A92H0003-Risk of Collision Between-Montreal International (Dorval) Airport, Quebec-17 February 1992

Safety Action Taken
(as indicated in the TSB Report)

Training Procedures Montreal ACC

Following this occurrence, Montreal ACC held an internal investigation which found that, in an abnormally high percentage of incidents when training was in progress, the controller-in-training had previous experience and the controller/instructor had over-estimated the trainee's abilities. Additionally, in several incidents, the instructor and the trainee had been colleagues for a long time. As a result, Montreal ACC now requires: that trainees demonstrate their aptitude prior to commencing training in the terminal specialty; that personal friends not be placed in an instructor/trainee situation; and, that instructor controllers be briefed on monitoring procedures to be used with trainees having previous IFR experience.

Safety Action Required
(as indicated in the TSB Report)

Staffing, Opening and Closing of ATC Sectors

This risk-of-collision incident was caused in part by the untimely opening of an ATC sector.

In the CASB's Report on the Special Investigation into Air Traffic Control Services in Canada (March 1990), problems were noted with respect to, inter alia, timely decisions regarding the opening of sectors. Considerable judgement is required with respect to the timing of sector opening and closing. It was recommended in the report that the Department of Transport prescribe operating guidelines for the timing, staffing, and transfer of responsibilities for opening and closing sectors. In response, Transport Canada (TC) indicated that, due to changing operational conditions, it was impractical to develop fixed guidelines, with respect to timing, for the opening and closing of sectors. 

Since 1990, the TSB has investigated two other occurrences in addition to this one in which the delayed opening or staffing of a sector was a factor (A9-0H0-008 and A90P034-7). In its final report on the latter incident, the Board expressed concern that occurrences resulting from the untimely opening of sectors were continuing. Furthermore, three recent TC Fact Finding Boards (FFB) on loss-of-separation incidents have identified factors related to the delayed opening of a sector (5400-42-38A-9203, 5400-42-48A-9207, and 5400-42-33A-9203). 

The Board appreciates that there could be difficulties associated with the implementation of fixed guidelines for timing the opening and closing of sectors. The Board is also aware that Air Traffic Services agencies in other countries have experienced problems caused by the late opening of sectors and apparently have not been able to develop a formula fix either. TC has procedures regarding how sectors are to be opened and how controllers are to assume or relinquish control responsibilities. Evidently, knowing how to open a sector is not the issue; deciding when it is time to do so apparently is. 

In view of the continuance of incidents in which the delayed opening of an ATC sector has been a contributing factor, operational supervisors require some form of assistance to ensure timely decisions on sector management. Therefore, the Board recommends that:

The Department of Transport provide operational supervisors with general criteria and practical training for making timely decisions on staffing, opening, and closing of sectors. (A93-13)

Transport Canada Response:

Transport Canada agrees with this recommendation. The following activities have been initiated in order to ensure that supervisory personnel are adequately trained:

  1. general criteria for the opening and closing of sectors are being developed and will be published for the guidance of all supervisors. Supervisors will be briefed on these criteria, once they are promulgated.
  2. these criteria will be reviewed on an annual basis during controller/supervisor refresher training;
  3. a formal training course is being developed for supervisory personnel.  Staffing and the opening/closing of sectors will be included as a part of this training programs;
  4. the required staffing levels for the specialties/sectors in each Area Control Center have been reviewed, and adjustments to these staff levels have been approved. The approved levels are considered adequate to provide supervisors with the flexibility to staff sectors with sufficient controllers to meet normal traffic demands; and
  5. an ATS Safety Bulletin (known as SQUAWK 7700) will be published to provide all staff with information on the criteria for staffing and opening/closing sectors. Back
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