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The Effects of Decision Making

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Submitted By 737pilot7
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The Liveware interface of the SHELL model is the human aspect of aviation. It is how people interact with each other as far as managing, teamwork and communication. In aviation, communication is key for a successful flight schedule whether it is between the pilots and their crew, or the maintainers on the ground. An example of a failure of the Liverware interface is with the incident Southwest Airlines had with flight 812 on April 1st, 2011. This airline experienced rapid cabin decompression while climbing after takeoff. This was due to a piece of the aircraft skin which was 60 inches long and 8 inches wide opening up mid flight and nearly falling off. After investigation it was found that the structure work that was done to that area of the aircraft was done at an unacceptable level. “Examination of the rivets in the fracture area revealed numerous anomalies, including oversized rivets, variations in finish, under-driven conditions, expanded shank areas, and crank-shafting.” (ntsb) While the mechanic may or may not have known that the hardware they were using was incorrect, a supervisor or a quality inspector should have caught it. This shows a huge lack of communication/training that could have resulted in this flight ending much worse than it did. Aviation mechanics receive extensive training before they can perform maintenance on an aircraft, somewhere along the line the parties involved here either where not trained or simply just missed it during inspection. It usually takes two people to shoot rivets; at least in this case because of the size of the aircraft, so there should have been some communication between the two about the quality of work that was being performed. On April 4th, 2011, Boeing released an Alert Service Bulletin instructing operators to inspect the area where the lap joint peeled up on all aircraft. It was effective

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