Page:KAL801Finalreport.pdf/164

 Fatigue degrades all aspects of performance and alertness, and deficiencies associated with fatigue were displayed in many aspects of the captain's behavior. The captain's preoccupation and confusion with the status of the glideslope to the exclusion of other critical information, his incomplete briefing, and his failure to react to the GPWS alerts are typical of fatigue effects that were found to be present in the Guantanamo Bay and Pine Bluff accidents.

On the basis of the time of day, statements recorded on the CVR, and sleep and fatigue research, the Safety Board concludes that the captain was fatigued, which degraded his performance and contributed to his failure to properly execute the approach.

The Safety Board examined Korean Air's Boeing 747 pilot training and proficiency checking program to determine what effect, if any, it may have had on the performance of the flight crew of flight 801. In training its pilots to fly the 747-200 and -300 series airplanes, Korean Air conducted 10 4-hour simulator sessions in which pilots were taught various maneuvers, emergencies, and scenarios, followed by a proficiency check in which pilot performance of certain maneuvers was assessed. The profile for each simulator training session outlined the specific airport, runway, weather, and airplane malfunction to be expected and whether the flight would result in a landing or missed approach. The training curriculum was not varied. Korean Air's Director of Academic Training testified at the Safety Board's public hearing that, at the time of the accident, the company's practice was to follow simulator scenarios exactly as outlined in the training curriculum and that instructors were not permitted to vary the scenarios. The director also indicated that the proficiency checks used the same approaches that had been practiced in the previous simulator training sessions.

Further, the only nonprecision approach practiced throughout the simulator sessions that used DME information was the VOR/DME approach to runway 32 at Seoul's Kimpo Airport. However, the DME at that airport is located on the field, unlike at Guam. No scenario was presented in which pilots were required to count down to and fly past the DME and then count up to the MAP, which was required for the Guam approach. Further, according to the airline's training syllabus, the VOR/DME approach to runway 32 at Kimpo was the only nonprecision approach that Korean Air flight crews were required to perform on their check ride.

The Safety Board notes that proper training in the execution of nonprecision approaches is essential to safe operations. The complexity of such approaches and the