. 63, 15–24. doi: 10.1111/j.1365-2648.2008.04695.x 
Dekker, S. (2010). Pilots, controllers and mechanics on trial: cases, concerns and countermeasures. Int. J. Appl. Aviat. Stud. 10, 31–50. 
Shappell, S., Detwiler, C., Holcomb, K., Hackworth, C., Boquet, A., and Wiegmann, D. A. (2017). Human error and commercial aviation accidents: an analysis using the human factors analysis and classification system. Human Error Aviat. 49, 73–88. doi: 10.4324/9781315092898-5