The U.S. wildland fire community has been interested in cultivating organizational learning to improve safety and overall performance for a number of years. A key focus has been on understanding the difference between culpability (to be guilty) and accountability (to explain) and on re-orienting review processes towards building a collective account of (as opposed to finding individual blame for) unwanted outcomes.
Recognizing the need to enhance learning from escaped prescribed fires, the Rocky Mountain Research Station analyzed current review processes through a series of five regional, interagency dialogue sessions. These two-day workshops were held in Portland, Denver, Salt Lake City, Tucson, and Tallahassee between January and July 2011. All drew participants from the interagency fire community and spanned the full spectrum of positions from ground operations to national policy makers.
Preliminary results suggest tremendous individual learning is occurring, but that the content of lessons varies by position and hierarchical level. For instance, those involved in the burn operation often gain insight during an event or during the informal unit-level after action reviews, but rarely from formal review processes. These latter are more likely to generate anxiety and defensiveness - the antithesis of an effective learning environment.
First-line managers find the reports generated by a formal review somewhat more useful, particularly for developing materials for burn boss refresher courses. Review team members report gaining valuable insight into their own practices while reviewing those of others.
Transfer of lessons occurs most vividly through personal contacts, particularly when combined with an emotional/experiential interaction, such as presentations at burn boss refresher courses and exercises that put the participant in the shoes of operational personnel. Managers in regional and national positions use reviews to demonstrate due diligence, help explain events to outside audiences, and to identify trends and patterns across units. These are practices upon which to build to further improve learning.
Preliminary results also reveal barriers that currently inhibit learning. There is a tendency for the review processes to feel like interrogations aimed at finding blame rather than opportunities to facilitate participant learning. Consequently, key information for improving future performance is driven underground. A key barrier to transfer of local learning to others is confusion about who is the target audience for the review process and the resulting products. Workshop dialogues revealed several audiences, each with different and relevant needs. The current one-process-and-one-report structure may meet the needs of higher management by capturing a story for accountability purposes, but inhibits ground-level learning and operational resiliency.
Two major gaps were identified: the lack of a swift and comprehensive distribution system for getting review results to the field, and lack of a process to turn written reports into more useful learning products for the field. Re-thinking and re-crafting the post-event reflection process to ensure that local and peer learning occurs should enhance organizational learning and result in a more robust system that accomplishes strategic, operational, and real-time learning.
Lessons learned from these and other fire reviews are available through the Wildland Fire Lessons Learned Center.
Black, A.E.. 2011. Learning from escaped prescribed fire reviews. U.S. Forest Service, Region 8 Fire Staff and Southern Fire Chiefs, May, 2011.
Black, A.E. 2011. Learning from escaped prescribed fire reviews. U.S. Forest Service, National Fuels Group, July 20, 2011.
Black, A.E. 2011. Learning from escaped prescribed fire reviews. NWCG Fire Use Subcommittee, Lakewood, CO, December 14, 2011.
Learning from escaped prescribed fire reviews. U.S. Fish & Wildlife Service National Fuels Meeting, January 25, 2012.
NWCG Fuels Management Committee, Boise, ID, February 2, 2012.
U.S. Forest Service National Fuels Group. March 29, 2012.
Black, A.; Thomas, D.; Saveland, J.; Ziegler, J.D. 2011. Learning from escaped prescribed fire reviews. 11th International Wildland Fire Safety Summit, Missoula, MT, April 4-8, 2011.
Black, A.E.; J.Ziegler; J. Saveland; D. Thomas. 2012. Learning as a shared responsibility: Insights about escaped prescribed fire reviews. (Presentation) 3rd Human Dimensions in Wildland Fire Conference, International Association of Wildland, Seattle, WA, April 17-19, 2012. Also: 12th International Wildland Fire Safety Summit, Sydney, Australia, Oct 25-26, 2012.
Ziegler, J., A.E. Black. 2012. Pleasing some of the people some of the time: How authors, subjects, and readers assess the complex landscape of audience in wildland fire incident reviews (Presentation). 3rd Human Dimensions in Wildland Fire Conference, International Association of Wildland, Seattle, WA, April 17-19, 2012.
Black, A.E. 2012. Tips, techniques, and suggestions for improving learning from escaped prescribed fire reviews (Poster). 3rd Human Dimensions in Wildland Fire Conference, International Association of Wildland, Seattle, WA, April 17-19, 2012.
Part 7: Stories Are Not Sterilized
Black, A.E.; Ziegler, J.; Thomas, D. 2011. Learning from escaped prescribed fire reviews: Workshop flip chart summary. 9p.
Black, A.E.; Ziegler, J.; Thomas, D. 2011. Learning from escaped prescribed fire reviews: Workshop discussion summary. 11p.
Black, A.E.; Thomas, D.; Saveland, J. 2011. Learning from escaped prescribed fire reviews: Initial findings. 2p.