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March 30, 1999 - VOL. 26, NO. 12
Helmreich's maneuvers: UT professor studies parallels between cockpit crews, medical teams
In 1990, a Colombian jetliner ran out of fuel and crashed on approach to Kennedy International Airport in New York. The crash investigation showed that cultural factors were a key cause of the fatal accident.
Junior crewmembers aboard the aircraft were unwilling to point out the critical lack of fuel to the captain and the crew accepted a lengthy routing from air traffic controllers.
It is cases such as this that have fueled more than 30 years of research by UT Austin social psychologist Dr. Robert Helmreich. Helmreich is particularly interested in how cultural factors affect behavior in complex settings such as aviation.
When he talks about culture, he means not only national culture but also professional and organizational cultures. In this decade, Helmreich and his research group, which includes professionals, graduate and undergraduate students and post-doctoral fellows, have expanded their focus from aviation to medicine. They are particularly interested in the operating room, where the parallels in work environment and various cultural influences are striking.
Aviation and medicine both have strong professional cultures with positive and negative aspects. Both pilots and doctors are well trained, highly motivated professionals who take pride in their work. However, both view themselves as immune to fatigue and other stressors.
As a result of this dual focus, Helmreich and post-doctoral fellow Ashleigh Merritt have co-authored a recently published book titled Culture at Work in Aviation and Medicine. "The theme of the book is understanding how people work together in demanding professions involving high technology and how the three cultures (national, organizational and professional) play into the scheme," Helmreich said.
To gather data on the three cultures, Helmreich and his collaborators developed surveys for pilots and medical teams. In aviation, they have collected data from nearly 20,000 pilots in more than 20 countries.
In addition, researchers actually observe cockpit crews in flight and medical teams at work in operating rooms. Since 1994, Helmreich and his fellow researchers have logged more than 3,500 flights and have compiled an enormous database of information on aviation crew interaction. They have a growing database for medicine.
"We've had a lot of surprises along the way," Helmreich said. "We think of ourselves living in a global village and that cultural differences might be dissolving." But that has not proven to be the case.
As Helmreich said, airlines are rapidly forming global alliances while in some developing countries, trained pilots are so scarce that airlines are forced to hire from all over the world. In medicine, multicultural teams are increasingly caring for patients in hospitals.
National culture is evident in relationships between subordinates and leaders, as in the 1990 airline crash in New York. Researchers also have found large differences in acceptance of rules and procedures (with people from the United States being least rule-oriented.) When it comes to technology, national culture also plays a critical role. Some cultures, especially in Asia and Latin America, are prone to rely heavily on computerized equipment. However, the Irish are least trusting of computer systems; those from the United States fall between the two extremes.
To deal with these differences, Helmreich and Merritt have helped develop training programs called Crew Resource Management that have proven to be highly successful in increasing the effectiveness of flight crews. This type of training is now required around the world.
The medical aspect of his research was sparked when physicians at the University of Basel in Switzerland invited him to adapt his approaches from the cockpit to the operating room. Acceptance of this application is growing in the United States. In February, he spoke to a patient forum on medical safety sponsored in Houston by the American Medical Association, Hermann Hospital and the University of Texas Medical Branch. Plans are under way to extend the research in U.S. hospitals.
The technology is not confined to aviation and medicine, Helmreich said. It has common threads to any teams that use technology, including oil tanker crews, nuclear power plants and teams that develop software or work in office settings.
Helmreich's interest in teamwork in stressful situations began in the 1960s, when he was a naval officer serving on warships in the Pacific, Atlantic and Mideast.
His research has been supported by the National Science Foundation and the National Aeronautics and Space Administration (NASA). His current research in aviation is backed by a grant from the Federal Aviation Administration. A new award from the Daimler-Benz Foundation in Germany will support the integration of the research in aviation and medicine.
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