The Science

Aviation

Modern aviation safety rests on more than aircraft systems and procedural checklists. The industry early recognised that many failures involved breakdowns in crew resource management (CRM) — communication, leadership, situational awareness, and decision making. Structured CRM training and behavioural marker systems such as NOTECHS were developed for flight crews; parallel research has addressed the non-technical skills of cabin crew and air traffic controllers, who manage congestion, complexity, and coordination under sustained workload. Aviation research established many of the taxonomies and assessment methods now used across other high-risk domains.⁸¹⁰¹¹

Healthcare

Across all domains of health care, patient safety depends on teams working under time pressure with incomplete information. Research shows that adverse events often involve breakdowns in non-technical skills — not just technical knowledge or manual skill. Behavioural marker systems such as ANTS (Anaesthetists’ Non-Technical Skills), N-ANTS for nurse anaesthetists, and NOTSS (Non-Technical Skills for Surgeons) were developed for observing and rating these competencies in clinical practice and simulation.^12131415 In the United States, TeamSTEPPS is a national team-training programme for healthcare in the same CRM lineage.³¹⁶

Fire & rescue

Fire and rescue operations are dynamic, hazardous, and information-limited. Incident commanders must maintain situational awareness of evolving fire behaviour, building conditions, and crew safety while making time-critical decisions, coordinating multi-agency teamwork, and communicating under extreme stress. Research on UK fire and rescue services has described the non-technical skills of incident command and developed the THINCS behavioural marker system to assess them.¹⁷¹⁸¹⁹

Law enforcement

Policing takes place in uncertain, time-pressured, and emotionally charged environments. Officers and commanders must read rapidly changing situations, coordinate across agencies, communicate under stress, and make consequential decisions when information is incomplete. Research on critical incident decision making shows that performance depends not only on policy knowledge and tactical skill, but on cognitive and interpersonal competencies that parallel NTS in aviation and healthcare. Studies of police–public encounters identify core competencies including perceptual and situational awareness, communication and de-escalation, decision making and problem solving, emotion and behaviour regulation, and stress management. In major incidents, researchers have documented decision inertia — redundant deliberation when all options appear to carry negative consequences — highlighting why structured training in judgment, leadership, and team coordination matters as much as technical proficiency.²⁰²¹²²

Disaster management

Major disasters and civil emergencies place commanders under extreme uncertainty, time pressure, and organisational complexity. Police, fire, ambulance, military, and local authority responders must build a shared picture of the incident, coordinate across agencies, and commit to action when every option may carry negative consequences. Research on decision inertia and multi-agency simulation shows how redundant deliberation, unclear goals, and poor inter-agency communication can delay life-saving action.²³²⁴²⁵

High-risk industry

Process industries with major-accident potential — including nuclear power, offshore oil and gas, well operations, and other energy sectors — were early adopters of CRM-style training after recognising that technical systems alone cannot prevent catastrophe. Control-room operators and emergency command teams must maintain situational awareness, communicate assertively, manage stress and fatigue, and make sound decisions in routine and emergency conditions. Research has identified team skills taxonomies for nuclear operations and adapted CRM to offshore platforms, informing syllabi now used across the energy sector. Investigations after major industry accidents have underscored how non-technical skills, safety culture, and system complexity interact when things go wrong.^26272829

Business & organizations

Modern organizations operate in complex, dynamic environments where leaders and teams must sense emerging risks, adapt to ambiguity, and coordinate across functions. Human factors research shows that the same cognitive and social skills underpinning safety in aviation and healthcare — often termed crew resource management (CRM) skills — are equally relevant in business settings where errors, miscommunication, or delayed decisions can have serious operational and financial consequences.^303132333435

Decision Workout is a simple, concrete digital course with self-evaluation, for learning and reflection. It is informed by the research tradition described on this page.

Course scores are not a validated assessment of professional competence, not clinical or operational advice, and not certification by a professional body.