This is an excerpt from a report made to the Aviation Safety Reporting System. The narrative is written by the pilot, rather than FAA or NTSB officials. To maintain anonymity, many details, such as aircraft model or airport, are often scrubbed from the reports.
My student almost caused a mid-air collision during his solo.
On my day off, the flight school had him solo. I have not flown with the student in about three weeks. Being a Part 141 school I was trusting the standards to still ensure his competency.
He was given the green light by another instructor at the school.
Not being there I still elected to go over the details of the flight with the student.
I discovered the incident by a phone call from my student upon landing and then again hours later from the flight school.
ATC instructed him to follow traffic left in the crosswind. He failed to identify the correct traffic, thinking the traffic abeam his wing in the left downwind was the traffic to follow. He turned left crosswind, which resulted in cutting off another aircraft, causing them to make evasive maneuvers. ATC had my student continue south and then rejoin and continue his landing practice. Upon landing, he stated he failed to look at any ADS-B in traffic.
The student was confused how he did not know it was a problem until hours later. The student was experiencing some external pressure that may have resulted in this incident. The student wants to get through training at a timely pace, which has not been happening.
The student’s total wind limitation was 7 knots.
After listening to the ATC recordings I discovered that before taking off for his lap in the pattern, there was a wind report of 8 gusting 13 knots. Being that this happened towards the end of his 3.1 hour flight, the student might have not realized the fatigue he was enduring operating outside his limitations. This might have caused him to neglect looking at his ADS-B In.
When discovered and asked the student why he continued it was due to wanting to get the mission done.
Primary Problem: Human Factors
ACN: 1991507
Can’t help but wonder if the CFI that signed off bothered to let the tower know *their* student pilot would be operating first solo in the pattern. Or if the pilot announced, “Student Pilot”, at any time. Not sure either is required but it could have alerted the tower to the situation and helped to mitigate the possibility of a tragic midair.
What happened to see and avoid? I learned to fly in 1993 at a small airport in TN 15 minutes from where I worked at the time. I bought into a club plane. Because the airport was so close I could fly almost every day after work meeting my instructor there. I don’t recall how many hours it took me to solo but I went from nothing to an instrument rating in 18 months. After I solod I started doing a lot of flying even at night building up hours. I am sure the intensity, consistentcy and experience of my CFI a retired Air Force pilot made me a careful pilot. ADS B did not exist at the time. See and avoid was all we had!
Man, I guess you still use paper notams and paper charts too? What relevance does former lack of technology have on failing to use all available current technology (like ads-b in to aid in looking for the correct traffic)?
An interesting CFI confession, but let’s not spin the Part 141 discussion sideways. As already mentioned: It does not say the student did not fly for 3 weeks; it says this instructor did not fly with him. The “3.1 hour” flight time is also missing some rational.
As far as some other select “quotes”:
“Being a Part 141 school I was trusting the standards to still ensure his competency.”
That is the concept: If the “approved syllabus” was executed properly up to that point, meeting those standards should have resulted in the student being competent/ready to solo. In many/most/all Part 141 schools, where the syllabus is divided into “stages”, the flight before (+/-) the initial “supervised solo” is a progress/stage check given by the chief instructor, assistant chief instructor, or designated check instructor.
“He was given the green light by another instructor at the school.” Maybe not the preferred option; but not ‘illegal’ and probably happens more frequently than is realized. I am assuming that this is the same instructor that flew the “Dual” portion of the initial supervised solo ride. As long as that CFI’s endorsement is in the student’s logbook, they are good to go. More to follow.
“Not being there I still elected to go over the details of the flight with the student.”
As I would expect, but was that before or after the flight? After the fact…doesn’t count.
“Upon landing, he stated he failed to look at any ADS-B in traffic.” NO… he “failed” to look outside! He should be looking out the window and following the traffic ahead of him in the pattern…visually. I am betting the plane he cut off on the crosswind, was also in front of him on his departure leg… ADS-B is definitely “not required” to stay behind someone in the pattern…
“The student was experiencing some external pressure that may have resulted in this incident. The student wants to get through training at a timely pace, which has not been happening.” Sounds like someone is paying lip service to PAVE and IMSAFE. Does the school use ANY flight risk assessment tool? These are organizational and cultural issues that need to be addressed at the Chief of Flight Operations and Chief Flight Instructor level. If students not completing the training at “a timely pace” is chronic at that 141 school, then their FAA POI will/should get involved.
“Being that this happened towards the end of his 3.1-hour flight, the student might have not realized the fatigue he was enduring operating outside his limitations.” In my Part 141 experience, the first supervised solo is scheduled as a Dual/Solo flight with @ .5-1.0 hours allocated for the dual part & .5-.7 for the solo: So, why was this flight “3.1 hours” long?
“Primary Problem: Human Factors”. There are some details missing, but this ASRS report seems to be a defensive move by a CFI who’s worried that ATC’s involvement in a ‘near miss’ will somehow get back to him/her as the student’s primary assigned instructor.
“In many/most/all Part 141 schools, where the syllabus is divided into “stages”, the flight before (+/-) the initial “supervised solo” is a progress/stage check given by the chief instructor, assistant chief instructor, or designated check instructor.”
The syllabus we used (approved by the FSDO and published by a major aviation company) had the initial progress check after the first supervised solo. This sort of amazed me at first but I think has some logic. The question is how can you not trust your cfi to know when it is time to let the learner solo? If the learner were in a Part 61 school, it would be totally up to the cfi, so in a sense, if the cfi is teaching in a Part 141 program, it would be saying that the cfi is not trusted. How is that going to make the cfi feel, and how is that going to affect the confidence of the learner toward the cfi? Not good in either case. This characteristic of the syllabus was even discussed at one of the FIRC’s I was required to attend annually as Chief Flight Instructor. It was brought up solely as a point to confirm that it was understood correctly, but I could tell by the expression on the face of the FIRC instructor following a question raised by an attendee that he probably thought the progress check should come before the solo, but he didn’t say so. Anyway in over 20 years as Chief Flight Instructor, I can say there was only one case where I thought the initial solo was done a little early. There was no incident or accident, but the landing skill wasn’t quite where it should have been to hold the it off the runway and touch down at minimum speed.
Hence my all-encompassing caveat: “(+\-)”…there is no “One Size Fits All” FAA-approved Part 141 syllabus.
I taught in a very large, well-known, collegiate Part 141 program where the first “stage check” was the ride after first solo. Passing this check was required to start the “cross-country” stage.
Yet, as we speak, I’m looking at two Part 141 course outlines, both produced by well-known & respected commercial vendors: One has the first stage check one ride before initial solo; the other has it two rides before solo.
As far as “not trusting” a particular CFI to determine whether a student is safe to solo…no comment.
Tom – thanks for that information. You are correct. The one we used apparently hasn’t changed, but I did find one that has a stage check before solo, and one that has two stage checks before solo. That would seem way too micro-managed to me, but as I think you are saying, if managed correctly, any program should result in a well trained pilot in a timely period.
My instructor asked me to solo after 10 hours total instruction time. I disagreed but He insisted, said I was ready. I did great that day but over the next 20 hours or so, I made bad mistakes in the pattern that should have been corrected before I soloed. He and I should have been in agreement before the first solo flight. 50 years ago.
The reporter did not say that the student had not flown in three weeks, he said that he had not flown with the student in three weeks. Perhaps the CFI that sent the student off solo had flown with the student more recently. Perhaps that second CFI had also changed the wind limitations in his endorsement. Perhaps the second CFI had just given 3.1 hours of dual instruction to the student. That would be a long and tiring lesson but we don’t know the second CFI’s reasoning and we have not heard from the student.
I understand the 141 school ideas (got my Instrument via one). But, these comments and the example given tell me how much I learned at a “normal” flight school (with a 2300×40′ runway on top of a hill with X/W). Later I was taught procedural flying once I had all the basics covered. But then, I learned to fly before GPS. So we were taught to take a road atlas with us on cross countries and binoculars. Got caught in IMC, found a hole (large one) and dropped through it. Saw a water tower and had my wife read the name on the tower. That told us where we were.
How many practice this kind of flying for when GPS dies (or is being jammed) or your EFB dies and your phone is not behaving?
So I knew from that where the closest airport was to refuel and get a new wx brief (IMC was unforecast — was supposed to be widely scattered). Once you get that certificate, does one today, out of a 141 school, have enough info to get out of trouble rather than getting in deeper? This article and these comments have me concerned and may explain why we see some of the behaviors we do at some airports.
ADSB is a fine tool but…we need to train newbies to get their heads out of the cockpit !!!
A good case study to discuss flight school vs traditional one-on-one training. I’m a freelance CFI based at a rural airport; and basically unemployed. However, it’s a good thing I’m retired after 22 years of flight instructing. A local high school graduate is headed to the nationally acclaimed state university flight school. Given he has virtually zero experience in the cockpit, I offered to fly with him a few hours over the summer. The answer: the university discourages this. Apparently, my years of experience instructing might taint him in some way. It’s better he pay for a couple hundred hours so he himself can become a collegiate CFI training new airline pilots.
Any university that would discourage this would be one to run away from.
Had a similar situation. My girlfriend was deemed ready for solo. Instead I took her out and changed up the entry, so no bird setting on the third mailbox for reference to turn and reduce RPM. I took the plane back at 100 feet AGL, power reduced and still descending, 3 miles short of the runway and still hadn’t reached for the throttle..
Rote teaching is hazardous to those who, for lack of a better word, mechanically inclined. ADS-B seems to be creating it’s own dependency caveat.
A student is just that, a student. He was doing, or not doing, exactly as he was taught.
A CFI having a student solo for the first time, that hasn’t flown in three weeks? Bad move. Not being present on that day? Bad move. Another CFI, who may not have flown with the student ‘giving the ok’ to the student to solo? Bad, bad bad.
As a DPE, I spend lots of time in flight schools. I see, often, the student that wants to finish in a timely manner. Everyone wants it NOW. And many end up with subpar training because of it.
Well said! It concerns me, as an AGI/IGI, how so many students aren’t being taught/assigned appropriate ground work to form a solid foundation for their flight training. A first solo is a huge deal, a life-and-death responsibility, not only to the student in question, but also other pilots, flight schools, airports, ATC, and the aviation community in general. As an “unconventional” flight student (my end goal is teaching), I can on the one hand understand how young students pursuing an airline or similar career pressure themselves to accomplish “the mission” as quickly as possible. That, however, is a hazardous attitude. I’m a firm believer in knowing the material to the core (not just at the level necessary to pass a knowledge test), and reading stories like this, frankly, scares me. What if this student had been at a non-towered airport and the traffic he cut off just happened to be a little closer and couldn’t react in time? The student should “go back to the drawing board,” so to speak, and the CFI should always err on the side of caution. Especially regarding student solos, if there’s one scintilla of doubt as to the student’s readiness, it’s a “no-go.”
Couldn’t agree more. If the student has a 7 kt limitation, which is low, that means there shouldn’t be any number higher than that on a metar or taf. If that limitation is in the student’s logbook, it must be followed per 61.89(a)(8). This has to be verified by the person authorizing the local solo flight, along with verifying a current 90-endorsement and all school guidelines. The total time of the flight, 3.1 hours, for a student pilot who hadn’t flown in 3 weeks? At that stage proficiency can drop off rapidly – at least a quick flight with a cfi was in order. I remember most students were done at the beginning, as far as energy, in about an hour. Plan the appropriate total time.
This sounds like a classic case of mis-identifying traffic called by the tower. Having traffic on the crosswind is unusual but the usual situation of two aircraft on final is a good example. With the pilot on downwind, the controller may say you are following traffic on final, but may leave out where on final. The pilot sees an airplane on really short final close to the threshold line, and the pilot reports traffic in sight. But the traffic to follow was on a mile final, so there’s the set-up for the turn in front of the traffic which is what appears to have happened in this case on the crosswind. What can be done is use a qualifier when reporting traffic in sight. I.e. the reply to the tower could have been I have the traffic in sight at my 9 o’clock. That should alert the controller that the pilot is looking in the wrong direction and the controller can make an appropriate clarification. It’s not the student’s fault – as said students will do what they are taught.