INTERVIEW TOOL ( UP )
Confirmation Number: C3RS-0000000000 (mmddyy, 4 random digits)
Date: ________________
Time of interview: _______ am pm (will be converted to 24 hr format in system)
Interviewer Name: _______________________
Interviewee Name: _______________________
Interviewee Phone Numbers: ____________________
Received Confirmation Call: Yes No
Participating Railroad: UP
Introduction:
Hello, this is (First, Last);
I would like to speak with Mr/Ms (First, Last).
(When you have the person on the line) Hi, (name again), I am a member of the Confidential Close Call Report Interview Team located in Washington, DC. You had indicated on your report that this would be a good time to contact you for an interview. (Pause, there may be a response) The interview may take 20-40 minutes; do you have that much time available now?
(If yes, proceed with the interview)
Next, I am going to read the Burden Statement to you. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2139-0010. As mentioned above, the interview is estimated to take approximately 20 to 40 minutes and it is voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Close Call Data Collection Officer, Demetra Collia, US DOT/BTS, 1200 New Jersey Avenue SE, Room E36-302, Washington, D.C. 20590 or email: [email protected]
(If no, ask for another time to conduct the interview) When would be the best time to reschedule the interview call? Record Below:
Time: __________________
Date: ________________
Ph #: _________________________
Before we proceed with the interview, I want to provide you with a little background and go over a few ground rules. There is an agreement between the UP, the labor unions, the FRA, and the agency I represent, the Bureau of Transportation Statistics, which provides employees that participate in the C3RS project protection from disciplinary and enforcement actions by the Railroad and FRA. The purpose of the project is to gather data related to close calls that may not be available following traditional incident investigation procedures. The information you are sharing with me will be kept strictly confidential. I will be asking you several questions that initially may seem unrelated to your incident, but the information you will provide is necessary to fully develop the circumstances of the incident, the safety culture environment and provide the summary data which may be useful in identifying the root causes of incidents and, thereby, improve safety.
Proceed with interview –
I have reviewed your close call report, but before going into the interview I would like to ask you to give me a verbal account of the incident so I can better understand how the incident occurred.
Description of Incident – Have individual describe the events leading up to including the incident and what happened afterwards. (In their description listen to see if the following are mentioned):
How long had this crew worked together?
What kind of harm could have occurred?
How and when did you communicate safety concerns related to the incident on which you are reporting?
What was your supervisor’s response?
What was your follow up on the incident with your supervisor?
Ask follow up questions to fill-in details to understand the incident and have individual provide explanation of any instructions, procedures or processes referenced.
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Comment field:
Text From Written Report –
Oral Report -
Before we begin the interview, would you please share the following information with our research team?
Height: _______ (feet) _____(inches)
Identify interviewee’s job category:
Brakeman
Conductor
Dispatcher
Engineer
Forman
Hostler
Pilot
Student Conductor
Student Engineer
Switchman
Yardmaster
Work experiences (in years): Railroad_________ Craft ____________
Comments field:
Enter Incident information obtained from written report or attempt to collect at the beginning of the interview (unless already submitted with report)
Incident information
Enter Work/Sleep and train consist information obtained from written report or attempt to collect at the beginning of the interview (unless already submitted with report)
3-Day Work/Sleep History Information
(Please use military time (24-Hour clock) for work and sleep periods)
3-Day Work Shift History |
Shift Start Time |
Incident Time |
Shift End Time |
Incident Shift Day |
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Day before Incident |
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2 Days before Incident |
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3-Day Sleep History |
Sleep Start Time |
Sleep End Time |
Nap – Yes/No |
Last Sleep before Incident Shift |
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Sleep Period the Day Before |
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Sleep Period 2 Days Before |
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Ask for Equipment/Brake information not part of written report.
Defective Equipment (any of the track, switches, equipment, etc.)
Yes If yes, describe:
No
NA
When did you become aware of the defective equipment?
Prior to the incident occurring
At the time the incident occurred
After the incident occurred
Comment field:
Brakes
Did the Close Call incident involve the use of brake systems?
Comment field:
a. Had these brake systems been used, prior to the incident?
b. If the conductor/brakeman is being interviewed; ask if he considered using the emergency brake to control the train and avoid the incident?
c. Any cars cut out or have defective brakes?
Comment field:
d. What brake systems were being used and in what order and amount?
TYPE ORDER USED AMOUNT USED
Automatic air 1 2 3 _________ (service to full)
Independent air 1 2 3 _________ (service to full)
Dynamic brakes 1 2 3
Comment field:
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Yellow Board/Slow Order Violations
What type of approach signs were displayed in advance of the incident slow order?
Yellow Board
Red/Yellow Board
Other
Comment field:
Did you check the incident location on your trip to see if the Yellow Boards were there?
Yes
No
Comment field:
How was the Yellow Approach Board mounted or posted?
What was the approximate distance of the Yellow Board placement from center line of the track?
Is this where you would expect to see the Yellow Board
Yes
No
Comment field:
What was the condition of the Yellow Board?
Was it difficult to observe for some reason?
How many slow orders did you have on this trip?
How many slow orders were within 10 miles of the incident site?
Was the incident slow order within the confines of another slow order?(This would include slow orders within the confines of a Form B order.)
Yes
No
Form A
Form B
Form C
Was your train operating in the normal or standard direction of travel for the track you were using?
Yes
No
No Standard Direction
Comment field:
What was the interaction or engagement between the engineer and conductor or other people in the locomotive cab?
Were you following or meeting other trains when the incident occurred?
Meeting
Following
Both
Comment field:
Did the incident occur near a junction, interlocking, intermediate station or major terminal?
Junction
Interlocking
Intermediate Station
Major Terminal
Comment field:
Did your train orders tell you the Yellow Boards were not displayed for the incident slow order?
Yes
No
Don’t Know
Comment field:
Now let’s start the interview questions.
1. Do you usually work a job from the: (Mark the one that best describes your situation.):
Regular Assignment
Pool Turn
Extra Board
1a. Was the incident job a:
Regular Assignment
Pool Turn
Extra Board
Comment field:
2. When the incident occurred, were you being paid by the:
Mile
Hour
Trip Rate
Basic Day
Comment field:
3. How long does it take you to commute to/from work from home?
____ hrs. ____ mins.
Comment field:
4. Do you feel that fatigue or lack of alertness contributed to this incident?
Yes If no, go to next question.
No
Drop down box to collect on fatigue and alertness information:
4a. Did you have trouble sleeping during the 3-days prior to the incident?
Yes
No
Comment field:
4b. On a scale of 1-5, with 5 being “the best”, how would you rate yourself on?
4b1.The quality of your sleep during your last rest period (1 - 5):
4b2. How rested you felt when you got up: (1 - 5):
4b3. How alert you felt just prior to the incident (1 - 5):
4c. If you were tired, did you attempt to Lay-Off when called for the incident shift?
Yes
No If no, why:
Comment field:
4d. Did you do anything to enhance your alertness prior to this incident?
□ Yes Mark below:
□ No
□ Caffeinated beverage
□ Stand up/walk around
□ Eat/Chew something
□ Talk
□ Fresh air
□ Drink or splash water
□ Other (Describe)
Comment field:
5. Were there any issues that affected the quality of your sleep?
Yes If no, go to next question.
No
Drop down box to collect information on potential issues related to sleeping:
5a. Were they personal?
Yes
No
Comment field:
5b. Were they work related?
Yes If yes, describe:
No
Comment field:
5c. Have you ever been diagnosed with any type of sleeping disorder?
Yes
No
5d. Describe condition:
5e. Describe treatment:
5f. Is the treatment effective: □ Yes □ No
Comment field:
6. Were there any issues that affected your ability to concentrate?
Yes If no, go to next question.
No
Comment field:
Drop down box for issues related to ability to concentrate:
6a. Were they personal?
Yes No description required
No
6b. Were they work related?
Yes If yes, describe:
No
Comment field
7. Was the paperwork a problem?
Yes If no, go to next question.
No
Comment field:
Drop down box for paperwork issues:
7a. What were the problems with the paperwork?
Out-of-date
Inaccessible
Incomplete
Not prioritized
Other (Describe)
Comment field:
7b. Did the paperwork problem have an effect on this incident?
Yes
No
Comment field:
8. Was a job/safety briefing conducted at the beginning of your shift and/or prior to the incident task?
Yes If no, go to next question.
No
Comment field:
Drop down box for job briefing questions:
8a. Who conducted the job briefing?
Job title: __________________________
Ask the subject to describe the job/safety briefing using the questions below:
8b. All members of the crew attended?
Yes
No
8c. Discussion of what was to be done and how to do it?
Yes If yes, what was discussed?
No
8d. Did you discuss what might go wrong and what to do then?
Yes If yes, what was discussed?
No
8e. Did you discuss the incident task?
Yes
No
8f. Were all questions about the incident task answered and understood?
Yes
No
Comment field:
9. On the incident day, did you have any job dissatisfaction issues?
Yes If yes describe:
No
Comment field:
10. How well did the crew getting along? Ask for a number rating. Rate on a scale of 1 to 5, with 5 being “the best” ( 9 being “did not want to answer” ).
Rating: ______
Comment field:
11. Performing assigned duties:
11a. Did you neglect to complete your work correctly?
Yes If yes, describe:
No
Comment field:
11b. Did anyone on the crew neglect to complete their assigned duties correctly?
Yes If yes, describe:
No
Comment field:
11c. Did anyone else in the working environment neglect to complete their assigned duties correctly?
Yes If yes, describe::
No
Comment field:
12. What form of communication was being used during the task just prior to the incident? (Mark all that apply)
Verbal direct
Radio
Hand signals
Other(Describe)
Comment field:
13. Communication when the incident occurred. (Mark all that apply)
Verbal Direct
Radio
Hand signals
Other(Describe)
Comment field:
14. Was there any confusion or misunderstanding leading up to the incident?
Yes If no, go to next question.
No
Comment field:
14a. In your experience, what was the cause of the confusion or misunderstanding?
Comment field:
15. How frequently do you do the incident job or task?
Several times a shift
Daily
Weekly
Once or twice a month
Not very often (Ask the subject if he can remember the last time he performed this task.)
Comment field:
16. What rule(s) applied in this incident?
Comment field:
17. Were there any recent changes in the rules or work practices associated with the incident work task?
Yes If yes, describe:
No
Comment field:
18. Do you have any suggestions for changes to the rules or practices? (The scribe should fill in based on the subject’s response. Some potential responses are listed below.)
Eliminate
Revise (Describe)
Add to the rule or modify the practice (Describe)
Other (Describe)
Comment field:
19. In your opinion, were any rules violated?
Yes If no, go to next question.
No
Drop down box for rules questions:
19a. Why do you think the rules were violated in this manner?
Comment field:
19b. Is this type of rule violation uncommon for you?
Comment field:
20. Can you think of any factors in your work environment that promotes or contributes to bending the rules?
Yes
No
Comment field:
21. When was the last time you received training on your job or the rules applicable to your job? (Try to get month and year at the very least.)
Month: __________ Year: __________
21a. When were you certified/recertified? _____________
22. What type of training do you think was most effective for learning you job?
On-the-job (OJT)
Classroom
Simulator
Some other type of training procedures (Describe)
Comment field:
23. Were there any changes at the incident location (tracks, switches, etc.)?
Yes If yes, describe:
No
Comment field:
24. Do you think the weather was a factor in the incident?
Yes If yes, describe:
No
Comment field:
24a. What were the weather conditions at the time of the incident? (Some typical responses could be: Clear, cloudy, light rain/snow, heavy rain/snow, hot, cold, fog, bright sunlight/moonlight, etc.) Time of day: (AM/PM and light/dark).
25. Were there any other physical factors (noise, vibration, lighting, walking conditions, etc.) that may have contributed to the incident?
Yes If yes, describe:
No
Comment field:
26. Was there any new technology involved with the incident?
Yes If no, go to next question.
No
Comment field:
26a. Do you feel that you were sufficiently familiar with equipment or new technology?
Yes
No(Describe)
26b. Were you provided any training on the equipment or new technology?
Yes
No
Comment field:
27. How safe did you feel working with the other member(s) of your crew?
Very safe
Safe
Slightly safe For slightly or not safe, describe:
Not safe
Comment field:
28. Was your immediate supervisor aware of the incident?
Yes If no, go to next question.
No
Comment field:
28a. In the context of this incident, did your immediate supervisor behave inappropriately in any way?
Yes If yes, describe:
No
Comment field:
29. Is there anything management/company should or could have done to prevent this incident?
Yes If yes, describe what they should/could have done:
No
Comment field:
30. Which of the following does your immediate supervisor use to monitor rules compliance? (The scribe should fill in based on the subject’s response. Some potential responses are listed below.)
Efficiency testing
Observations
FTX
Total Safety Culture
Event recorder downloads
Ride along
Stop boards
Other (Describe)
Comment field:
31. On a scale of 1 to 5, with 5 being “the best”, how do you rate your immediate supervisor with respect to the following knowledge, skill, and ability factors?
KSA factors |
Ranking (1-5) |
Don’t know |
General knowledge of operating and safety rules |
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Building effective relationships with you and your crew |
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Clear communication of job tasks and instructions |
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Coaching/Mentoring |
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Consistent enforcement of rules and requirements |
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Problem solving |
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32. What do you do when you see or become aware of an unsafe condition, practice or piece of equipment in your workplace? (Check all that apply.)
C3RS
Take care of it myself (including coaching other employees)
Report it directly to a supervisor or manager
Report to the TSC
Make a report on the “Safety Hotline”
Report the matter to my union representative
Report the matter to the Safety Committee
File an Unsafe Condition Report
Other (Describe)
Comment field:
33. When you have reported safety concerns, does management respond and effectively address your concerns?
Yes If yes, go to next question.
No
33a. Did management provide feedback on what would be done to address your safety concern?
Yes If yes, how was feedback provided? ____________________________
No
Comment field:
34. Do you think your immediate supervisors are generally helpful and supportive of your safety concerns?
Yes
No If no, can you give an example?
Comment field:
35. How would you rate the effectiveness of communication processes for resolving safety concerns?
Very effective
Moderately effective
Slightly effective For slightly or not effective, describe:
Not effective
Comment field:
36. How would you describe the relationship between management and labor at your work location? (Ask for an explanation for why for each below.)
Just
Both
Blame
Comment field:
We are just about finished with the interview; just two more questions.
37. In your opinion, what prevented this from becoming or causing a more serious incident?
38. Is there anything that could have been done differently to have prevented this incident?
39. This space is reserved for the interviewer to comment on the level of risk associated with this incident with respect to: (H = High, M = Moderate, L = Low)
The people (employees) directly involved in the incident H M L
Other employees H M L
Public Safety H M L
Damage to equipment and/or property H M L
The environment H M L
Comment field:
End of Interview
BTS-0011A
| File Type | application/msword |
| File Title | Corrected interview tool 8/2011 |
| Subject | C3RS |
| Author | Ed Dobranetski |
| Last Modified By | USDOT User |
| File Modified | 2013-08-01 |
| File Created | 2013-08-01 |