While observing surgeons, use CUSS for graded assertiveness:

1. I am Concerned about what you’re doing
2. I don’t Understand why you are doing what you’re doing
3. I am Seriously worried about what you’re doing
4. Please Stop what you are doing

In 1977, KLM Flight 4805 and Pan Am Flight 1736 collided on the runway in Tenerife, killing 583 people, the deadliest airplane accident in history. Captain Veldhuyzen van Zanten, KLM’s chief of flight training, and one of their most senior pilots took off without clearance, smashing into the other 747 on the runway. In 2009, Captain Chesley “Sully” Sullender landed a crippled airplane on the Hudson River, with no loss of life. In the former, other crew members were reluctant to question the captain. They died. In the latter, the team concentrated on doing the right thing at the right time. They lived.