Human Factor Training

Standard Operating procedures, background & development



For many years the International Civil Aviation Organization (ICAO) has identified deficiencies in standard operating procedures (SOPs) as contributing causal factors in aviation accidents.

The ICAO has recognized the importance of SOPs for safe flight operations. ICAO Annex 6 and PANS-OPS Document 8168, Vol I, establish that each Member State shall require that SOPs for each phase of flight be contained in the operations manual used by pilots.

One size doesn’t fit all, therefore the SOP’s must be critically analysed, developed and disseminated. The intent of the procedure must be clear since a particular SOP has the desired objective. If in a particular situation the desired outcome is not achievable, then using good CRM practices and background knowledge, the SOP can be bypassed considering all risks.

Background of Safety Enhancement Initiative (SEI)

Standard operating procedures (SOPs) are universally recognized as being basic to safe aviation operations. Effective crew coordination and crew performance,  two central concepts of crew resource management (CRM), depend upon the crew’s having a shared mental model of each task. That mental model, in turn, is founded on SOPs.

A study of CFIT accidents found almost 50 per cent of the 107 CFIT interventions identified by an analysis team related to the flight crew’s failure to adhere to SOPs or the AOC holder’s failure to establish adequate SOPs.

Pinc and Punc

James Huntzinger, the former Vice President of Safety, Security & Compliance at Korean Air has been credited with coining the terms procedural intentional noncompliance (PINC) and procedural unintentional noncompliance (PUNC) (Agur, 2007). Quite simply, these acronyms are used to label behavior as pilots’ unintentional or intentional deviation from company-prescribed SOP. The Air Safety Foundation (2007) reported that a review of accidents involving professionally flown aircraft shows that four out of five events included PINC or PUNC by pilots.
Additionally, ‘‘PINCs and PUNCs are reduced dramatically when an effective safety culture exists.’’

Modern Airline Pilots9 Quandary: Standard Operating Procedures—
to Comply or Not to Comply (Carrie N. Giles Minnesota State University, Mankato

The Mission of SOPs

To achieve consistently safe flight operations through adherence to SOPs that are clear, comprehensive, and readily available to flight crew members.

SOP, Emergency procedures, Abnormal procedures & Limitations

Which ones of these are recommendations and which ones mandatory?

Limitations are must comply
Emergency procedures
Abnormal procedures
Normal procedures

Key Features of Effective SOPs

  1. Many experts agree that implementation of any procedure as an SOP is most effective if:
  • The procedure is appropriate for the situation.
  • The procedure is practical to use.
  • Crew members understand the reasons for the procedure.
  • Pilot Flying (PF), Pilot Monitoring (PM) are clearly delineated.
  • Effective combined means of information dissemination, be it through descriptive circulars (electronic or paper), courses (virtual or classroom) & line or scenario-based simulator training, is conducted.
  • Collective endorsement and continuous review of a new procedure by all stakeholders are fundamental to successful implementation and effective operations.
  • The procedure should be equipped with redundancy and thereby not be limiting. This will permit crews a degree of lateral flexibility when managing non- normal scenarios

2. The above seven elements are further reinforced by effective Crew Resource Management (CRM) skills, such as task sharing and communication, as well as a disciplined approach towards checklist philosophy. A process of continual open feedback, review and modification of all procedures will serve to enhance the organization’s overall level of safety.

The Importance of Understanding the Reasons for an SOP

  • Effective Feedback. When flight crew members understand the underlying reasons for an SOP they are better prepared and more eager to offer effective feedback for improvements. The operator/airline, in turn, benefits from more competent feedback in revising existing SOPs and in developing new SOPs. Those benefits include safety, efficiency, and employee morale.
  • Troubleshooting. When flight crew members understand the underlying reasons for and SOP, they are generally better prepared to handle a related in-flight problem that may not be explicitly or completely addressed in their operating manuals.

Collaborating for Effective SOPs

  • In general, effective SOPs are the product of healthy collaboration among managers and flight operations personnel, including flight crews. A safety culture promoting continuous feedback from flight crew and others, and continuous revision by the collaborators distinguish effective SOPs at air operators of all sizes and ages.
  • New operators, operators adding a new aircraft fleet, or operators retiring one aircraft fleet for another must be especially diligent in developing SOPs. Stakeholders with applicable experience may be more difficult to bring together in those instances.
  • For a startup AOC holder, the developers should pay close attention to the approved Airplane Flight Manual (AFM), to AFM revisions and operations bulletins issued by the manufacturer. Desirable partners in the collaboration would certainly include representatives of the airplane manufacturer, pilots having previous experience with the airplane or with the kind of operations planned by the operator,  and representatives from the CAA. The development of SOPs should maintain a close parallel with the ICAO Safety Management System (SMS) principles in that the process is subjected to constant open feedback, review and modification from all stakeholders. Together, managers and flight crews are able to review the effectiveness of SOPs and to reach valid conclusions for revisions.
  • An existing AOC holder introducing a new airplane fleet should also collaborate using the best resources available, including the AFM and operations bulletins. Experience has shown that representatives of the airplane manufacturer, managers, check pilot, instructors, and line pilots work well together as a team to develop effective SOPs. A trial period might be implemented, followed by feedback and revision, in which SOPs are improved. By being part of an iterative process for changes in SOPs, the end user, the flight crew member, is generally inclined to accept the validity of changes and to implement them readily.
  • Long-established operators should be careful not to assume too readily that they can operate an airplane recently added to the fleet in the same, standard way as older types or models. Managers, check pilot, and instructors should collaborate using the best resources available, including the AFM and operations bulletins to ensure that SOPs developed or adapted for a new airplane are in fact effective for that aircraft, and are not inappropriate carryovers.