AIRCREW PERFORMANCE 

CUTTING-EDGE TECH 

by 

Kris M. Belland, Commander, USN 

September 2003 

Occasional Paper No. 35 

Center for Strategy and Technology 

Air War College 

Air University 

Maxwell Air Force Base, Alabama 
AIRCREW PERFORMANCE CUTTING-EDGE 

TECHNOLOGY: 

EMERGING HUMAN PERFORMANCE 

ENHANCEMENT TECHNOLOGY 

VISION IN SUPPORT OF OPERATIONAL MILITARY 

AVIATION STRATEGY

Kris M. Belland, Commander, USN 

September 2003 

The Occasional papers series was established by the Center for 

Strategy and Technology as a forum for research on topics that reflect 

long-term strategic thinking about technology and its implications for 

U.S. national security. Copies of No. 35 in this series are available 

from the Center for Strategy and Technology, Air War College, 325 

Chennault Circle, Maxwell AFB, Alabama 36112. The fax number is 

(334) 953-6158; phone (334) 953-6460. 

Occasional Paper No. 35 

Center for Strategy and Technology 

Air University 

Maxwell Air Force Base, Alabama 36112 
Contents 

Page

Disclaimer.....................................................................................................i 

Author......................................................................................................... ii 

Acknowledgements.................................................................................... iii 

Abstract.......................................................................................................iv 

I. Introduction to Human Performance.......................................................1 

II. Fatigue Operations .................................................................................5 

III. Vision Enhancement/Refractive Eye Surgery ....................................11 

IV. Nuclear Biological and Chemical (NBC) Threat Environment 

and the Tactical Air (TACAIR) Operator............................................19 

V. Directed Energy Weapons/Battlefield Lasers......................................25 

VI. Mishap Reduction...............................................................................31 

VII. Conclusions/Recommendations ........................................................43 

Appendix A: US Navy corneal surgery policy.........................................47 

Notes..........................................................................................................49 

Disclaimer 

The views expressed in this academic research paper are those of

the author and do not reflect the official policy or position of Air

University, the US government or the Department of Defense. In 

accordance with Air Force Instruction 51-303, it is not copyrighted, but is 

the property of the United States government. 

i
Author 

Commander Kris M. “Doc” Belland, USN, is a 1984 graduate of

the United States Naval Academy and 1989 graduate of the Philadelphia 

College of Osteopathic Medicine. He is board certified in family practice 

and licensed as a physician and surgeon in California. After a general 

surgery internship at Oakland Naval Hospital, he attended the Naval 

Aerospace Medical Institute in Pensacola, Florida where he was 

designated a naval flight surgeon. This was followed by operational 

combat tours aboard the aircraft carriers USS Midway (CV-41), USS

Independence (CV-62), and USS Carl Vinson (CVN-70), during 

Operation Southern Watch with Carrier Air Wings five and fourteen 

respectively. He was then selected for flight training, leading to an 

additional designation as a naval aviator. He has accrued over 1,200 hours 

of flight time in various aircraft including the F/A-18, F-14, EA-6B, and 

S-3 with over 112 arrested landings aboard aircraft carriers and 25 combat 

missions over Iraq. The Society of U. S. Naval Flight Surgeons has 

bestowed him with both the Richard Leuhrs Flight Surgeon of the Year 

Award for U.S. Navy and Marine Corps in 1994 and the Sonny Carter 

Memorial Award in 2000. He has been a co-investigator for Navy/Air 

Force photorefractive keratectomy (PRK) studies and battlefield laser 

experiments and is a Navy subject matter expert in directed energy

weapons (battlefield lasers), Joint Strike Fighter, human performance 

maintenance during sustained/continuous operations, and human factors as 

they relate to mishap avoidance and mission accomplishment. He has 

served as senior dual-designated flight surgeon at Naval Strike and Air 

Warfare Center (NSAWC)/Navy Fighter Weapons School (TOPGUN) in 

Fallon, Nevada and is serving as the battle group Force Surgeon and 

Senior Medical Officer aboard (CV-63), USS Kitty Hawk, during 

Operation Iraqi Freedom. 

ii 
Acknowledgements 

I wish to thank the following individuals, Dr. Grant Hammond, 

Mr. Ted Hailes, CAPT Dave Brown, CAPT Fran Rash, CAPT Steve 

Schallhorn, CDR Dave Tanzer, CDR Michael Reddix, LCDR Paul 

Anthony, Mr Norman Barsalou, Ms Elsa Hennings, CAPT Angus Rupert, 

Ms Connie Gillan, CAPT Dennis Flaherty, CDR Scott Shappel, CAPT 

James Fraser, CAPT “Skip” Lind, CAPT William Miller, CAPT C. T. 

Cuninghame, RADM Don Arthur, CAPT Charlie Barker, CAPT Dean

Bailey, RADM “Bernie” Smith, RADM “Wizard” McCabe, RADM Brent 

Bennitt, and particularly Lt Col John Geis for their leadership, friendship, 

mentoring, and assistance in the preparation of this paper. 

The author dedicates this work to Sailors, Airmen, Soldiers,

Marines, Police, Firemen and innocents who have lost their lives in

terrorist acts against the United States, as well as those that are continuing 

the fight against terrorism in all of its forms. 

iii
Abstract 

Using cutting-edge technology to create a human factors advantage 

in military operations will contribute to success on the battlefield of the 

future—whether below the surface, on the surface, in the air, or in space. 

Human factors system selection in the past has appeared to be arbitrary 

and intermittent, with no unifying vision and apparently little or no

coordination between the military services. Mature, timely applied

technology will reduce risk and enhance combat capability. By decreasing 

mishaps during training and combat, there will be a reduced number of 

lost lives of highly trained and costly aircrew, while preserving training 

and combat assets—both manned aircraft and unmanned air vehicles. A

concomitant increase in survivability through better understanding of 

human factors technology will ultimately give the modern aviation warrior 

a tactical edge throughout the full spectrum of combat and provide 

secondary benefits to the civilian aviation sector as well. This paper

explains currently available and emerging aviation human factors 

technological advances in today’s military aviation weapons systems and 

recommends a vision and direction for the most promising of these

emerging aviation human factors-related technological advances. 

iv 
Aircrew Performance Cutting-Edge Technology...1 

I. Introduction to Human Performance 

The quality of the box matters little. Success depends upon

the man who sits in it. 

— Baron Manfred von Richthofen 

 80 Victories, WWI 

Manned flight will be around for a while: 

No doubt, the future will hold an increasing emphasis on

unmanned aero-vehicles and unmanned combat aero-vehicles to address

the rapidly changing scenarios of war. However, current DOD 

procurement commitments and planning have guaranteed that manned 

aircraft will be in combat airspace of the future well beyond 2050. An 

example of this commitment to manned combat aircraft is the Joint Strike

Fighter competition won by Lockheed Martin Aeronautics Company on 

26 October 2001. The Joint Strike Fighter is scheduled for initial 

operational capability in 2011 for the Air Force and 2012 for Navy, with 

significant service life to follow, most likely past 2050.1

 CAPT William 

Miller, a U.S. Navy dual-designated flight surgeon and pilot, when 

discussing technology and human factors advances states: 

I think it is a matter of consciousness, bandwidth, and 

economy. The USAF proved that the required level of 

artificial intelligence is not here yet with “pilot’s 

associate”.... There is no replacement for the combat 

aviator. The unpredictable flight environment demands a 

robust, reliable real-time operator. He or she has to be 

located in the battle space. How do you do the economic

comparison when there really is no competing system

available at any price?2

 

Manned combat aircraft are a fact of operational life for the near- and midterm; even so, many human factors technological advances are equally 

applicable to both manned and un-manned military and civilian aviation 

environments. For the foreseeable future, human control over flight is 

here to stay. 
2... Aircrew Performance Cutting-Edge Technology 

Why are human factors so important to flight? 

Atlas of Injuries in the U. S. Armed Forces, the latest and only 

study of its kind to determine the magnitude of the injury problem in the 

armed forces, covers a fifteen-year period between 1980-1994. This study 

shows that the highest cost for personnel mishaps was aviation, at a cost of 

$381 million dollars for fiscal year 1994 alone, with overall Department of 

Defense aviation losses calculated to be $632 million dollars.3

 The loss in

life and National treasure is significant. The good news is military

aviation mishaps continue to decrease. The bad news is the Department of 

Defense still loses an average of one to two aviators per week as an 

aggregate of all flying, including operational and training flights.4

In military aviation operations, one measure of human 

performance is human factors mishap rates. The Navy, as a representative

service for mishaps, had total Naval aircraft losses between 1987 and 1996 

recorded at $13.4 billion.5

 Of the 268 aircraft lost and 192 aircrew killed 

or severely injured, approximately fifty-five lives and over half of the lost 

aircraft could have been saved if technology available today had been 

implemented prior to the mishaps.6

 This represents a potential savings of 

between 3.52 and 7.15 billion dollars.7

 Estimated savings may have been 

realized if the technology of today was available in the studied mishap 

aircraft of the past. Some may dispute this claim due to the many 

variables involved, but it is one way to consider the benefits of 

implementing cutting-edge technological advancements. 

Can’t Technology fix it? 

Americans are enamored with technology for technology’s sake 

and all too often forget the critical man-machine interface piece of the 

equation when developing new weapon systems. Given that the human 

being matters most, there has been a paradoxical paucity in incorporating 

existing human factors specific technologies in combat aircraft. This is 

typified by the “stove-pipe” development of aircraft systems that rarely

integrate multiple existing and emerging human factors concepts. Often, 

discovered technological advances and safety-related systems go 

unincorporated in current aircraft, primarily because of the military

prioritization of weapons systems over human engineering/safety 

systems.8

 One example of this dearth of incorporated safety systems is the 

Automatic Ground Proximity Warning system that has been developed for 
Aircrew Performance Cutting-Edge Technology...3 

fourteen years yet is still not included in many operational aircraft. Given 

the competitive nature of current DOD budgets, this prioritization is

somewhat understandable; but this myopic view of technology 

incorporation is not a new thought. Azar Gat, when discussing 

Napoleonic Warfare wrote, “techno-tactical developments...had been 

virtually ignored by the military thinkers of the enlightenment.”9

 So too is 

remains today, at least for human factors emerging technologies. 

Is there any good news? 

Although there has been a steady decrease in all types of mishaps 

over the years, there is still significant room for further reduction in the 

numbers of mishaps through the implementation and advancement of 

human factors technology development. There is a great potential for a 

significant savings of priceless lives and valuable training/combat assets. 

One should guard against merely accepting an improved status quo or 

even a single human/aircraft loss as the “cost of doing business.” A 

quantum leap in civilian and military aircraft efficacy and safety is 

currently attainable if only the right resources are applied and senior 

leadership commitment is obtained. 

Aviation human factors advances will decrease mishaps by freeing 

up the pilot from distracting aircraft operations and add an additional 

benefit of an increased ability of the pilot to employ the aircraft in combat. 

Workload will be decreased during all phases of flight, thus freeing pilot’s 

cognitive processing to address tactical situations in a timely manner. 

Advances are almost universally applicable to manned and unmanned 

aircraft. 

The remainder of this paper will describe emerging, cutting-edge 

human factors technology and put forth the methods to achieve them. 

Technology areas addressed here include fatigue, vision enhancement, 

NBC/DEW threats, and mishap reduction, as well as more nebulous areas

of culture, situational awareness, spatial disorientation, simulators, and 

training. It is hoped that this vision will focus technological direction, so

that the advances may be incorporated more rapidly into operational 

aviation combat systems. There is reason for hope. 
4... Aircrew Performance Cutting-Edge Technology 
Aircrew Performance Cutting-Edge Technology...5 

II. Fatigue Operations 

My mind clicks on and off...I try letting one eyelid close at 

a time while propping the other open with my will. But the 

effort is too much. Sleep is winning. My whole body 

argues dully that nothing, nothing life can attain, is quite so 

desirable as sleep. 

C. A. Lindbergh 

The Spirit of St. Louis 

Reflecting on his 33 hour transatlantic solo flight 

When fatigued, a pilot has decreased ability to handle an aircraft 

emergency or a surprise combat situation. Research has shown that after 

17 hours of wakefulness, performance degradation is equivalent to an 

individual imbibing two drinks of alcohol. After twenty-four hours of 

wakefulness, that performance is degraded equal to a blood alcohol level 

of legal intoxication (0.10%).10 However, many of us would readily drive 

a car or fly an aircraft after seventeen to twenty four hours of wakefulness, 

even though our performance would be equivalent to being “drunk.” 

Undoubtedly, fatigue is an insidious problem that most of us do not fully 

appreciate. 

It is insightful to understand that since the beginning of aerial 

combat, the first pilot to detect the enemy enters the ObservationOrientation-Decision-Action (OODA) loop soonest. This allows that pilot 

to seize the tactical edge and to ultimately defeat the enemy. As John 

Boyd stated in his discourse on Winning and Losing, “Get inside adversary 

OODA-loops (at all levels) by being more subtle, more indistinct, more 

irregular, and quicker—yet appear to be otherwise.”11 To win the

conflicts of the future, aviators will need to be at and perform at their 

peak, and clearly, fatigue is a significant inhibitor of peak performance 

that must be controlled. 

Fatigue is not due to lack of motivation or poor attitude. Sleep 

loss, circadian rhythm disruption, nutrition, environmental conditions, and 

hard work combine to produce fatigue. Sleep cannot be stored or built up 

prior to continuous or sustained operations, despite what some aviators

may think. As a result, most aviators will become fatigued prior to 

combat flights due to extensive flight planning, nervousness, chair-flying 

mission, etc. Standardized tests show there are performance peaks and 
6... Aircrew Performance Cutting-Edge Technology 

troughs throughout the day referred to as circadian rhythms.12 Circadian

rhythm, physical/mental fatigue, stresses, and cumulative fatigue all work 

against an aviator to impair performance to one degree or another. 

Fatigue is Endemic to Military Operations 

Between 1974 and 1992, the Air Force Safety Center attributed 

twenty-five percent of night tactical fighter Class A (greater than one 

million dollars damage or permanent disability/death), mishaps to 

fatigue.13 The Naval Safety Center attributed twelve percent of Class A 

mishaps between 1977 and 1990 to fatigue.14 Fatigue signs and symptoms

include forgetfulness, poor decisions, fixation, reduced vigilance, poor 

communication, slowed reaction time, apathy, lethargy, change in mood, 

and micro-sleep.15 Micro-sleep is very short periods of sleep, and may be 

as short as the momentary closure of the eyelids. Prior to combat flight

operations, many aviators, particularly the senior ones, were heavily 

involved in strike planning and were fatigued to one extent or another.16 

Senior aviators flew all the early-on strikes into Iraq during Operation 

Southern Watch due to their rank and experience.17 If an aviator is 

significantly fatigued at the start of combat operations, chronic or acute 

fatigue may ensue. Fatigue affects cognitive functions, which are the 

higher orders of thought processing that are used in combat. Other less 

obvious areas affected by fatigue includes leadership and supervisory 

duties. 

Poor combat and safety performance is the ultimate price of fatigue 

in continuous operations. This is a double threat; not only is the safety 

margin decreased, but mission performance, which is the ability to defeat 

the enemy in the air or deliver ordnance on target, can also be adversely 

affected. The Navy Surgeon General says it best: 

Fatigue in sustained, continuous naval flight operations is 

expected and can lead to poor flight performance and 

increased aircraft mishap potential. Thus, preventing 

fatigue and maintaining optimal performance in sustained

operations are primary concerns for squadron commanding 

officers and their flight surgeons. The uses of sleep, 

combat naps, proper nutrition, and caffeine are currently 

approved and accepted ways flight surgeons can 
Aircrew Performance Cutting-Edge Technology...7 

recommend to prevent and manage fatigue. However, in 

sustained and continuous operations, these methods may be 

insufficient to prevent fatigue and maintain combat-ready

performance. Properly administered use of stimulant and 

sedative medications, i.e., Dexedrine, Ambien, and 

Restoril, is an additional measure flight surgeons can 

recommend to manage fatigue and maintain pilot 

performance in continuous, sustained naval flight 

operations. 18

Fatigue can and should be managed. The idea is not to create superhuman performance, but to maintain an acceptable level of performance 

and avoid the degradation caused by fatigue during sustained or 

continuous flight operations.19 

Go and No-Go Medications 

They were dull-eyed, bodily worn and too tired to think 

connectedly. Even a thirty-minute flop on the turf with the

stars for a blanket would have doubled the power of this 

body and quickened the minds of its leaders to ideas, which

they had blanked out. But no one thought to take that 

precaution. The United States Army is indifferent toward 

common-sense rules by which the energy of men may be 

conserved in combat.... said Captain Patch of his people on 

the far right, “They were so beat that they could not 

understand words even if an order was clearly expressed. I 

was too tired to talk straight. Nothing I heard made a firm 

impression on me. I spoke jerkily in phrases because I 

could not remember the thoughts which had preceded what 

I said.20

S. Marshal 

Night Drops: The American Invasion of Normandy 

Stimulant use to sustain performance continues to be controversial, 

and for some, it is a very emotional topic. Fatigue medications were 

successfully utilized by the Air Force during Operation Desert Storm.

21 

One newspaper article title during the Operation Southern Watch was 
8... Aircrew Performance Cutting-Edge Technology 

entitled “Gulf War Pilots Flew on Speed.”22 This article and the

controversy surrounding stimulant use apparently resulted in the Air Force 

Chief of Staff, General Merrill McPeak, banning the use of stimulants on 

13 March 1992. Current Air Force policy allows use of stimulants but 

only in a strictly regulated and voluntary way.23 The very consideration of 

chemically influencing something as finely tuned as a military aviator’s

body and mind can be foreign to many, especially to physicians and flight 

surgeons whose mandate is “first do no harm.” The United States Navy 

Surgeon General wrote the following in the forward of the Navy’s recently 

released performance maintenance manual: 

Historically, the use of medications to maintain 

performance in aviators is not a new idea; the British and

Germans used amphetamines during WWII in their pilots. 

Later, the British used sedatives to regulate sleep for pilots

during the Falklands conflict. The U. S. Air Force and

Navy used amphetamines in aviators during Vietnam, and 

the Air Force used both amphetamines and sedatives during

Desert Storm and have used both off and on since. Use in 

all these circumstances was reported to be safe and 

effective.24 

The Navy’s Carrier Air Wing Five promulgated policy approving 

the use of stimulants and sedatives during sustained continuous operations 

prior to the beginning of Operation Southern Watch on 27 August 1992, 

and it additionally requested the use of these medications through the 

medical chain of command. Higher authority did not approve this request 

due to no standing policy to address the medication use in combat 

operations. This initial request from a forward deployed aircraft carrier 

ultimately resulted in the United States Navy Performance Maintenance 

Manual, initially published in 2000, a process that took over eight years. 

The performance maintenance manual was also approved by the 

Carrier Air Wing commanders conference, a yearly meeting of US Navy 

Carrier Air Wing commanders, and the aviation board of senior naval 

aviation flag officers. The performance maintenance manual was also 

endorsed by the Naval Safety Center as an Operational Risk Management 

(ORM) tool to minimize the known risk of combat fatigue and was 

codified in the Naval Aviation Training and Operations Procedures

Standardization manual.25 
Aircrew Performance Cutting-Edge Technology...9 

The United States Navy performance maintenance manual is now 

an accepted operational risk management tool to control fatigue during 

combat or exceptional circumstances of operational necessity as 

determined by the squadron Commanding Officer following consultation 

with the Air Wing Commander (or his equivalent) and Flight Surgeon. 

This guide for flight surgeons provides background on the subject, 

strategies for fatigue reduction, and guidance in the use of sleep-inducing 

and anti-fatigue medications (no-go and go pills) in aircrews. 

Commanding Officers, in consultation with their Flight Surgeons, are

authorized the use of any of the strategies including stimulants and/or 

sedatives for pilots, naval flight officers, and aircrew when mission 

requirements and operational risk management indicate use would be

appropriate.26 The flight surgeon will consult with his supervisor in the

aeromedical chain-of-command. No aviator is required to use these 

medications; in fact, rest (including combat naps), nutrition, selfregulation, and exercise are recommended and stressed above all other 

modalities. Only as a last resort is medication use recommended. The 

approved stimulant in the Navy is dextro-amphetamine, (Dexedrine), and 

approved sedatives include zolpidem (Ambien) and temazepam (Restoril).

The Navy Surgeon General further states: 

The fleet’s request to use stimulant and sedative 

medications during contemplated continuous and sustained 

flight operations provided the impetus to develop the 

performance maintenance manual. Naval Strike and Air 

Warfare Center collaborated with Naval Operational 

Medicine Institute and Naval Aerospace Medical Research 

Lab to develop a protocol for appropriate use of stimulants 

and sedatives. The performance maintenance manual was 

subsequently recommended by the Aeromedical Advisory 

Council and approved by Naval Operational Medical 

Institute as the acceptable standard of care guide for flight 

surgeons. Naval Operational Medical Institute 

appropriately cautions that use of stimulants and sedatives 

should be used only in combat or during exceptional 

circumstances of operational necessity and only with 

authorization by the squadron commanding officer.27
10... Aircrew Performance Cutting-Edge Technology 

The military manages maintenance, fuel, and weapons; why not 

manage fatigue in a similar fashion?

28 That is, minimize fatigue by proper 

nutrition, exercise and rest, and only when necessary supplement with Go 

and No-Go medications. Further research is needed on the emerging and 

potential use of stimulants such as Pemoline, a sympathomimetic,29 and 

sedatives/sleep inducing modalities such as Melatonin to support sustained

air operations. DOD standardization of a performance maintenance 

manual type document would go a long way in addressing a known threat 

to airmen. 
Aircrew Performance Cutting-Edge Technology...11 

III. Vision Enhancement/Refractive Eye Surgery 

The guy you don’t see will kill you. 

Brigadier General Robin Olds, USAF 

16 Victories, WWII and Vietnam

Like hands to a surgeon, a pilot maintains situational awareness 

through his senses, foremost of which is vision, and as discussed earlier, 

the first pilot to see his adversary enters the OODA loop and will be at an 

advantage. One emerging way to improve vision is with laser eye surgery. 

Significant strides have been completed and many more are under 

investigation in the fields of laser eye surgery. Refractive eye surgery is a 

surgical procedure on the cornea to adjust the focal point of the eye on the 

retina. Refractive surgery can correct myopia (near-sightedness), 

Hyperopia (far-sightedness), and some types of astigmatism (irregularities 

of the cornea). 

Refractive Surgery Origin and History, (RK, PRK, LASIK) 

Refractive surgery was first considered as early as 1898 by a Dutch 

professor and was unsuccessfully attempted in Japan in the 1930’s. A 

Russian physician named Dr. Fyodorov later improved the procedure. His 

patients’ vision markedly improved after a laceration and subsequent scar

formation to the globe of the eye. Russian physicians then molded the 

surgery into a fine art. They would later perform the procedure in a 

conveyor belt fashion, providing the surgery to the largest number of 

individuals in the truest form of socialized medicine. This procedure is 

referred to as Radial Keratotomy (RK) because there are several surgical 

incisions made radially through the majority of the thickness of the cornea 

outwards toward the periphery of the eye. This results in fine, almost 

invisible scars that heal and change the focal point of the eye. This 

particular form of refractive surgery has now fallen out of favor for several 

reasons, including susceptibility of the corneal scar to later trauma. The 

scar can potentially cause a foreign body projectile aimed at the surgerized 

eye to be directed into the eye, resulting in a worse injury. 

The event that most negatively affected the popularity of radial 

keratotomy, and is most significant to the aviation community, was 
12... Aircrew Performance Cutting-Edge Technology 

discovered during a tragic Mt. Everest expedition. Dr. Beck Weathers, an 

individual who had received radial keratotomy surgery earlier, essentially 

became blind at altitude. He was disoriented, became lost from the main 

expedition for twenty-two hours, and nearly died. Later studies have 

confirmed a hyperopic shift in visual acuity of radial keratotomy patients 

that occurs at altitude.30 A study by Mader et al., in 1999 of six radial 

keratotomy patients, six photorefractive keratectomy patients, and nine 

myopes (near-sighted persons) showed that with seventy-two hours of 

exposure at an altitude of 14,100 feet, radial keratotomy eyes had 

“significant, progressive, and reversible hyperoptic shifts.” In other 

words, patients who received RK became blind at altitude, or their vision 

was significantly and adversely affected.31 Additionally, diurnal visual

acuity variations of treated eyes as well as glare issues have plagued radial 

keratotomy patients. As a result, RK is not compatible with military

aviation. 

Photo-Refractive Keratectomy (PRK) 

Photo-Refractive Keratectomy (PRK), a follow-on procedure 

without many of the RK detractors, has become the laser eye surgery of 

choice for military aviation. PRK is the laser molding of the cornea with

an excimer laser that uses ultraviolet wavelength pulsed energy to remove

multiple small disc-shaped tissues. The epithelium or surface layer of the 

eye is first removed with the laser, and then the cornea is molded. The top

layer of the eye rapidly grows back over the newly shaped cornea. Naval 

Special Forces known as SEALS were the first military group to embrace 

and financially support this vision correction technology due to 

operational necessity. It would be awkward at best to lose glasses while 

underwater, while conducting covert operations, or during hand-to-hand 

combat. Likewise, aviators have helmet-mounted displays to which 

glasses or contacts add an unwanted layer. In the possible ejection and

survival scenario, the PRK recipient would have the advantage over those 

aviators with glasses that might be lost during the egress. 

PRK Studies 

Ongoing areas within the evaluation of photorefractive 

keratectomy include pressure chamber, centrifuge, contrast sensitivity, and 
Aircrew Performance Cutting-Edge Technology...13 

NVG effects. In 1998, Dr. Schallhorn, a prior TOPGUN Instructor and 

current navy ophthalmologist, believed that Naval Strike and Air Warfare 

Center (NSAWC), home of the Navy’s TOPGUN School was the next 

logical step for a study to include naval flight officers. Due to the 

command’s high operational tempo and flight envelope extremes, as well 

as night vision goggle lab and strong command support, it was an ideal 

place to conduct the study. A prospective study was constructed to select 

aircrew (not to include pilots) to evaluate night vision prior to and after 

photorefractive keratectomy. This evaluation would be one year in length 

and a joint study with the Air Force Research Laboratories. Out of sixtyfive volunteers, thirty individuals passed screening for the study, including 

fifteen naval flight officers, one physiologist, and one aircrew member. 

The rest of the participants were non-rated active duty officers and 

enlisted personnel stationed at Naval Strike and Air Warfare Center in 

Fallon, Nevada. The results were overwhelmingly positive with better

than seventy-five percent of recipients receiving visual acuity of 20/20 or 

better and night vision returning to better than baseline within two weeks

of the photorefractive keratectomy procedure for all participants.32 Most

of the study participants started with visual acuities worse than 20/200. 

Two of the total NSAWC participants necessitated a second treatment to 

“fine-tune” their vision and later obtained better than 20/20 visual acuity.33 

On a personnel morale note, the procedure was subsequently 

provided to fifty naval flight officers (NFO) stationed at Naval Strike and 

Air Warfare Center from 1998-2001, with overwhelmingly positive

results. Some NFOs requested orders to come to the command so that

they could enter the PRK study and receive the procedure, while others 

pulled letters of resignation in order to receive the procedure. This 

positive effect, especially during a time of severe aviator shortages, cannot 

be overemphasized. There were several cases of aviators whose vision 

had deteriorated to the point that they did not meet minimum visual acuity 

standards to fly, and their careers were subsequently saved by this 

procedure. 

Research and an increasing body of anecdotal evidence suggest 

PRK is safe for all aviation environments, including ejection. There is a 

case of a lieutenant NFO who had ejected without subsequent injury after

having received PRK a year earlier. The NFO was a qualified instructor in 

the S-3 Viking aircraft with over seven years of flight experience. During 

a training flight, his aircraft experienced a catastrophic engine failure, 

which necessitated an ejection at 120 knots airspeed at low altitude. Post-
14... Aircrew Performance Cutting-Edge Technology 

ejection examination showed that there were no significant injuries and 

visual acuity was unchanged at 20/20. There were no visual problems 

before, during, or after the ejection, and the NFO’s vision and post PRK 

status was not listed as a causal factor in the mishap investigation report.34 

This ejection demonstrated one extreme facet of the safety of PRK. 

Laser-Assisted In Situ Keratomileusis (LASIK) 

LASIK offers the greatest potential for improving aviator vision 

and is the latest PRK-similar procedure. First, a flap of cornea is made 

and lifted out of the way, and then a laser (the same laser as PRK) is used 

to mold the cornea. After the procedure, the flap is returned over the laser 

treated cornea, and it acts as a natural dressing as the eye heals. LASIK 

eliminates the need for the surface layer or epithelium to grow back and is 

remarkable in that it begins to improve vision almost immediately after the 

surgery. The discomfort level is significantly less than for other refractive

procedures. A study of altitude effects on LASIK recipients (subjects

exposed to 14,100 feet for 72 hours) showed that after LASIK, subjects 

did not exhibit a refractive shift of clinical significance.35 Therefore 

LASIK and PRK, recipients had no significant vision changes at altitude,

unlike recipients of RK. The LASIK procedure holds great promise, and 

early joint research indications are encouraging.36 

“LASIK has been performed internationally for

approximately 10 years. It was first performed in U.S. 

clinical trials in 1991. It is important to note that the major 

components of the procedure have a long history. 

Ophthalmologists have been reshaping the cornea for over

50 years, creating a protective layer of tissue for over 35 

years, and using the excimer laser since the 1980’s.”37 

Some of the unique considerations include ‘Will the flap be stable 

at high altitudes especially in situations like explosive decompression of 

the cockpit in an emergency’ and ‘What would the effects on high altitude, 

wind blast, and low oxygenation experienced by the surgical site during a 

high speed, high altitude ejection be?’ The other questions that relate 

directly to survival, escape, and evasion in enemy territory are ‘How will 

the flap react during an ejection and then saltwater exposure (as many 
Aircrew Performance Cutting-Edge Technology...15 

naval aviation mishaps occur over the water)? If the eyes are painful after 

ejection, then survival, escape, and evasion will be markedly affected. If 

the LASIK flap is not stable, especially during high-speed ejection, a saltwater exposure could potentially intensify pain and severely affect visual 

acuity and chances for survival. Some additional questions that need to be 

answered prior to approving the procedure include, ‘Will the circular

incision and scar of the LASIK flap interfere with day/night/enhanced

night vision’ and ‘Will Mission Oriented Protective Posture gear required 

for the nuclear, biological, and chemical warfare environment be 

compatible with the eye surgery?’ As these questions point out, many

areas of research need to be conducted prior to approving the LASIK for

Department of Defense aviators. 

Disadvantages 

Potential disadvantages of all refractive surgery are infection, overor-under correction, and abnormal scar formation. LASIK specific 

potential disadvantages include questions as to the long-term stability of 

the flap and durability in the aviation environment, especially in the 

extreme ejection and survival scenario. There have been anecdotal cases

of the LASIK flap becoming dislodged in patients up to two and one-half 

years after the initial procedure due to severe, direct trauma to the eye. 

Ongoing animal studies that subject a post LASIK eye to a jet blast of air

to essentially recreate ejection forces are encouraging in that the flaps are 

remarkably stable.38

DOD Policy 

In accordance with the current US Air Force and Navy policy for 

the air warfare community, all forms of corneal surgery are disqualifying. 

Photorefractive keratectomy is the only procedure that will be considered 

for waiver. Naval air warfare new accession applicants who have had 

PRK (civilians, Naval Reserve Officers Training Corps, Naval Academy, 

and enlisted accessions) may be waivered for aviation duty if they meet 

specific criteria (see appendix A) and are entered into the Navy’s study 

protocol.39 Even with early encouraging findings with photorefractive 

keratectomy, a metered, scientific approach is needed in order to conduct a
16... Aircrew Performance Cutting-Edge Technology 

timely evaluation of the efficacy of this procedure in the operational 

tactical environment of Department of Defense aviation. 

Emerging Vision Concepts and Procedures 

There are other procedures to correct vision. These include intracorneal (intra-stromal) rings, which are clear plastic rings that are 

implanted into the cornea to change the shape and focal point of the eye.

The Food and Drug Administration approved use of these rings in March 

of 1999. Additionally, intraocular lenses are being implanted in eyes to 

improve vision. These intraocular lenses are similar to contact lenses but 

are permanently implanted in the eye. Rings and implanted lenses are not 

currently approved for military aviation because no aviation specific 

studies have been conducted to prove safety and efficacy through all 

phases of military aviation.

Recent cutting-edge research is being done on a laser mapping of

the eye technique called wave front mapping. A laser is flashed into the

eye and the reflected/refracted energy is digitally gathered, stored, and 

calculated to produce a very exacting map of the imperfections of each 

eye. It is hoped that this exact mapping of the eye will assist in more

precise correction in future refractive surgeries.

40 The theoretical best

limit of vision correction for the human eye is approximately 20/10. 

Controversies About Vision Correction 

These refractive studies raise an interesting question...should these 

procedures be used to enhance vision? That is, should many aviators be

corrected, including those that are already 20/20, to an unheard of visual 

acuity of 20/10? A super-human group of aviators would then exist who 

would have the advantage in any visual arena. Is maintenance of human 

performance the goal or rather enhancement to create a group of superhuman weapon systems operators? Military medicine is ideally situated to 

study and recommend the road ahead in this exciting and emerging area of 

vision correction. 

In the past, visual acuity has been the deciding factor for the initial 

selection of whether an aviator is a pilot or a flight officer. Now that there

exists the ability to make every student aviator 20/20 or better, how will 

pilots be selected from flight officers? Should it be personal preference, 
Aircrew Performance Cutting-Edge Technology...17 

or performance based upon the selection process? These are a few of the 

interesting and intriguing questions raised by this type of emerging human

factors technology. 

Parting Shots 

Research efforts in the area of vision correction are rapidly

progressing and are truly a joint effort. There is strong operational support 

for PRK, and aviators are pushing for early acceptance of LASIK in the 

US military aviator community. However, this desire to plunge ahead 

must be balanced with a measured scientific approach to the medical 

technology. It is important to ensure that the science supports the 

procedure for military aviation. It would not be prudent to approve a 

procedure that later was responsible for the loss of an aviator or loss of an 

aircraft only because appropriate basic research was not conducted. On 

the other hand, as soon as military medicine is comfortable with the 

stability of the LASIK procedure, it should be approved. Critical studies

are ongoing and should be completed shortly. 
18... Aircrew Performance Cutting-Edge Technology 
Aircrew Performance Cutting-Edge Technology...19 

IV. Nuclear Biological and Chemical (NBC) Threat 

Environment and the Tactical Air (TACAIR)

Operator 

One of the principal advantages of biological agents is that

they are almost impossible to detect, which complicates the 

task of tracing the author of a biological attack. This 

makes them as suitable for terrorism and crime as for 

strategic warfare.... It is easier to make a biological 

weapon than to create an effective system of biological 

defense. Based on our current level of knowledge, at least 

seventy different types of bacteria, viruses, rickettsiae, and

fungi can be weaponized. We can reliably treat no more

than 20 to 30 percent of the diseases they cause.41 

Ken Alibek, Secret Bio-weapons 

Soviet Union Biopreparat 1975-92 

First Deputy Chief 1988-92 

Problem 

Al Qaeda interest in weapons of mass destruction, as well as the 

weaponized Bacillus anthracis discovered in letters mailed within the 

United States, once again raises concern that nuclear, biological, and 

chemical (NBC) weapons continue to be an emerging threat. NBC arms

are rapidly becoming the weapons of choice by potential enemies of the

US including conventional and unconventional actors in symmetric (North 

Korea, formal Soviet Union, or China) and asymmetric warfare scenarios 

(Terrorist), as they offer a relatively cheap and expedient way to challenge 

the US hegemony. The use of these weapons will likely increase across

the spectrum of human conflict in frequency and intensity. Major 

suspected players in the nuclear, biological, and chemical arena include 

the former Soviet Union, France, Britain, China, Libya, Syria, Pakistan, 

North Korea, South Korea, Taiwan, Iran, Egypt, Vietnam, Laos, Cuba, 

Bulgaria, South Africa, Iraq, Israel, and India; non-state proliferants

include terrorists and organized criminals throughout the world.42 As a

result, combat aircraft will most likely be required to operate in an
20... Aircrew Performance Cutting-Edge Technology 

environment that increasingly includes chemical, biological, and possibly 

even nuclear weapons. 

According to Dr. Barry Schneider in Future War and 

Counterproliferation, “failure to solve the airbase and aircraft 

decontamination problem could result in significant portions of U.S. 

aircraft being put out of action by contamination or because war planners 

are unwilling to risk sending aircraft and crews into contaminated 

bases.”43 It is apparent that DOD aircraft are not optimized to operate in 

the NBC environment. When tasked to work in this environment, they

will be limited in scope and effectiveness during combat operations. 

These are some key challenges compelling consideration, research, and 

ultimately evaluation, of proposed solutions in the operational aviation 

environment to test their validity against the nuclear, biological, and 

chemical threat. 

Arguably, the U.S. is in its infancy as to defense against the NBC 

threat. Currently, the only defense includes Mission Oriented Protective 

Posture (MOPP) gear and modifications of aircraft environmental control 

systems. Rotary wing aircraft are at the highest risk, primarily due to the 

altitude they operate at and the missions they conduct—particularly the 

combat search and rescue mission, although scenarios exist that pose 

threats to all DOD aircraft. 

Prevention 

A representative example of how NBC countermeasures are 

difficult to incorporate in operational aircraft is seen in the V-22 Osprey 

program. The Osprey is the only aircraft designed from the ground-up 

specifically to counter the nuclear, biological, or chemical threat 

environment. The Osprey was originally designed to have overpressure 

and filtration systems, resistant materials, and filtered avionics cooling.

The aircraft was further designed to be decontaminable by gaseous, liquid, 

or elevated temperature with a five-minute turnaround and thirty-minute 

servicing requirement. Potential on-board systems included long-range 

standoff chemical and biological agent detection and identification sensors 

and off-board/on-board chemical and biological agent contact sensors. 44 

Unfortunately, on 22 October 2001, the Marine Corps and Special

Operations Command dropped plans for overpressure and filtration 

systems designed to protect troops carried by the Osprey from nuclear, 
Aircrew Performance Cutting-Edge Technology...21 

biological, or chemical weapons because the enhancements are too 

difficult and expensive to accomplish. The following quote from an 

insider publication elucidates a recurrent common operational cost-benefit 

theme during the consideration and implementation of many emerging 

human factors technologies: 

These enhancements—overpressure and filtration 

systems—have been planned for years but are not the only 

means of protecting the Osprey crews from NBC weapons. 

In halting plans for the systems, however, officials are 

omitting NBC protection that would have been unique to

the Osprey and more advanced than anything in today’s 

military rotocraft. Without the unique overpressure and

filtration systems, the Osprey will be relying on special 

suits to protect any troops in the back of the aircraft, an 

approach that has some observers of the program

concerned.... Due to difficulties encountered in making

the features perform adequately, the program office

(Marine Corps and U. S. Special Operations Command) 

determined that the cost vs. benefit of those enhancements

was not acceptable.... In an NBC operational scenario, the 

features would have “limited mission utility,” in part 

because they would not be relied upon as primary personal

protection for the passengers or crew, the program office 

said. The need for the people aboard the V-22 to wear 

mission-oriented protective posture (MOPP) gear would

not be alleviated by the existence of the overpressure or

filtration systems, according to the program office. 

Further, the program office said the features would not save 

the military the trouble of decontaminating a V-22 that

might be exposed to NBC agents if a door were opened, for 

instance, for troops to deploy during an operation. Third, 

the program office said the features involved added

penalties of weight and increased cost and maintenance.... 

During development testing, numerous problems were

encountered with the seals intended to maintain the 

overpressure...necessitating the wearing of cumbersome 

MOPP gear to operate in the contaminated environments 

required by the JORD. 45
22... Aircrew Performance Cutting-Edge Technology 

The USMC operational NBC risk-benefit assessment has resulted in the 

omission of NBC protective measures; the wisdom of this decision is yet 

to be determined. Clearly, if the operating threat environment increasingly 

includes NBC weapons then this decision would be premature. 

Aircrew Protection Considerations 

Current standard operating procedure for many DOD aircrews is to 

wear MOPP gear in a high threat area as defined by intelligence and the 

commanding officer’s standing orders. However, is this extensive use of

MOPP gear necessary? MOPP gear provides adequate protection from 

chem-bio agents when used properly, however, protection comes at a cost 

of decreased manual dexterity, reduced range of motion, restricted/foggy 

vision with significantly reduced peripheral vision, poor verbal 

communication, increased heat stress, and decreased man-machine 

interface. All of these negative factors have potentially significant and 

detrimental effects on flyers, mission accomplishment, and flight safety.46 

The already extreme aviation environment can only be made more

difficult by layers of protective gear. For example, a carrier flight deck in 

the Persian Gulf during Desert Shield and Desert Storm recorded 

temperatures in excess of 130-180 degrees Fahrenheit; with temperatures 

prior to launch in the aircraft already stifling, this limitation that could 

only be compounded by prolonged transit/loiter times.47 MOPP gear 

markedly increases heat exposure and dehydration in the aircraft, 

especially in warm climates and during aircraft start-up prior to 

environmental control system (air conditioning) activation.48 If not

prevented or treated, heat stress can ultimately cause unconsciousness and 

loss of aircraft and crew. 

At the other end of temperature extremes, Air Force C-130 crews 

have reported wind-chill temperatures of minus 110 degrees Fahrenheit, 

freezing protective gear solid on occasion, making respiration difficult.49 

These extremes of temperature coupled with prolonged use of biochemical protective gear can lead to dehydration, reduced performance, 

compromised mission effectiveness, and ultimately, incapacitation. 

Additionally aviators have complained about NBC gear digging 

into their heads and creating hot spots during flight as well as being unable 

to perform a valsalva, a potentially sinus-saving maneuver. Most of these 

issues are being resolved with better-designed systems in the development 
Aircrew Performance Cutting-Edge Technology...23 

pipeline.50 In the past, costs of physical discomfort and inconvenience of 

MOPP gear outweighed its benefits, and aviators flew without the gear in 

high threat environments.51 

Detection and Warning Considerations 

There are multiple sensors available on the battlefield and in the

airspace, but they are bulky and take time to detect threat contaminates.

Additionally, there is a current lack of sophisticated sensors for tactical 

aircraft, although the technology to alleviate this deficiency is nearly 

mature. Most airspace is vast, and unless there is a chem-bio sensor near

or aboard each aircraft, contamination may only be determined either post 

facto or not at all. We certainly do not know how to treat if we do not 

even know if we are attacked. In the actual event of aircraft NBC attack 

or exposure, how much contaminant will reach the aircraft and

subsequently the pilot? This is a quite complex calculation, as it must take 

into consideration environmental variables such as altitude, airspeed, 

humidity, precipitation and cloud formations, temperature, atmospheric 

pressure, dispersal, and plume distribution from the release point. Given 

the speeds and temperatures of operational tactical aircraft and the 

potential exposure to minimal dispersed particles at altitude, it may be

prudent for aircrew to wear MOPP gear only prior to and during critical 

exposure sorties. Critical exposure sorties must be designated via 

intelligence collection and confirmed by sensors that record exposures. 

Decontamination 

Because most aircraft are pressurized from air coming directly

from outside the aircraft via a turbine tap-off, if an aircraft were 

contaminated, internal and external decontamination may be required. 

Much more research must be accomplished to determine reasonable 

guidelines for decontamination. For instance, decontamination may 

already start the minute the aircraft leaves a NBC plume. Air stream, 

sunlight, jet exhaust, and hydraulic vapors will degrade contaminates to

some degree. If contaminate exposure, amount, and type are determined 

in flight by a sensor prior to landing, specific techniques and 

decontaminate materials can be utilized post flight, if required at all. It 

may only be necessary to know an aircraft is contaminated, regardless of 
24... Aircrew Performance Cutting-Edge Technology 

origin. Water soaks, similar to what US Navy P-3 Orion aircraft routinely

accomplish after long missions to keep their aircraft clean, could

potentially eliminate external contaminate from the aircraft, but 

verification of this supposition would be required and wastewater would 

have to be collected and treated to avoid secondary ground water 

contamination. 

Parting NBC Shots 

Countermeasures to the NBC attack will require timely

intelligence, aircrew protection, detection and warning, and 

decontamination. It is clear that unresolved issues remain. Compact 

reliable sensors need to be strategically located to detect record and 

identify threats to air and ground crew. Further understanding of what

detection, identification, warning, evasion, and decontamination can do to 

minimize the risk is required. MOPP gear may only be required in very 

limited situations, if at all, thus alleviating the aviator of the added burden. 

Clear guidance to the operator pertaining to when MOPP gear is actually 

required is vital. 
Aircrew Performance Cutting-Edge Technology...25 

V. Directed Energy Weapons/Battlefield Lasers 

Directed energy weapons are here today. They will be 

considerably more widespread, more available, more 

powerful, and more lethal on the battlefields of tomorrow. 

As such, the Air Force and DOD must grapple with the 

strategic implications of these weapons, and that struggle 

must begin today.52

Lt Col John Geis, USAF 

Air University Center for Strategy and Technology 

Problem 

Continuous wave lasers in the 2020-2030 timeframe are 

extrapolated to be of the 10-megawatt class aboard aircraft and ground 

vehicles, and up to 100-megawatt on fixed ground stations, with 

significant ranges of effectiveness from 100 to 1000 kilometers. Similar

advances are projected for pulsed lasers, with extrapolated power on the 

500 trillion watt range.53 As this Directed Energy Weapon (DEW) threat 

develops, manned aircrew will be increasingly susceptible. 

There is projected to be a significant amount of laser power on the 

ground and in the air. An example of this vulnerability is chronicled in a 

Reader’s Digest article entitled “Shot by a Laser.” On 4 April 1997, 

United States Navy intelligence officer Lieutenant Jack Daly and 

Canadian helicopter pilot Captain Patrick Barnes were flying aboard a 

Canadian Armed Forces CH-124 Sea King helicopter that was intercepted 

a Russian spy ship in the strait separating Washington state from Canada’s 

Vancouver Island. A Far East Shipping Company-owned ship, the 

Kapitan Man, allegedly illuminated the helicopter with a laser weapon. 

Both officers subsequently experienced pain and visual acuity 

disturbances consistent with laser injury. Capt Barnes will never fly 

again.54 

Tactical aircraft are currently unable to safely operate in a directed

energy warfare environment, i.e., laser, radio frequency, and particle beam 

weapon threats. The ability to rapidly respond to these threats will 

become a focus of future battlefield commanders. The low cost and 

proliferation of lasers have led the directed energy weapons community to 
26... Aircrew Performance Cutting-Edge Technology 

predict that low- and medium-energy, portable lasers will be increasingly 

deployed by adversaries as cost-effective tactical weapons.55 The

expanded use of laser technology in military applications, coupled with 

maturing laser technology and increased availability, combine to increase 

the risk that military aircrews, aircraft, and aircraft weapons systems 

sensors will experience hazardous laser exposures. All types of aircraft 

will potentially be targets, but those most susceptible will be the rotary

wing community, which routinely have exposure at lower altitudes—

particularly in the combat search and rescue (CSAR) role. 

Recent incidences of accidental and purposeful exposure of

military and civilian aircrews to hazardous levels of laser light confirm the 

capability of both military and commercial off-the-shelf (COTS) laser 

systems to illuminate aircraft at tactically significant ranges and change 

behavior in the aircraft cockpit (e.g., mission abort/increased 

workload/decreased controllability).56 Purposeful or accidental exposure 

to visible and infrared laser light can result in temporary, prolonged, or 

permanent changes in aircrew visual function. Additionally, some laser 

wavelengths may adversely affect other aircraft and weapons sensors (e.g., 

night vision goggles, and forward-looking infrared sensors). Dr. Reddix 

from the tri-service command states: 

Depending upon the wavelength, power or energy, 

modulation format, and divergence of the laser, the effects 

of an exposure to a laser can be varied from mere 

distraction to a retinal hemorrhagic lesion or blood eyeball. 

With respect to human ocular exposures, laser effects are 

typically delineated as non-lehtal (i.e., glare and flash 

insensitivity or “flashblindness”) or lethal, (i.e., retinal 

tissue damage).57 

DOD aviation fixed- and rotary-wing operational environments include 

lethal and non-lethal DEW threats. The need will only become more 

pressing as the world threat matures. 
Aircrew Performance Cutting-Edge Technology...27 

Detection 

Another piece of the directed energy threat-protection puzzle 

includes developing sensors to detect, warn and record directed energy 

attacks. Several projects are underway; one such project is being 

conducted by NAVAIR to develop and test a low cost laser-warning 

receiver or (LCLWR). The LCLWR includes a self-contained, selfpowered laser hazard sensor with a pulse detection and measurement 

capability over the 400 to 1600 nm band.58 Ground testing is scheduled 

for early fall 2002 and a flight demonstration in the summer.59 In order to 

protect against directed energy, we need to know where it is coming from 

and what type of energy it is. The intelligence obtained by this sensor will 

allow for appropriate threat area tactics to minimize damage, optimized 

mission accomplishment and selection of appropriate eye protection for 

missions into the threat area. 

Solution—laser eye protection (LEP) 

Laser Eye Protection (LEP) technologies in the cockpit are 

advancing slowly, and the eye protection options that are available today 

are neither comfortable nor inexpensive. Research is focusing on the 

Navy’s EDU-5P as well as the next generation of Air Force rugate 

technology based LEP. LEP can cost up to 400 dollars per visor and can 

be easily degraded through repeated use. There is no standardization of 

LEP and no consistent intelligence effort to ensure the right protection is 

available at the right time in the right place.60 The operational community 

may wish to ask whether the current tactics and fielded LEP are necessary, 

and if so, what is optimal protection. The currently developed EDU 5/P is

designed to protect against seven wavelengths, but the down side is the 

glasses block too much of the visual spectrum for safe operations across 

all phases of flight. Much more work needs to be done, both in 

developing LEP and in getting the right protection to the right aviators at

the right time. 
28... Aircrew Performance Cutting-Edge Technology 

Solution—computer modeling and mission planning 

Aviation laser threat models and algorithms are currently being 

developed at the Tri-Service Directed Energy Bioeffects Complex at 

Brooks AFB, Texas to support mission planning functions. This TriService effort includes basic and applied research on laser effects and

countermeasures, and one product of this research includes computerbased mission planning as well through joint work with Naval Strike and 

Air Warfare Center (NSAWC).61 The Army, Navy, and Air Force team is 

working on software that allows directed energy weapon threat rings to be 

incorporated into mission planning so that the DEW threat can be 

minimized prior to the actual flight. Models have been verified in flight 

operations held at NSAWC in Fallon, Nevada. 

One example of how to deal with the directed energy weapons 

threat due to the increasing proliferation of lasers in military operations is 

the development of the Laser Threat and Mission Planning System 

(LTAMPS) by the Tri-Service team. LTAMPS has evolved from a

“digital map” to its current iteration, which includes a laser weapon 

simulation, and is coupled with the Army’s Low Energy Laser Weapon 

Simulation (LELAWS) software, a laser range safety tool. The system is

also integrated with software modules from the Air Force’s Laser Hazard 

Assessment Program (LHAZ 4.0). The LTAMPS computer program can 

show safe standoff distances for a particular flight path to minimize 

directed energy threats during a mission. The system allows the aircrew to 

pre-fly the mission and modify it to reduce exposure to DEW threats;

potential applications are for air, ground and sea units. When coupled to 

an appropriately configured video display, LTAMPS will allow for 

analysis, mission playback and mission rehearsal to assist in training of 

threat area tactics.62 The system has the capability of modeling flash

blindness and glare effects for representative scenarios if specific energies

and specific task threshold data are provided for these complex visual 

tasks. 

LTAMPS is being used to study current laser eye protection (LEP) 

and evaluate their protection for the Navy’s EDU-5P as well as the next 

generation of Air Force rugate technology based LEP. The mission flight

profiles collected since 1995 in partnership with NSAWC provide the 

basis of realistic attack profiles, which are graded against man-portable

laser threats anywhere on the map representing the target area. These LEP 
Aircrew Performance Cutting-Edge Technology...29 

requirement assessment studies are angular vulnerability studies, which 

help determine the probability of a clear-line-of-sight into the cockpit for 

various tactical strike aircraft. Limiting the angular protection coverage 

can significantly reduce the cost of LEP without reducing crew protection 

and will facilitate getting the LEP to the aviators.63

Solution—Threat Area Tactics 

Simple threat area tactics are needed to minimize laser energy 

exposure, especially as we develop LEP and other countermeasures. 

Initial studies have been completed to develop tactics at NSAWC for both 

rotary- and fixed-winged aircraft in conjunction with the Tri-Service team. 

Simple procedures may offer great protection and include common sense

solutions like looking away from laser light source, going immediately to

an instrument scan, turning the aircraft away form the energy source and 

putting aircraft structure between the aircrew and the source. Specific 

maneuvering may also decrease exposure to the aircrew and allow for

increased chance of mission accomplishment. Tactics need to be further 

developed and practiced in simulators and on training flights to increase 

aviator effectiveness while operating in DEW threat areas. 
30... Aircrew Performance Cutting-Edge Technology 
Aircrew Performance Cutting-Edge Technology...31 

VI. Mishap Reduction 

Good flying never killed an enemy yet. 

Maj Edward Mannock, RAF 

73 Victories, WWI 

Problem 

Situational awareness is knowing what is going on in and around 

your aircraft. Spatial orientation is knowing where your aircraft is threedimensionally with respect to significant aircraft, maneuvering space, and 

the ground. From 1980 to 1985, disorientation was a direct or contributing 

cause of thirty-four percent of pilot error accidents in the Air Force.

Spatial disorientation mishap statistics show that from 1980 through 1989 

the Air Force experienced 263 mishaps and 425 fatalities at a cost of over 

two billion dollars. These mishaps resulted from “loss of situational 

awareness.”64 Between 1989 and 1994, there were eighty-five incidents 

involving spatial disorientation-related Air Force aircraft mishaps.65 The

Federal Aviation Administration determines that between five and ten

percent of all general aviation accidents can be attributed to spatial 

disorientation, and ninety-percent are fatal.66 

These are several types of spatial disorientation. Type I is 

unrecognized, or mis-orientation, where the pilot does not consciously 

perceive any disorientation. Examples of type I disorientation include a 

pilot who hits a ridgeline believing he will clear it, misjudging the 

clearance. Vestibular ocular effect is another example of type I 

disorientation that frequently occurs on very dark nights, where the 

positive Gs of take-off give the pilot a continuing nose-up movement 

sensation of the aircraft resulting in over-compensated stick-down input 

and subsequent impact with the ground.67

Type II spatial disorientation is recognized; the pilot perceives 

disorientation. This is the classic case of feeling vertigo. An example of 

type II is the “leans” when a pilot makes a prolonged turn and then returns

to level flight after his vestibular-ocular system compensated to the turn. 

The resultant sensation is that the aircraft is in a banked turn when it is 

actually flying straight and level. It takes several seconds for the pilot’s 

system to re-set itself. The pilot may only perceive he has a problem 
32... Aircrew Performance Cutting-Edge Technology 

controlling the aircraft; while not knowing there is spatial disorientation, 

he does know something is wrong. 

Type III spatial disorientation is incapacitation. There is an 

overwhelming vestibular ocular mismatch and incapacitation. Nystagmus, 

or side-to-side movement of the eyes caused by neurologic mismatch, and 

nausea can occur. The pilot’s senses are not telling the pilot what is 

actually happening as they are overwhelmed with input. 

Solution—Ground Proximity Warning System (GPWS) 

An example of why spatial disorientation is not optimally 

addressed in Department of Defense tactical aircraft is seen in the F/A-18

Hornet ground proximity warning system, which is restricted by the onboard radar altimeter limits. The radar does not work when the aircraft is

in a greater than forty-five degree nosedive because it is blocked by the 

nose of the aircraft; it was not designed to work beyond this limit. 

Additionally the radar system is passive and not predictive in that it does

not have a digital database to extrapolate its flight path. In other words, it

does not consider the terrain into which the aircraft is flying. It is 

essentially a dumb system only considering what is directly under the 

aircraft irrespective of aircraft speed, motion, or rising terrain. Multiple 

aircraft have impacted rising terrain that was not considered by the current

radar and ground proximity warning systems.68

The F/A-18 altitude system is redundant in that there are four 

altitude warning systems comprised of two software and one hardware 

“bugs” that are set prior to take off and modifiable during flight along with 

a ground proximity warning system which will give a last-ditch warning if 

the aircraft gets too low. Because there are four warnings, they desensitize 

the aviator through repeated simulator and flight re-enforcement. There 

have been several reported military mishaps where altitude warnings were 

either ignored or missed altogether.69 It is understandable to see how an 

aviator could become task saturated, channelized (over focusing attention), 

or fixated on the wrong thing at the wrong time and could fly into the 

ground or another aircraft with only a moment of inattention. If an 

adequate system were incorporated to guard against controlled flight into 

terrain or midair collisions, it would save more aircraft to train and fight. 

Most importantly, however, many more aviators’ lives would be saved. 

The idea is to supplement the pilot’s situational awareness by providing a 
Aircrew Performance Cutting-Edge Technology...33 

buffer between the ground and other aircraft. The buffer is provided with 

computer power and system integration that can continuously and reliably 

monitor safety parameters, a job ideally suited for a computer and one that 

will better support the pilot’s ability to carry out the mission. The good 

news is there is theoretical room for tactical aircraft to incorporate these 

emerging technologies as they mature.70

Solution—Automatic Predictive Ground Collision 

Avoidance System (APGCAS) 

An emerging technology that addresses aviation spatial 

disorientation is the Automatic Predictive Ground Collision Avoidance 

Systems (APGCAS/AGCAS). The technology to produce an APGCAS 

has been present for many years. It was originally developed by the Air 

Force and was a requirement prior to night tests of low-level tactical 

flights using a helmet mounted display system. More recently, an

APGCAS has been a joint project developed by the Air Force Research 

Laboratory, the 416th Flight Test Squadron at Edwards Air Force Base,

California, Lockheed Martin, and a Swedish-sponsored (Grippen aircraft) 

development effort. Flight-testing began in 1998 to address spatial 

disorientation, loss of situational awareness, and gravity-induced loss of 

consciousness.71

A United States Air Force News release dated 29 November 1999 

states: 

The AGCAS provides protection. While active, the system 

monitors what an aircraft is doing. That includes knowing 

where the plane is positioned in the air, where on Earth 

(literally) it is located and how close it is to the ground. If 

AGCAS believes the plane is going to be flown into the

ground, an autopilot system activates and attempts to pull 

out of the dive. This is done through a series of 

sophisticated navigation systems, radars, and Global 

Positioning System monitor to determine the aircraft’s

position. The system also incorporates voice messages. If 

a crash is imminent, the AGCAS will tell the pilot to “fly 

up, fly up.” When back in control, the system will chirp,

“You’ve got it.” Researchers have tailored other messages 

for different conditions. Meanwhile, visual messages in the 
34... Aircrew Performance Cutting-Edge Technology 

cockpit are flashing five seconds before the autopilot would 

kick in.72

This system clearly has great potential to decrease controlled flight into 

terrain and gravity induced loss of consciousness (G-LOC) mishaps. The 

aircraft computer knows where the aircraft is going. For example, the 

F/A-18 Hornet has a computer system that determines a constant 

computed impact point on the ground for bombs dropped; that is, it 

calculates the impact point of weapons dropped from the aircraft up to six 

times a second. The same calculations can be made for where the aircraft 

is going through space in relationship to the ground. The aircraft 

computers determine where the aircraft is in three-dimensional space by

the on-board inertial navigation system (INS). Modern INS systems use 

ring laser gyroscopes and incorporate Global Positioning System for

accuracy and redundancy. The aircraft database knows what terrain lies 

ahead by using digital terrain moving map data. Prior to 1996, digital 

terrain elevation databases had one hundred foot vertical errors and were 

completely missing some part of the terrain.73 More recently, the National 

Imagery and Mapping Agency in conjunction with the National 

Aeronautics and Space Administration have collected data of the earth. 

This new database is accurate down to 30 meters or one arc second. This 

new data has decreased error rate and is much more complete, covering 

most of the world with fewer holes. This latest data was gathered during a 

shuttle mission using Shuttle Radar Topographic Mapper from fifty-seven 

degrees south latitude to sixty degrees north and has produced digital 

terrain elevation dataset for the Department of Defense.74 

One tactical advantage of this system, if implemented, would be 

that if a pilot did have a bandit on his tail, he could essentially do a ninetydegree nose low dive toward the ground and let the APGCAS recover the 

aircraft with a minimum altitude and pre-set G’s. The aircraft will bottom 

out at a pre-set minimum altitude, say twenty-five feet above ground level,

and the pursuing aircraft either will chicken out or be scraped off on the

ground. US pilots would have the ability to fly at very low altitudes with 

little or no chance for an adversary to pursue. 

There is much to be optimistic about concerning the integration of 

this technology into military aircraft. CDR “Rhino” Unterhiner, the 

United States Navy Joint Strike Fighter (JSF) program manager, has put 

an APGCAS into the joint operations requirement document (JORD) for 

the JSF, and the joint and international participants subsequently approved 
Aircrew Performance Cutting-Edge Technology...35 

the input. This manufacturer mandate has the potential to make the JSF a

safer and more tactical aircraft with a fully integrated APGCAS and

midair collision avoidance system (MCAS), thus saving priceless lives and 

valuable training assets.75

These same technologies (APGCAS/MCAS), if applied to 

unmanned aircraft, commercial aircraft and older military aircraft, would 

have the potential to significantly decrease human error mishaps 

associated with controlled flight into terrain, terrorist takeover of the 

aircraft, and G-induced loss-of-consciousness mishaps. As this system is

human engineered, it is imperative that it reduces the number of false

warnings in order to compliment the pilot rather than distract or overload 

him. In fiscal year 1998, 9 million dollars were budgeted for the 

APGCAS that is currently being investigated by the Air Force. This 

funding has primarily come from Sweden, approximately 7.5 million

dollars, and the United States, 1.5 million dollars.76 The bulk of the

money goes directly to Lockheed-Martin to do the work. There is also 

promising Swedish follow-on technology that provides digital terrain 

mapping that is accurate to within one meter and has the potential to make 

the system even more accurate.77 

As these automatic systems are continually refined, the developing 

engineers and test pilots must use common sense algorithms to ensure 

there will be few if any false alarms. Human reaction time, including 

perceiving, processing, and reacting, can take approximately 1.5 seconds 

if the aviator is looking in the right place at the right time. If an aviator

did not take evasive action to avoid controlled flight into terrain or a 

midair collision within 1.5 seconds, then the aircraft would crash. But, if 

the aircraft has a self-recovery mode that reacts within that 1.5-second 

human response time and automatically flies the aircraft and aviator to a

safe position and altitude, then collision is averted. This just-in-time 

recovery ensures that the aviator has been given every chance to recover, 

and if he does not attempt to recover, the aircraft will recover for him. 

There must always be an override capability similar to the F/A-18 Hornet 

paddle switch on the control stick that allows the pilot to override the

automatic recovery, as there may be times when the pilot does not need 

the system. 

The value-added piece of this technology is that not only is it a 

safety improvement concept, it has the potential to significantly increase

combat capability and increase the safe operating envelope. If these

technologies are marginally successful, they have the potential to 
36... Aircrew Performance Cutting-Edge Technology 

significantly increase aircraft availability through saved aircraft and 

decreased loss of scarce aviator assets. Priority fast track funding, 

research development, and operational test and evaluation and aircraft 

implementation is imperative. 

Solution—Training/Simulators 

Distributed mission training and rehearsal capability, as promoted 

by General Hawley, former Commander of Air Combat Command, is an 

Air Force concept for future conduct of operational training. This will

most likely become a joint services program in the next ten years.78 

Distributed Mission Training is a program to provide aircrews advanced 

training in complex multi-aircraft environment through a multi-linkedsimulator environment and is a supplement to actual flight operations. 

The advantages are multiple, including threat simulation, concentration on 

specific skill areas, fuel conservation, and a safer learning environment. 

The Air Force will eventually acquire new, multi-ship simulators for every 

aircraft in its operational inventory.79 

Simulators alone will never replace live exercises, but distributed 

training will allow many of the procedures to be rehearsed before aircraft

leave the ground. Under a 335 million dollar contract, fourteen sites 

around the world will be linked together. At each site, suites of four F-15 

training devices will be installed that can be used in a local network or

linked to remote locations. When these sites are networked, forty-six 

pilots will be able to fly against each other on a given mission.80

It is important from a human factors position to identify the salient

differences between simulator and in-flight training in order to determine 

those skills which will be most degraded by heavy reliance on simulators. 

Of concern are decreased pilot tolerance for acceleration effects including 

gravity-induced loss of consciousness tolerance as well as near- or almostloss of consciousness (G-Loc and A-Loc, referring to cognitive deficits in

high gravity force flight), changes in visual scan patterns (3-D 

environment modeled by 2-D near-field representation), and simulator

sickness, which even highly seasoned aviators can experience. 

Nevertheless, high fidelity simulation, or virtual reality training,

can significantly enhance operational training in DOD aircraft if used in 

an augmentation role.81 There is great potential to increase combat 

effectiveness, extend airframe service-life, and at the same time, preserve 
Aircrew Performance Cutting-Edge Technology...37 

valuable lives and combat assets by avoiding training mishaps. Simulators 

can sharpen and augment many areas, especially “switch-ology” and 

refreshing and reinforcing productive habit patterns. Having said this, 

there is no replacement for actually sweating, straining, and problem 

solving real-time in flight; simulators must augment rather than replace

actual flight time. 

Simulator Mishap Reduction 

One method of reducing the impact of spatial disorientation on 

pilots is through enhanced awareness and training. A simulator is a safe 

and effective environment to develop skills for coping with spatial 

disorientation. The resulting visual simulator scenarios can be used to 

train aviators to recognize, avoid, and overcome spatial disorientation. 

This reinforces aircrew coordination concepts, improves judgment skills, 

develops decision-making skills, and enhances real-time risk assessment 

and management. Other areas that should be pursued to supplement 

training include low-cost technologies that improve situational awareness 

and intuitive decision-making capabilities. 

The United States Army Aeromedical Research Laboratory has 

developed a visual simulator flight that exposes helicopter pilots to actual 

conditions that result in mishaps.82 These simulator sorties decrease

spatial disorientation mishaps through enhanced awareness and training. 

By safely and effectively demonstrating actual spatial disorientation 

mishaps in a visual flight simulator, the sorties help aviators identify,

avoid and overcome spatial disorientation.83 

The United States Air Force and Navy should implement specific 

spatial disorientation simulator training using the top-ten most commonly 

occurring spatial disorientation mishaps or “actual” representative mishap 

recreations similar to the Army program. It is recommended that the most

common human factors scenarios specific to aircraft type be reviewed. 

Service safety centers already compile mishap records and hazard reports 

that show the most common scenarios of each airframe that have resulted 

in a degraded mission and or mishaps. In the best framework of risk 

management, these high-risk areas should be taught to students via

simulator recreations and compilations. The idea is to continuously 

identify the highest risk areas of mishaps via the service safety centers and 

keep modifying the simulator scenarios to address these highest risk areas 

as they change. This self-updating process will continue to address the
38... Aircrew Performance Cutting-Edge Technology 

highest risk human factors areas of flight in a timely fashion and result in a

decrease of human factors related mishaps. 

Solution—Situational Awareness/Spatial Disorientation 

Training Flights 

Another excellent example of this type of integration of common 

mishap scenario training into an actual flight is the British Army Air 

Corps spatial disorientation sortie trainer, where an instructor pilot 

demonstrates several spatial disorientation maneuvers to build a

knowledge base the student can later draw upon. Following didactic 

instruction, the British helicopter student receives airborne demonstration 

of the limitations of their orientation senses. In published reports, the 

maneuvers performed in the spatial disorientation demonstration sortie, 

and the sortie overall, were extremely effective at demonstrating the 

limitations of the orientation senses. Analysis of helicopter accidents 

demonstrates that this training is operationally effective by contributing to 

a reduction of spatial disorientation mishaps.84 A spatial disorientation

sortie similar to the British example should be considered for training in 

the DOD rotary wing community. 

Solution—Vibro-Tactile Situation Awareness System 

(TSAS) suit 

There is also promising technology that has the potential to 

significantly improve a pilot’s situational awareness, particularly for the 

rotary wing communities in brownout scenarios. Captain Angus H. 

Rupert of the Naval Aerospace Medical Research Laboratory’s Spatial 

Orientation Systems Department, in conjunction with NASA, is 

developing a Tactile Situation Awareness System (TSAS), which provides 

accurate orientation information through a tactile sensory pathway in 

aerospace, land, and sea environments.85 This torso suit provides

vibration to keep the pilot informed of where the ground is at all times and 

has the ability to give the pilot threat warnings such as surface-to-air

missile firings or anti-aircraft fire location. The suit provides correct 

perception of attitude, altitude, or motion relative to the earth or other 

significant objects by providing non-visual orientation information to 

operators aboard aerospace platforms and the diving community. The suit 
Aircrew Performance Cutting-Edge Technology...39 

improves the ability of personnel to detect and determine relative position 

and motion of targets. This system, which is currently under development, 

has great potential in navigation and communication as well as training 

and simulation. Continued development and funding of this promising 

technology should be encouraged. 

Solution—Computer Assisted Performance Analysis System 

(CAPAS) 

There is promising work being conducted at North Island in San 

Diego, California, by the S-3 Viking community on Computer Assisted 

Performance Analysis Systems (CAPAS).86 This commercial off-the-shelf

system is one of a number of computer-aided debriefing tools for flight 

training currently being developed. It provides standardized data (audiovisual) collection and performance measurements throughout the training 

process. Flight instruments, gauges, flight paths, and tactical plots can be 

displayed. Three-dimensional graphics of the simulated aircraft can be

viewed from any external angle (from a wingman’s view, the landing 

safety officers (LSO) platform, tower, or pilot’s view inside the cockpit).

The system has the ability to mark, record, and retrieve technical and 

human factors performance data during brief, flight, and debrief, making it 

a great teaching tool that provides detailed feedback to aircrews and 

instructors. 

Currently, the data, which is scenario-based using the fleet 

replacement squadron-training syllabus, has successfully assisted in 

training aviators to recognize emergencies and has helped in cognitive 

skills development. This system allows trend analysis of groups and 

individuals by creating a database for comparison to standard performance 

from previous students/peers at same stage of training. It has improved 

the quality of instruction by creating a higher reliability in observation and

grading. The data can also identify behavior and skills that lead to 

consistent, successful performance.87 The CAPAS system may be the 

intervention strategy of the future in the training and operational 

environment. 

The routine extraction of flight data in order to screen for limits 

that are exceeded would be of great benefit in the identification of skillbased errors or violations that would go otherwise unrecognized. It is

important to extract this information in a non-attribution manner, one in 
40... Aircrew Performance Cutting-Edge Technology 

which the information can be used to modify behavior not punish it, 

especially in operational world. This would be a powerful tool that would 

allow for the correction of deficiencies before those deficiencies led to a 

mishap.

88 The debriefing and training benefits of a tool that combines

flight visualization software that collects aircraft data to display and replay 

the mission would help our aviators remain proficient with their flying

skills at reasonable costs.

89

The next logical step in the development of an intervention 

strategy to reduce skill-based errors is to move beyond the training 

scenario and adopt the data-centric-aircraft concept for daily operations. 

Flight Information Recorders, which include Flight Data Recorders, and 

combination devices similar to CAPAS are a part of this development. 

Although these systems were designed to reconstruct mishaps, the 

information recorded can be extracted for other very important purposes to 

include flight debriefs, aircraft maintenance, and trend analysis.90 

Solution—Culture/Operational Risk Management (ORM) 

Operational Risk Management was introduced to the Air Force and 

U.S. Navy in 1995. It was an adaptation of the US Army aviation’s highly 

successful program. The Navy’s Air Board identified Risk Management 

as one of three initiatives they would take to reduce Class A mishaps in 

Naval aviation (the other two being Human Factors Boards/Councils and 

Aircrew Coordination Training – ACT). A Process Action Team was

formed and met at the Naval Safety Center in the fall of 1995. The team 

consisted of naval reservists with commercial airline, aviation safety, and 

command experience. These reservists worked with Safety Center

personnel to produce the Navy’s approach to risk management. A 

message was promulgated to all wing and squadron commanders with 

recommended implementation steps, and finally, OPNAVINST 

3500.39/Marine Corps Order 3500.27 was signed-out as a combined 

instruction in the spring of 1997. 

ORM is a decision-making tool used by people at all levels to

increase operational effectiveness by anticipating hazards and reducing the 

potential for loss, thereby increasing the probability of successful 

missions. The five-step process consists of identifying hazards, assessing 

hazards, (Air Force adds a sixth step to analyze risk control measures),

making risk decisions, implementing controls and supervising the
Aircrew Performance Cutting-Edge Technology...41 

implementation of decisions. Operational risk management (ORM) 

consists of three levels: time critical or “on the run,” deliberate and indepth. There are four main principles: first, accepting risk when benefits

outweigh costs; second, accepting no unnecessary risk; third, anticipating

and managing risk by planning; and finally, making risk decisions at the 

right level.91 

As with any undertaking where hundreds of thousands of people 

are involved, it has taken time to communicate, train, implement and 

internalize ORM. The task is far from over, but there are many 

outstanding examples of implementation and lessons learned to date. 

Another encouraging sign of the embrace of ORM and senior commitment

to the effort is the DOD injury and occupational illness prevention

committee (IOIPC), which was chartered on 13 August 1999 and includes

a Joint Operational Risk Management Team (JORMT). 

Solution—Cultural Workshop (CWS) 

The Culture Workshop, or “Safety Culture Workshop” as it was 

known when first introduced to Naval Aviation in 1997, is a risk 

management tool for commanding officers to use in identifying cultural 

hazards that exist in their squadrons. This, like ORM, was an adaptation

of a highly successful program from another service. “Safety Culture 

Workshops” had been used in the US Air National Guard for most of the 

1990’s and was credited with a fifty percent reduction in Class A mishaps 

over that period. 

The workshop is based on the premise that “a good squadron 

culture is based on trust, integrity, and leadership, which are created and

sustained by effective communication.”92 Culture Workshops are 

conducted in strict confidentiality for the sole benefit of the unit by

Commanding Officer, at their invitation only. The workshop identifies the 

culture of the organization and relates this culture to mishap prevention. 

Culture is the non-physical operating environment. It supports a wide 

range of informal rules and attitudes that profoundly affect how the 

organization works and trains. Culture is impacted by past and present 

leadership styles, as they exert great influence on the attitudes and 

operating rules that form the culture. Leaders communicate acceptance of 

specific attitudes and rules either through direct and visible action of 

support or through sustained tolerance.93
42... Aircrew Performance Cutting-Edge Technology 

The process uses a senior reserve officer facilitator teamed with a 

junior aviator and senior enlisted maintenance member from a sister 

squadron. The three-member team begins by conducting individual 

informal interviews throughout the squadron. The facilitator then 

conducts three seminars composed of horizontal cuts of the organization, 

i.e., E-5 and below, E-6/7, and officers/senior enlisted. The mission or 

goal of the workshop is to paint a picture of the unit’s culture for the 

commander, which is developed by listening to the unit’s members in the 

seminars and individual conversations. This provides credibility, as it is 

not an evaluation by the team, but rather, a forum for the unit’s members

to communicate to the commander. The results are briefed to the 

commanding officer as both good things that were relayed to the team and 

as potential hazards to the organization. The facilitator briefs the team 

members that everything that was discussed during the visit is strictly 

confidential to that unit and not to be discussed after the completion of the 

workshop. No reports are written; the only take-away for the facilitator is 

a short evaluation form filled out by the commanding officer (CO) or

executive officer (XO) of the unit, grading the value of the workshop to 

them.

94 The culture workshop has had great success and even greater 

potential to further reduce mishaps through a better understanding of how 

culture and communication affect a squadron’s safety and working 

environment. 
Aircrew Performance Cutting-Edge Technology...43 

VII. Conclusions/Recommendations 

Victory smiles upon those who anticipate the changes in the 

character of war, not upon those who wait to adapt 

themselves after the changes occur. 

Guilio Douhet 

The New Form of War 

Private, commercial and military manned flight will continue with 

increasing military emphasis on un-manned aerial and combat vehicles. 

Human factors technological advances are applicable to both the manned 

and un-manned cultures/environments. Far too many human factors errors 

can be avoided by the proper application of technology and training today 

to settle for the status quo in development and implementation of these 

systems. Appropriately applied technology will not only make aircraft

safer, but also will decrease workload and increase ability to focus and 

accomplish a mission. The return on minimal investment would be

tremendous. 

Fatigue is endemic in military aviation; it is dangerous and kills on 

a regular basis. Fatigue should be managed like fuel and bullets utilizing 

nutrition, exercise, sleep and only when necessary, go and no-go 

medications. 

PRK surgery should be approved for all military aviation, requiring

initial waiver application and then service specific follow-up as dictated 

by operational commitments. LASIK should be approved for military

aviation as soon as it is proven safe in all phases of military flying. 

We are entirely ill prepared for combat aviation in the NBC or

DEW environments. We conclude either future losses are the price of 

doing business, or we adequately prepare and protect our aviators and

aircraft through focused research, development, test, and evaluation 

processes. For the DEW environment, timely, adequate, robust, and costeffective LEP is necessary. Mission planning tools, threat areas tactics 

and integrated laser sensors are needed to adequately operate in the 

emerging environment. 

Loss of situational awareness and spatial disorientation are major 

killers in all forms of aviation. Better training is needed to include real recreation scenario simulator flights (re-creation of top-ten killer scenarios 

in the simulator) and actual aircraft sorties dedicated to spatial 
44... Aircrew Performance Cutting-Edge Technology 

disorientation, especially in the rotary wing community. The technology

is here today to field automatic predicative ground proximity warning 

systems and automatic midair collision avoidance systems that will save 

lives and aircraft. These systems not only create a safety buffer for the 

aircraft, but as an added advantage improve tactical capability, especially 

if a pilot can take advantage of the ability to fly closer to the ground or 

closer to another aircraft. This area, above all others of human factors

technology, will save aircraft and priceless aviators’ lives almost 

immediately and will more than pay for any investment within one year of 

implementation. 

Network centric aircraft and simulators that include digital 

playback capabilities and recorders must be integrated better into training

and routine sorties as training aids and for mishap re-creation. The 

computer assisted performance analysis concept holds great promise for 

cognitive flight training and flight debrief. 

Vibro-tactile situation awareness system suits hold great promise 

for increasing situational awareness, particularly for the rotary-wing 

community; it is important that we continue funding and development of 

this system. 

Operational risk management and organizational culture are the 

most difficult areas to address because we need to understand them so 

much more, but the potential to save additional aircraft and lives is

significant. Continued concerted efforts and funding need to be focused 

on joint integration of the study of human factors issues as they relate to

aviation, as well as across all disciplines of aviation research development 

test and evaluation. Dual-designated aviators and flight surgeons are 

ideally suited to take the lead in this emerging area of study. Cultural 

workshops and operational risk management tools are starting to get at a 

most difficult area of organizational culture as it relates to aircraft mishaps 

and should be strongly supported. 

Manned and unmanned aircraft can benefit from human factors 

advances. It is recommended that greater coordination, emphasis, and 

resources be given to developing the human factors technologies discussed 

in this paper. As Baron Manfred von Richthofen said, “the quality of the 

box matters little, success depends upon the man who sits in it.” Given the 

pace of technological advancement in military aircraft, we need to prepare 

the man or woman in the box to be successful in every engagement. That 

box may either be air born, or ground based in the case of non-piloted 

aero-vehicles. Complete human factors incorporation can only be done 
Aircrew Performance Cutting-Edge Technology...45 

through an integrated effort of instructors, researchers, scientists, 

developers and operational test pilots that make the training more relevant, 

the box more efficient, and the weapon system more lethal so that the man 

or woman in the box continues to have the edge in the combat airspace of 

the future. 
46... Aircrew Performance Cutting-Edge Technology 
Aircrew Performance Cutting-Edge Technology...47 

Appendix A: US Navy corneal surgery policy 

All forms of corneal surgery are disqualifying. Photorefractive 

keratectomy is the only procedure that will be considered for waiver. Air 

warfare new accession applicants having had photorefractive keratectomy

(civilians, NROTC, Naval Academy and enlisted accessions) may be 

waivered for aviation duty if they meet all the following criteria: 

a. Accepted into a Navy-approved photorefractive keratectomy study 

protocol for long-term follow-up 

b. Pre-photorefractive keratectomy refractive error was less than or 

equal to plus or minus 5.50 (total) diopters in any meridian with 

less than or equal to plus or minus 3.00 diopters of cylinder and 

anisometropia less than or equal to 3.50 diopters. 

c. Civilian applicants must provide detailed pre-operative, operative,

and post-operative PRK follow-up records prior to acceptance into 

a Navy approved photorefractive keratectomy study. 

d. At least three months have elapsed since surgery or re-treatment

and evidence of stable refractive error is demonstrated by two 

separate examinations performed at least one month apart. 

e. Meet all other applicant entrance criteria as delineated in

references (the Manual of the Medical Department (NAVMED 

P117)) and (the 1997 Navy Aeromedical Reference and Waiver 

Guide) and as specified by approved aviation PRK-study 

protocols. 

Designated Naval aviation personnel (flying class one, flying class 

two, and class three designated enlisted aircrew and flight deck personnel), 

upon approval by their commanding officers, may seek acceptance into a 

Navy photorefractive keratectomy aviation study protocol involving actual 

PRK surgery. A waiver to return to flight duties will be recommended if 

they meet all study requirements and all other physical standards as 

delineated in references (the Manual of the Medical Department 

(NAVMED P117)) and (the 1997 Navy Aeromedical Reference and

Waiver Guide). 

Personnel electing the surgery must receive authorization from

their commanding officer prior to the procedure. 

For more information concerning corneal refractive surgery and 

photorefractive keratectomy in the Navy/Marine Corps, go to 

http://navymedicine_dev/refractive_questions.htm. 
48... Aircrew Performance Cutting-Edge Technology 
Aircrew Performance Cutting-Edge Technology...49 

Notes 

1

 HJointH Strike Fighter Program Briefing, December 2002. 

Available from Hhttp://www.jsf.mil/Program/Prog_Brief.htmH. 

2

 Personal email correspondence with CAPT William Miller, USN, 

Command Physician, US Navy and Marine Corps School of Aviation 

Safety, Naval Postgraduate School, Monterey, California. 

3 Military Medicine, Supplement to Military Medicine volume 164, no 

8 August 1999. Table depicting % of costs by mishap type for military 

personnel showed 81% were due to Aviation for FY 1994, with a total 

dollar cost of $ 381million. By comparison, places two through four for 

the same year were Shore operational (5%), Afloat (5%) and Nonoperational Private Motor Vehicles (5%). 

4

American Journal of Preventive Medicine, Supplement to American 

Journal of Preventive Medicine, “Injuries in the U.S. Armed Forces 

Surveillance, Research, and Prevention,” April 2000, 30-31. Department 

of Defense publication, re-printed with permission. 

5

 Elsa J. Hennings, Mishap Data Evaluation of Current Naval Aircraft 

1987–1996, NAWCWPSN-TP-8332 (China Lake, CA, Naval Air Warfare 

Center Weapons Division, August 1998). Cost data determined by China 

Lake research team. 6

 Ibid. 

7

 Ibid. 

8

 This statement is based on conversations between the author and 

United States Navy N-78, RADM Michael McCabe, Assistant Chief of 

Naval Operations, in charge of Air Warfare. The hard truth is that the 

DOD buys bombs and the ability to put them on target, while year after

year, safety enhancements are either under funded or partially funded. 

9

 Azar Gat, “Jomini: Synthesizing the Legacy of the Enlightenment 

with Napoleonic Warfare,” in The Origins of Military Thought from the 

Enlightenment to Clausewitz, (Oxford: Oxford University Press, 1989), 

106-135. 

10 Hohn A. Caldwell, “Sleepiness in the Cockpit,” Combat Edge, 

August 1999. 

11 John Boyd, “A Discourse on Winning and Losing,” August 1987, 

175. 
50... Aircrew Performance Cutting-Edge Technology 

Notes 

12 Mark R. Rosekind et al., “Crew Factors in Flight Operations X: 

Strategies for Alertness Management in Flight Operations,” NASA 

Technical Memorandum, final draft (NASA Ames Research Center,

Moffet Field, CA, 1994); U.S. Congress, Office of Technology 

Assessment, “Biological Rhythms: Implications for the Worker,” OTABA-463 (Washington, DC: U.S. Government Printing Office, September 

1991); and Meir H. Kryger, Thomas Roth, and William C. Dement,

editors, “Principles and Practice of Sleep Medicine,” W. B. Saunders 

Company, 1989. 

13 LeClair, Michael “Fatigue Management for AEF Deployment and 

Sustained Operations.” Air Command and Staff College, Air University,

April 2000. Class Alpha mishap occurs when an aircraft is destroyed or 

missing, a fatality occurs or there is an injury that results in permanent 

total disability, or the total cost of damage is $1,000,000 or greater. 

14 Carol S. Ramsey and Suzanne E. McGlohn, “Zolipidem as a 

Fatigue Countermeasure,” Aviation, Space, and Environmental Medicine, 

68, no. 10, (October 1997): 926-931. 

15 M. R. Rosekind et al., “Managing Fatigue in Operational Settings I: 

Physiological Considerations and Countermeasures,” Behavioral Medicine

21 (1996): 157-165. 

16 K. M. Belland and C. Bissell, “A Subjective Study of Fatigue 

During Navy Flight Operations Over Southern Iraq: Operation Southern 

Watch,” Aviation, Space, and Environmental Medicine 65, no. 6 (June 

1994): 557-561. 

17 Ibid. 

18 RADM R. A. Nelson, Surgeon General of the Navy, Forward to 

“Performance Maintenance During Continuous Flight Operations, A guide

for flight surgeons,” First edition, Naval Strike and Air Warfare Center, 

1 Jan 2000, 1. Available on-line from 

Hhttp://www.safetycenter.navy.mil/aviation/aeromedical/downloads/perfo

rmancemanual.pdfH. 

19 Ibid. 

20 S. Marshal, Night Drops: The American Invasion of Normandy, 

(Boston, MA: Little, Brown, 1962). 

21 “Desert Shield/Desert Storm Aerospace Medicine Consolidated 

After-Action Report.” USAF (only) summary of 29 individual after action 
Aircrew Performance Cutting-Edge Technology...51 

Notes 

reports, proceedings of the Squadron Medical Element (SME) After 

Action Conference at Langley AFB, VA 20-22 May 1991 and telephone 

conversations between CENTAF(rear)/SGPA and individual SME’s and 

CAPT Dave Brown, Navy dual-designated flight surgeon and pilot. 

22 Mark Sauter, “Gulf war pilots flew on speed, Air Force approved of

pill use,” Morning News Tribune (Tacoma, WA), 9 April 1992, and 

Associated Press article “Air Force admits pilots used uppers in gulf war,”

12 April 1992, Pensacola News Journal. 23 Colonel Peter Demitry, USAF, International Association of

Military Pilots President, interviewed by author.

24 RADM R. A. Nelson. 

25 OPNAV Instruction 3710.7S, Naval Aviation Training and 

Operations Procedures Standardization General Flight and Operating 

Instructions, 15 November 2001, available on-line from 

Hhttp://www.hq.navy.mil/natops/37107s.pdfH. 26 Ibid., 8.3.3. 

27 RADM R. A. Nelson. 

28 Ibid., 2. 

29 Anthony N. Nicholoson, “Intensive and Sustained Air Operations: 

Potential Use of the Stimulant, Pemoline,” Aviation, Space, and 

Environmental Medicine 69, No. 7 (July 1998), 647-655. 

Sympathomimetic describes a drug that has the effect of stimulating the 

sympathetic nervous system; the actions are adrenergic (resembling those

of norepinepherine). 

30 “History of Laser Eye Surgery,” LaserSurgeryForEyes.com, online, Internet, 26 May 2003, available from 

Hhttp://www.lasersurgeryforeyes.com/history.htmlH 

31 T. H. Mader and L. J. White, “Refractive Changes at Extreme 

Altitude after Radial Keratotomy,” American Journal of Ophthalmology

119, no. 6 (Jun 1995): 733-7; T. H. Mader et al., “Refractive changes 

during 72-hour exposure to high altitude after refractive surgery.” 

Ophthalmology 103, no. 8 (August 1996): 1188-95; and R. K. Winkle et 

al., “The etiology of refractive changes at high altitude after radial 

keratotomy. Hypoxia versus hypobaria,” Ophthalmology 105, no. 2 

(February 1998): 282-6. 
52... Aircrew Performance Cutting-Edge Technology 

Notes 

32 Personal conversations with Refractive Surgery professionals 

assigned to the Naval Medical Center San Diego. Also see “PRK in Naval

Aviation,” The Society of U.S. Naval Flight Surgeons Newsletter vol. 

XXIV, no. 1, January 2000, 11. Available on-line from

 Hhttp://www.aerospacemed.org/newsletter/vol24-1jan00.pdfH. 

33 Ibid. 

34 CDR Dave J. Tanzer, Co-Director PRK program Naval Medical 

Center San Diego, lecture to the Aerospace Medical Association 

Conference, Reno NV, May 2003. 

35 S. E. Kaupp et al., “Quality of vision changes during prolonged 

exposure to altitude following refractive surgery” (paper presented at 

Association for Research in Vision and Ophthalmology Conference, Fort 

Lauderdale, FL, 2000). 

36 Personal conversations with Refractive Surgery professionals 

assigned to the Naval Medical Center San Diego. 

37 “History of Laser Eye Surgery.” 

38 Personal conversations with Refractive Surgery professionals 

assigned to the Naval Medical Center San Diego. 

39 The United States refractive surgery Navy team, led by CAPT Steve 

C. Schallhorn and CDR Dave J. Tanzer, are actively engaged jointly with 

the Air Force Colonels Doug Ivans and Bruce Baldwin, and Army Colonel 

Corina VandePol, Lt Colonels Morris Lattimore and Major Scott Barnes 

to thoroughly evaluate photorefractive keratectomy. 

40 Research conducted by Naval Medical Center San Diego Refractive 

Surgery Department in conjunction with the Naval Strike and Air Warfare 

Center, Fallon Nevada. See “PRK in Naval Aviation,” The Society of 

U.S. Naval Flight Surgeons Newsletter vol. XXIV, no. 1, January 2000, 

11. Available on-line from 

Hhttp://www.aerospacemed.org/newsletter/vol24-1jan00.pdfH. 

41 Ken Alibek, Biohazard, (New York: Random House, 1999), 176 

and 281. 

42 Peter L. Hays, Vincent J. Jodoin, and Alan R. Van Tassel, 

Countering the Proliferation and Use of Weapons of Mass Destruction, 

(New York: McGraw-Hill, 1998) 4; Kris Belland, “Battlefield Lasers,” 

Naval Strike and Air Warfare Center Journal, Fall 1999; and Alibek.
Aircrew Performance Cutting-Edge Technology...53 

Notes 

43 Barry R. Schneider, Future War and Counterproliferation U.S. 

Military Responses to NBC proliferation Threats, (Westport, CT: Praeger 

Publishers 1999), 98. 

44 Norm Josten, “V-22 Shines in simulated force protection scenario,” 

Bell Boeing Tiltrotor Team’s Osprey Facts 12, no. 2 (February 2001), 3. 

Available on-line from Hhttp://www.boeing.com/rotorcraft/military/v22/ 

tilttimes/feb01.pdfH. 

45 Christopher J. Castelli, “V-22 Program Cancels Plans for two 

Chem-Bio Protective Features,” InsideDefense.com Special Report: V-22

Crash, 12 December 2000, n.p.; on-line, Internet, 2 July 2003, available 

from Hhttp://www.insidedefense.com/public/special.aspH

46 See, for example, Schneider or Hays et al. 47 Belland and Bissell. 

48 Author’s experience in the Gulf during Operation Southern Watch, 

flight deck temperature in excess of 130 degrees Fahrenheit, and EA-6B 

prowler environmental control system not working adequately until power

on the aircraft and airborne. With sometimes ten- to thirty-minute waits 

prior to catapult, dehydration rapidly becomes a factor. 

49 Lt Col John Geis, C-130 aircrew member, reported temperatures in 

cockpit of 136 degrees Fahrenheit in Florida, and anecdotal reports of 

greater than 150-degree temperatures in Arizona and over 180 degree 

Fahrenheit in Saudi Arabia operations also exist. AC-130 H gun ships

have recorded wind chill factors to minus 150 degrees Fahrenheit for the 

aircrew (Gunners, loadmaster) in the aft of the aircraft, with MOPP gear 

freezing solid on occasion, making respiration impossible. 

50 U. S. Navy Aircrew Systems Operational Advisory Group (OAG), 

1998 and 1999. Air Crew Systems OAG executive steering committee 

member and chairperson of the fixed wing, ejection seat aircraft group. 

51 USMC pilots during operation DESERT STORM, conversations 

with USMC flight surgeons. 

52 Lt Col John P. Geis, Directed Energy Weapons on the Battlefield: A

new vision for 2020, Center for Strategy and Technology, Air University 

Press, 2003. 

53 Ibid. 

54 Michael Waller, “Shot by a Laser,” Readers Digest, October 1999. 
54... Aircrew Performance Cutting-Edge Technology 

Notes 

55 Statements are based on the author’s discussions with various 

members of the directed energy technology community while attending 

the International Military Laser Conference in London, England, in 1998 

and 1999. 

56 Ibid. 

57 Naval Health Research Center Detachment, Tri-Service Directed 

Energy Bioeffects Complex at Brooks AFB, Texas. 

58 Event laser sensor/recorder developed under a Phase I SBIR grant 

from the National Institute for Occupational Safety and Health, (NIOSH), 

Naval Health Research Center Detachment, Tri-Service Directed Energy

Bioeffects Complex at Brooks AFB, Texas. 

59 Jeri Tribble, Vision Lam Manager (Code 4.6.3.1) Patuxent River 

MD, Life Support and Personal Protection and Norman Barsalou, US

Navy detachment Brooks Air Force Base, interviewed by author, Naval 

Strike and Air Warfare Center, May 2001. 

60 Ibid. 

61 Bryant, Rentmeister and Barsalou, Norm, of the Naval Health 

Research Center Detachment, Tri-Service Directed Energy Bioeffects 

Complex at Brooks AFB, Texas. 

62 Naval Health Research Center Detachment, Tri-Service Directed

Energy Bioeffects Complex at Brooks AFB, Texas. The LTAMPS 

modeling/simulation system provides a flight simulation and data 

playback capability using reconstructed test range flight/weapon delivery 

profiles based on TSPI/GPS (Time-Space Position Information/Global 

Positioning System) test range data bases. Integrated into aircraft

wire-frame models (both fixed and rotary wing) are an anthropometric 

representation of the pilot head-LEP spectacle geometry. The wireframes 

can then be modulated via TSPI over National Imagery Management

Agency (NIMA) tactical pilotage charts and Digital Terrain Elevation 

Data (DTED) through use of the Advanced Distributed Interactive 

Simulation (ADST) or IEEE Distributed Interactive Simulation protocol 

(IEEE 1278.1-1994). This allows LTAMPS to provide aircraft (or any

allowable DIS vehicle) entity locations and orientations to any simulation 

which communicates via this protocol, thus allowing LTAMPS to be

incorporated in simulation war games involving the use of lasers as 

counter sensor weapons. LTAMPS uses NIMA products directly in the 
Aircrew Performance Cutting-Edge Technology...55 

Notes 

format as produced by NIMA. These products include the aforementioned 

Tactical Pilotage Charts in the Advanced Digitized Raster Graphics 

(ADRG) format, terrain, or topographical relief data in the DTED format, 

and for appropriately configured video systems, playback over imagery 

provided by NIMA. 

63 US Navy detachment Brooks Air Force Base, Tri-Service Directed 

Energy Bioeffects Complex at Brooks AFB, Texas 

64 Air Force News release dated 29 Nov 1999 originally found on 

website Hhttp://www.af.mil/news/Nov1999/n19991123_992139.htmlH. 

65 Ibid. 

66 Melchor J. Antunano, Medical Facts for Pilots Publication AM400-00/1, Spatial Disorientation: Visual Illusions, 11 September 2002, 

Federal Aviation Administration, Civil Aerospace Medical Institute 

Aeromedical Education Division. 

67 Kent Gillingham and Fred Previc, Spatial Orientation in Flight, 

(Williams & Wilkins, 1996), 309-98.

68 Author’s personal experience investigating controlled flight into

terrain mishaps, discussing mishaps with other investigators, and 

participating in high visibility mishap reviews. 

69 Author’s personal experience in over 30 mishap investigations, 

several of which included spatial disorientation, loss of situational 

awareness and ignored or missed altitude warnings. 

70 Elsa Hennings, United States Navy Active Network Guidance and 

Emergency Logic, China Lake Naval Air Station, interviewed by author.

71 Air Force News release dated 29 Nov 1999. 

72 Ibid. 

73 ESOH TPIPT Need Assessment Summary, Need #: 1903, 

Hhttps://xre22brooks.af.mil/NASs/purpcont1903.htmH 

74 Ibid. 

75 CDR “Rhino” Unterhiner, Program Manager, United States Navy 

Joint Strike Fighter Program, interviewed by the author, 2001. 

76 Air Force News release dated 29 Nov 1999. 

77 Ibid. 

78 “TASC Wins Big on Air Force DMT Contract: Distributed Mission 

Training Program Will Link Aircraft Training Simulators Worldwide,” 

Northrop Grumman Information Technology Prism 7, no. 2 (June 2000), 
56... Aircrew Performance Cutting-Edge Technology 

Notes 

n.p., on-line, Internet, 2 July 2003, available from 

Hhttp://www.tasc.com/news/prism/0006/1.txt.shtmlH. 

79 Ibid. 

80 Tim Ripley, “Distributed mission training,” 2000 Globaldefence.com, n.p., on-line, Internet, 7 July 2003, available from 

Hhttp://www.global-defence.com/2000/pages/distrib.htmlH. 

81 Eric Pagenkopf, Naval Strike and Air Warfare Center/Navy Fighter 

Weapons School (TOPGUN) flight surgeon, internal trip report from 

USAF simulator utilization conference. 

82 Arthur Estrada et al., Spatial disorientation awareness training 

scenarios for US Army aviators in visual flight simulators, USAARL

Report No. 98-17 (Fort Rucker, Alabama: US Army Aeromedical 

Research Laboratory, January 1998). Available from Hhttp://www.usaarl. 

army.mil/TechReports/98-17.PDFH. Related USAARL reports 97-11, 97-

15, 97-26, 97-22 and 97-13 are also available from the website. 

83 Ibid. 

84 Braithwaite, Malcom G. “The British Army Air Corps In-Flight 

Spatial Disorentation Demonstration Sortie.” Aviation, Space, and 

Enviornmental Medicine, Volume 68, No 4 April 1997, 342-345. 

85 Angus H. Rupert, “Tactile Situation Awareness System” program

overview briefing, Joint NASA/Naval Aerospace Medical Research 

Laboratory, 10 August 1999. Available on-line from

Hhttp://www.namrl.navy.mil/TSAS/H. 

86 CAPT Donald Hepfer, Commodore S-3 Viking Command, Crew 

Resource Management (CRM) initiative presentation to Human Factors 

QMB/Training Improvements Working Group, NAS North Island 4 

February, 2000. 

87 Ibid. 

88 Ibid. 

89 Ibid. 

90 Ibid. 

91 Captain J. J. Skip Lind, USNR, Commander Naval Air Forces 

Pacific, Cultural Workshop Facilitator. 

92 Ibid. 

93 Ibid. 

94 Ibid.