11.3 Building on the Results of a Critical Incident Technique Session
The process flow or map is just the first step in the development of a risk assessment, using the CIT. The process map can be used to guide future interviews on the process with the intent of eliciting other pertinent facts about a process of failure path. Figure 11.4 is a simple process map of an incident.
The risk analyst can then use this process map as a guide for interviewing participants on the attributes of the process. There are five steps in this process. The questions a risk analyst might ask for each step include the following.
11.3.1 Step 1: Ramp Agent observes Anomaly on Aircraft Cargo Door
1. Approximately, how big was the anomaly?
2. Could you describe its appearance?
3. Do you normally perform a visual inspection of the cargo door and/or is this a part of your normal job requirements?
4. Were you following a procedure when you performed the inspection?
5. What time of day was it?
6. Was it overcast?
7. Was it bright sunshine?
8. If at night, did you use a flashlight?
9. How did you perceive the lighting to be?
10. Do you wear corrective lenses?
11. Was it very noisy?
12. Were you wearing hearing protection?
13. Was anything obscuring your vision?
14. Was it hot or cold at that time?
15. Was the panel generally clean or dirty when you observed the damage?
16. How often do you find anomalies?
17. In your rough estimation, what is the probability that you could find such anomaly in the future?
11.3.2 Step 2: Ramp Agent Discusses Damage with Supervisor
1. How is your relationship with your supervisor?
2. Did you show the damage to your supervisor?
3. What was your supervisors response?
4. Did the supervisor provide any guidance on reporting the damage without your input?
11.3.3 Step 3: Ramp Agent Discusses Decision to Report Damage to Maintenance Control with Supervisor
1. How receptive was the supervisor in your desire to report the damage?
2. Did the supervisor provide any insight into reporting the damage?
3. Where did you discuss this?
11.3.4 Step 4: Ramp Agent Decides to Report Damage to Maintenance Control
1. Why did you decide to report the damage to maintenance control?
2. Were you following a procedure or protocol when you reported the damage?
3. In the past, were you rewarded for reporting damage?
4. What do you feel the consequences would be if you did not report the damage?
5. How was your report received?
11.3.5 Step 5: Ramp Agent Shows Maintenance Control the Damage
1. Had conditions changed from your initial observations?
2. How did maintenance control respond to your finding?
3. How did you feel after this interaction with maintenance control?
4. Did maintenance control provide you any feedback from your finding?
The answers from these questions would then be used to further flesh out the parameters of the risk assessment.
The same type of process could be used for gaining insights into hardware failures as well. In this case, the process map would be created with the hardware system as the focus. The questions would then relate to the hardware components' successes and failures. There is nothing that would prevent a combined human and hardware analysis either. In fact, an integrated approach is always of benefit.
