A New Method for Combined Hyperventilation and Hypoxia Training in a Tactical Fighter Simulator.

INTRODUCTION: Physiological episodes are an issue in military aviation. Some non-pressure-related in-flight symptoms are proved to be due to hyperventilation rather than hypoxia. The aim of this study was to validate a new training method provoking hyperventilation during normobaric hypoxia (NH) training in an F/A-18 Hornet simulator.METHODS: In a double-blind setting, 26 fighter pilots from the Finnish Air Force performed 2 setups in a WTSAT simulator in randomized order with full flight gear. Without the pilot's knowledge, 6% O2 in nitrogen or 6% O2 + 4% CO2 in nitrogen was turned on. Ventilation (VE) was measured before, during, and after hypoxia. Spo2 and ECG were monitored and symptoms documented. The subjects performed a tactical identification flight until they recognized symptoms of hypoxia. Thereafter, they performed hypoxia emergency procedures with 100% O2 and returned to the base with a GPS malfunction and executed an instrument landing system (ILS) approach with the waterline HUD mode evaluated by the flight instructor on a scale of 1 to 5.RESULTS: Ventilation increased during normobaric hypoxia (NH) from 12 L · min-1 to 19 L · min-1 at Spo2 75% with 6% O2, and from 12 L · min-1 to 26 L · min-1 at Spo2 77% with 6% O2 + 4% CO2. ILS flight performance was similar 10 min after combined hyperventilation and hypoxia (3.1 with 6% O2 + 4% CO2 and 3.2 with 6% O2). No adverse effects were reported during the 24-h follow-up.DISCUSSION: Hyperventilation-provoking normobaric hypoxia training is a new and well-tolerated method to meet NATO Standardization Agreement hypoxia training requirements.Leinonen AM, Varis NO, Kokki HJ, Leino TK. A new method for combined hyperventilation and hypoxia training in a tactical fighter simulator. Aerosp Med Hum Perform. 2022; 93(9):681-687.

A comparison of general aviation accidents involving airline pilots and instrument-rated private pilots.

INTRODUCTION: The extremely low accident rate for U.S air carriers relative to that of general aviation (∼1 and ∼60/million flight hours respectively) partly reflects advanced airman certification, more demanding recurrency training and stringent operational regulations. However, whether such skillset/training/regulations translate into improved safety for airline pilots operating in the general aviation environment is unknown and the aim of this study. METHODS: Accidents (1998-2017) involving airline pilots and instrument-rated private pilots (PPL-IFR) operating non-revenue light aircraft were identified from the NTSB accident database. An online survey informed general aviation flight exposure for both pilot cohorts. Statistics used proportion testing and Mann-Whitney U tests. RESULTS: In degraded visibility, 0 and 40% (χ2p = 0.043) of fatal accidents involving airline and PPL-IFR airmen were due to in-flight loss-of-control, respectively. For landing accidents, airline pilots were under-represented for mishaps related to airspeed mismanagement (p = 0.036) relative to PPL-IFR but showed a dis-proportionate count (2X) of ground loss-of-directional control accidents (p = 0.009) the latter likely reflecting a preference for tail-wheel aircraft. The proportion of FAA rule violation-related mishaps by airline pilots was >2X (7 vs. 3%) that for PPL-IFR airmen. Moreover, airline pilots showed a disproportionate (χ2p = 0.021) count of flights below legal minimum altitudes. Not performing an official preflight weather briefing or intentionally operating in instrument conditions without an IFR flight plan represented 43% of airline pilot accidents involving FAA rule infractions. CONCLUSIONS: These findings inform safety deficiencies for: (a) airline pilots, landing/ground operations in tail-wheel aircraft and lack of 14CFR 91 familiarization regulations regarding minimum operating altitudes and (b) PPL-IFR airmen in-flight loss-of-control and poor landing speed management. Practical Applications: For PPL-IFR airmen, training/recurrency should focus on unusual attitude recovery and managing approach speeds. Airline pilots should seek additional instructional time regarding landing tail-wheel aircraft and become familiar with 14CFR 91 rules covering minimum altitudes.

Spatial Disorientation Survey Among Military Pilots.

BACKGROUND: Spatial disorientation (SD) remains a significant cause of accidents and near accidents. A variety of training methods have been used to assist pilots to anticipate the SD problem. The value of such training in the prevention of disorientation has been difficult to assess.METHODS: To study transfer of SD awareness training, we related reported incidents to the content and frequency of SD awareness training received. The questionnaire was completed by 368 out of 495 pilots; 189 currently flying fixed-wing, and 150 flying rotary-wing aircraft. On average, their age was 38, and they had 2466 flight hours on-type.RESULTS: Respondents gave high ratings for the importance of SD training and their awareness of SD, the latter being one of the training objectives. The amount of SD training received by respondents was positively correlated with ratings for appreciation and importance. Self-rated awareness was positively correlated with the number of reported SD experiences. Although the correlations were below 0.50, the results provide an indication that SD training is effective. In total, respondents reported 5773 SD experiences, 195 of them resulting in a serious risk for flight safety. Narratives of these serious events show that, in many cases, pilots managed their SD by carefully checking the flight instruments, and also by good crew coordination.DISCUSSION: The results of the survey provide some evidence, although based on subjective reports, for transfer of SD training. The results of the SD experiences can be used to improve the SD training in terms of content and frequency.Pennings HJM, Oprins EAPB, Wittenberg H, Houben MMJ, Groen EL. Spatial disorientation survey among military pilots. Aerosp Med Hum Perform. 2020; 91(1):4-10.

The instructor assistant system (iASSYST) - utilizing eye tracking for commercial aviation training purposes.

This work investigates the potential of providing commercial aviation flight instructors with an eye tracking enhanced observation system to support the training process. During training, instructors must deal with many parallel tasks, such as operating the flight simulator, acting as air traffic controllers, observing the pilots and taking notes. This can cause instructors to miss relevant information that is crucial for debriefing the pilots. To support instructors, the instructor ASsistant SYSTem (iASSYST) was developed. It includes video, audio, simulator and eye tracking recordings. iASSYST was evaluated in a study involving 7 instructors. The results show that with iASSYST, instructors were able to support their observations of errors, find new errors, determine that some previously identified errors were not errors, and to reclassify the types of errors that they had originally identified. Instructors agreed that eye tracking can help identifying causes of pilot error. Practitioner summary: This paper introduces an instructor assistant system, which is evaluated in a user study involving 7 airline flight instructors. The system can be used by airline flight instructors to complement their observations, as a basis for discussions with pilots during debriefing, and by airline pilots to improve their flight performance.

ACTN-3 Genotype, Body Composition, Fitness, and +Gz Tolerance in Senior Cadets.

BACKGROUND: This study aimed to investigate the relationships among ACTN-3, body composition, fitness, and +Gz tolerance for senior cadet training development and their safe task performance.METHODS: The subjects were all senior cadets (N = 68) at the Korea Air Force Academy. All cadets are required to pass a physical fitness test (3-km running, sit-ups, push-ups) and body composition test on a semiannual basis. Isokinetic muscle function (strength and endurance), +Gz test (+6 Gz ⋅ 30 s-1), and target gene (ACTN-3) were analyzed.RESULTS: The effects of body composition and physical fitness along with the relationship of the ACTN-3 genotype to the +6 Gz test results were determined. Consequently, no significant difference was found concerning the effect of ACTN-3 on the +6 Gz test result, body composition, and physical fitness; however, body fat (%) and isokinetic muscle strength (peak torque right leg extension and left leg flexion) showed significance between the pass and failure groups in the +Gz test.DISCUSSION: The cadets of the Korea Air Force Academy showed dominant fast genetic expression type based on their ACTN-3 genotype [RR and RX (N = 51, 75%) > XX (N = 17, 25%)]. Body fat (%) and isokinetic muscle strength (PT R EX, L FL) can be more effective predictors in the +6 Gz test for cadet training. Another speculation is that more RR- and RX-type-oriented training can promote cadets' Gz tolerance from the isokinetic factors such as high peak torque and low fatigue index.Shin S, Jee H. ACTN-3 genotype, body composition, fitness, and +Gz tolerance in senior cadets. Aerosp Med Hum Perform. 2019; 90(12):1055-1060.

Squamous Cell Papilloma in a Student Aviator.

BACKGROUND: Although oropharyngeal squamous cell papilloma (OSCP) is not uncommon in the general population, reports of OSCP in aviators are rare. This case report serves as a call for flight surgeons to consider all oropharyngeal pathology as a potential source of airway compromise during flight, and highlights regional risk factors for developing malignancies of the oropharynx.CASE REPORT: A 24-yr-old male foreign national student aviator from a central Asian country was at Fort Rucker for flight training. He presented to the clinic with a chief complaint of sore throat and cough for 2 d. He was afebrile but reported a history of a "throat" mass which was previously evaluated by a U.S. military otolaryngologist. Said mass was approximately 0.5 cm × 0.5 cm, irregular appearing, inflamed, and protruding from the inferior aspect of the right tonsil. Previous biopsy report revealed a squamous cell papilloma and, after consideration of the pilot's training program, active surveillance of the lesion was mutually agreed upon until the student's training had concluded and definitive excision was performed.DISCUSSION: A robust history and physical exam including an occupational, social, and environmental exposure history is crucial to diagnosis. Foreign national patients often have unique backgrounds that merit consideration when developing a differential diagnosis, assessment, and plan. In the field of Flight Medicine, a patient's occupational demands are essential to his or her care. In particular, any potential obstruction of the airway during flight must be considered, even if a pathology does not represent an immediate threat to the pilot's health.Swinson K, Burlile J, Pavelites J. Squamous cell papilloma in a student aviator. Aerosp Med Hum Perform. 2019; 90(11):978-981.

Success Rates at an Air Force Pilot Academy and Its Relation to Methylphenidate Use.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a chronic neurological disorder characterized by persistent patterns of inattention, impulsivity, and hyperactivity. The most common treatment for this disorder is methylphenidate, which is a disqualifying medication for flight. Candidates with previous use of methylphenidate are not necessarily disqualified from the Israeli Air Force (IAF) flight academy.METHODS: Flight cadets from 12 consecutive flight courses who have used methylphenidate at least once in the past were identified according to their medical records. The graduation ratio of cadets with previous use of methylphenidate was compared with that of the rest of the cadets. A comparison was also made with regard to the causes of disqualification from the flight course. Statistical significance was assessed using the Fischer Test.RESULTS: Among the 90 flight cadets who have used methylphenidate, only 2 (2.2%) successfully graduated from the IAF flight academy. Among the 2983 flight cadets who have no history of methylphenidate use, 461 (15.4%) successfully graduated. We found no significant differences in the disqualification causes between the two groups.CONCLUSION: The IAF flight academy graduation rate was meaningfully and significantly lower among cadets who reported previous use of methylphenidate. The study design, however, limits the inference of causal relationship.Sarfati S, Nakdimon I, Tsodyks J, Assa A, Gordon B. Success rates at an air force pilot academy and its relation to methylphenidate use. Aerosp Med Hum Perform. 2019; 90(9):788-791.

Recurrent Middle Ear Barotrauma in Student Pilots.

INTRODUCTION: The present study evaluated the efficacy of the nine-step inflation-deflation tympanometric test for predicting recurrence of middle ear barotrauma.METHODS: Student pilots who were diagnosed with middle ear barotrauma from October 2010 to April 2011 were enrolled. The grade of barotrauma was assigned using Teed's classification. All subjects underwent tympanometry and nine-step inflation-deflation testing at first visit and after improvement. Recurrence was monitored for 2 wk after they resumed flight. The relationships among the recurrence of middle ear barotrauma, the grade and duration of disease, and tympanometric and nine-step test results were evaluated.RESULTS: There were 35 cases enrolled. According to Teed's classification, 16 cases were Grade 0 (45.7%) and 11 cases were Grade I (31.4%). Grade III was shown in seven cases (20.0%) and one subject was Grade IV (2.9%). The mean duration of illness was 5.9 d. In the initial 9-step tests, 29 subjects (85.3%) failed to pass the entire test. On follow-up tests, eight cases (22.9%) failed. Seven pilots (20.0%) showed recurrent middle ear barotrauma after resumed flight. All of the cases with recurrence failed the follow-up nine-step tests. The nine-step test showed high sensitivity and specificity values for predicting recurrence. A clear correlation was observed between recurrence and nine-step test results.DISCUSSION: The nine-step inflation-deflation test provides useful information about Eustachian tube function. The nine-step test can be useful to reduce the risk of recurrence of middle ear barotrauma in pilots.Sohn JH. Recurrent middle ear barotrauma in student pilots. Aerosp Med Hum Perform. 2019; 90(8):681-687.

Hypoxia Hangover and Flight Performance After Normobaric Hypoxia Exposure in a Hawk Simulator.

INTRODUCTION: The incidence of hypoxia-like symptoms in military aviators is on the rise. Cases can be related to On-Board Oxygen Generating System (OBOGS) malfunction, air contamination, loss of cabin pressurization, hyperventilation, or a combination of these issues simultaneously. Normobaric hypoxia training in tactical fighter simulations has been conducted in the Finnish Air Force since 2008. This training helps aviators to recognize their individual hypoxia symptoms and refreshes hypoxia emergency procedures in a realistic cockpit.METHODS: A flight mission included three set-ups and a return to base (RTB) after the third set-up. In a tactical Hawk simulator, different concentrations of oxygen were used (8%, 7%, and 6% oxygen in nitrogen) to create normobaric hypoxia exposures. During the RTB, the flight instructor evaluated the subjects' flight performance (N = 16) in order to estimate cognitive functions after hypoxia. A control flight was evaluated before or after the flight with normobaric hypoxia exposure.RESULTS: Instrumental flight rule performance during RTB decreased significantly from 4.81 to 3.63 after normobaric hypoxia and emergency procedures. Some pilots reported fatigue, headache, memory problems, and cognitive impairment as adverse effects up to 12 h after normobaric hypoxia training.DISCUSSION: Hypoxia has a significant effect on flight performance during RTB, even 10 min after hypoxia emergency procedures. Since 100% oxygen was used as emergency oxygen, as in a real aircraft, the oxygen paradox may decrease flight performance. Hypoxia training in tactical fighter simulations provides an opportunity for pilots to also understand the effects of the "hypoxia hangover" on their flight performance.Varis N, Parkkola KI, Leino TK. Hypoxia hangover and flight performance after normobaric hypoxia exposure in a Hawk simulator. Aerosp Med Hum Perform. 2019; 90(8):720-724.

Training and assessment of non-technical skills in Norwegian helicopter emergency services: a cross-sectional and longitudinal study.

BACKGROUND: Deficient non-technical skills (NTS) among providers of critical care in helicopter emergency medical services (HEMS) is a threat to patient and operational safety. Skills can be improved through simulation-based training and assessment. A previous study indicated that physicians underwent less frequent training compared to pilots and HEMS crew members (HCM) and that all professional groups in Norwegian HEMS received limited training in how to cope with fatigue. Since then, training initiatives and a fatigue risk management project has been initiated. Our study aimed to explore if the frequency of simulation-based training and assessment of NTS in Norwegian HEMS has changed since 2011 following these measures. METHODS: A cross-sectional web-based survey from October through December 2016, of physicians, HCM and pilots from all civilian Norwegian HEMS-bases reporting the overall extent of simulation-based training and assessment of NTS. RESULTS: Of 214 invited, 109 responses were eligible for analysis. The frequency of simulation-based training and assessment of NTS has increased significantly for all professional groups in Norwegian HEMS, most prominently for the physicians. For all groups, the frequency of assessment is generally lower than the frequency of training. CONCLUSIONS: Physicians in Norwegian HEMS seem to have adjusted to the NTS training culture of the other crew member groups. This might be a consequence of improved NTS training programs. The use of behavioural marker systems systematically in HEMS should be emphasized.

Psychophysiological response of different aircrew in normobaric hypoxia training.

Hypoxia remains the most important hazard in high altitude flights, but there is still a need for deeper analysis of the effect of hypoxia exposition in the psychophysiological and cognitive functions. The aim of this study was to study the effect of hypoxia training in cortical arousal, autonomic modulation, muscle strength and cognitive function. We analysed 23 male aircrew personnel of the Spanish Army and Air Force (10 Helicopter Pilots, 7 Transport Aircrew, 3 Transport Pilots and 3 F-18 Fighter Pilots) before, during and after a normobaric hypoxia exposition. Hypoxia produced an increase in perceived stress and effort, a higher Heart Rate and a decreased function of breath muscles. Working memory and pattern recognition were impaired after hypoxia exposition. Significant differences were found in cognitive tests performance among aircrew groups, suggesting differences on their previous training. These results can improve specific training for better preparation of pilots and aircrews for hypoxic threats. Practitioner summary: Distinct aircrew preparation produces a different hypoxia exposition effect on psychophysiological response and cognitive functions. Hypoxia produced an increase in Heart Rate, a decreased function of breath muscles, being more negatively affected in Transport Pilots. Cognition abilities were impaired after hypoxia exposition, independently of the aircrew group.

Eye tracking as a debriefing tool in upset prevention and recovery training (UPRT) for general aviation pilots.

Upset prevention and recovery training (UPRT) is intended to improve the ability of pilots to recognize and avoid situations that can lead to airplane upsets and to improve their ability to recover control of an airplane that has exceeded the normal flight envelope. To this end, a set of different training contents - from theoretical knowledge of aerodynamics and human factors to practice-based flight training - is necessary. In order to support the debriefing with an objective feedback, and because visual scanning is a core competence, two studies on subjective evaluation of aviation pilots - one conducted in a flight simulator and the other one in-flight - focussed on the practical application of eye tracking as a debriefing tool in UPRT. From a practitioner's perspective, eye tracking appeared to be a useful method in terms of visualising instrument scanning techniques, supporting the instructor with objective debriefing material and fostering self-awareness in human processes. The discussion recommends adjusted UPRT instructor training and further improvements to eye tracking hardware and software. Practitioner Summary: The article focuses on pilot evaluations of eye tracking as a debriefing tool in UPRT and the identification of critical elements in its use. Eye tracking is a promising debriefing tool for UPRT. The discussion points to desirable improvements of eye tracking hardware and software as well as adjustments to instructor training that are pertinent.

A comparative study on the frequency of simulation-based training and assessment of non-technical skills in the Norwegian ground ambulance services and helicopter emergency medical services.

BACKGROUND: Inadequate non-technical skills (NTSs) among employees in the Norwegian prehospital emergency medical services (EMSs) are a risk for patient and operational safety. Simulation-based training and assessment is promising with respect to improving NTSs. The frequency of simulation-based training in and assessment of NTSs among crewmembers in the Norwegian helicopter emergency medical service (HEMS) has gained increased attention over recent years, whereas there has been much less focus on the Norwegian ground emergency medical service (GEMS). The aim of the study was to compare and document the frequencies of simulation-based training in and assessment of seven NTSs between the Norwegian HEMS and GEMS, conditional on workplace and occupation. METHOD: A comparative study of the results from cross-sectional questionnaires responded to by employees in the Norwegian prehospital EMSs in 2016 regarding training in and assessment of NTSs during 2015, with a focus on the Norwegian GEMS and HEMS. Professional groups of interest are: pilots, HEMS crew members (HCMs), physicians, paramedics, emergency medical technicians (EMTs), EMT apprentices, nurses and nurses with an EMT licence. RESULTS: The frequency of simulation-based training in and assessment of seven generic NTSs was statistically significantly greater for HEMS than for GEMS during 2015. Compared with pilots and HCMs, other health care providers in GEMS and HEMS undergo statistically significantly less frequent simulation-based training in and assessment of NTSs. Physicians working in the HEMS appear to be undergoing training and assessment more frequently than the rest of the health trust employees. The study indicates a tendency for lesser focus on the assessment of NTSs compared to simulation-based training. CONCLUSION: HEMS has become superior to GEMS, in terms of frequency of training in and assessment of NTSs. The low frequency of training in and assessment of NTSs in GEMS suggests that there is a great potential to learn from HEMS and to strengthen the focus on NTSs. Increased frequency of assessment of NTSs in both HEMS and GEMS is called for.

Training Pilots for Unexpected Events: A Simulator Study on the Advantage of Unpredictable and Variable Scenarios.

OBJECTIVE: This study tested whether simulator-based training of pilot responses to unexpected or novel events can be improved by including unpredictability and variability in training scenarios. BACKGROUND: Current regulations allow for highly predictable and invariable training, which may not be sufficient to prepare pilots for unexpected or novel situations in-flight. Training for surprise will become mandatory in the near future. METHOD: Using an aircraft model largely unfamiliar to the participants, one group of 10 pilots (the unpredictable and variable [U/V] group) practiced responses to controllability issues in a relatively U/V manner. A control group of another 10 pilots practiced the same failures in a highly predictable and invariable manner. After the practice, performance of all pilots was tested in a surprise scenario, in which the pilots had to apply the learned knowledge. To control for surprise habituation and familiarization with the controls, two control tests were included. RESULTS: Whereas the U/V group required more time than the control group to identify failures during the practice, the results indicated superior understanding and performance in the U/V group as compared to the control group in the surprise test. There were no significant differences between the groups in surprise or performance in the control tests. CONCLUSION: Given the results, we conclude that organizing pilot training in a more U/V way improves transfer of training to unexpected situations in-flight. APPLICATION: The outcomes suggest that the inclusion of U/V simulator training scenarios is important when training pilots for unexpected situations.

Learning flight procedures by enacting and receiving feedback.

Learning flight procedures is part of any pilot training. The conventional learning method consists in learning and practicing the procedure written on a sheet of paper along with printed images of the cockpit. The purpose of the present paper was to test the efficiency of a tactile interactive multimedia training tool designed to foster the self-regulated learning of flight procedures, especially through enacting relevant gestures and providing feedback. Results showed that learning with this tool did not lead to significant shorter learning times than with the conventional learning. However, on a delayed retention test in a real A320 cockpit simulator, learners of the experimental group performed the procedure more rapidly than those of the control group. Results suggested that a training tool that incites learners to perform similar gestures than those in the real environment and that provides feedback, helped learners to transform declarative into procedural knowledge.

Arabian, Asian, western: a cross-cultural comparison of aircraft accidents from human factor perspectives.

INTRODUCTION: Rates of aviation accident differ in different regions; and national culture has been implicated as a factor. This invites a discussion about the role of national culture in aviation accidents. This study makes a cross-cultural comparison between Oman, Taiwan and the USA. METHOD: A cross-cultural comparison was acquired using data from three studies, including this study, by applying the Human Factors Analysis and Classification System (HFACS) framework. The Taiwan study presented 523 mishaps with 1762 occurrences of human error obtained from the Republic of China Air Force. The study from the USA carried out for commercial aviation had 119 accidents with 245 instances of human error. This study carried out in Oman had a total of 40 aircraft accidents with 129 incidences. RESULTS: Variations were found between Oman, Taiwan and the USA at the levels of organisational influence and unsafe supervision. Seven HFACS categories showed significant differences between the three countries (p < 0.05). CONCLUSION: Although not given much consideration, national culture can have an impact on aviation safety. This study revealed that national culture plays a role in aircraft accidents related to human factors that cannot be disregarded.

Differences in Multitask Resource Reallocation After Change in Task Values.

OBJECTIVE: The objective was to characterize multitask resource reallocation strategies when managing subtasks with various assigned values. BACKGROUND: When solving a resource conflict in multitasking, Salvucci and Taatgen predict a globally rational strategy will be followed that favors the most urgent subtask and optimizes global performance. However, Katidioti and Taatgen identified a locally rational strategy that optimizes only a subcomponent of the whole task, leading to detrimental consequences on global performance. Moreover, the question remains open whether expertise would have an impact on the choice of the strategy. METHOD: We adopted a multitask environment used for pilot selection with a change in emphasis on two out of four subtasks while all subtasks had to be maintained over a minimum performance. A laboratory eye-tracking study contrasted 20 recently selected pilot students considered as experienced with this task and 15 university students considered as novices. RESULTS: When two subtasks were emphasized, novices focused their resources particularly on one high-value subtask and failed to prevent both low-value subtasks falling below minimum performance. On the contrary, experienced people delayed the processing of one low-value subtask but managed to optimize global performance. CONCLUSION: In a multitasking environment where some subtasks are emphasized, novices follow a locally rational strategy whereas experienced participants follow a globally rational strategy. APPLICATION: During complex training, trainees are only able to adjust their resource allocation strategy to subtask emphasis changes once they are familiar with the multitasking environment.

The Effectiveness of Simulator Motion in the Transfer of Performance on a Tracking Task Is Influenced by Vision and Motion Disturbance Cues.

OBJECTIVE: To examine the importance of platform motion to the transfer of performance in motion simulators. BACKGROUND: The importance of platform motion in simulators for pilot training is strongly debated. We hypothesized that the type of motion (e.g., disturbance) contributes significantly to performance differences. METHODS: Participants used a joystick to perform a target tracking task in a pod on top of a MOOG Stewart motion platform. Five conditions compared training without motion, with correlated motion, with disturbance motion, with disturbance motion isolated to the visual display, and with both correlated and disturbance motion. The test condition involved the full motion model with both correlated and disturbance motion. We analyzed speed and accuracy across training and test as well as strategic differences in joystick control. RESULTS: Training with disturbance cues produced critical behavioral differences compared to training without disturbance; motion itself was less important. CONCLUSION: Incorporation of disturbance cues is a potentially important source of variance between studies that do or do not show a benefit of motion platforms in the transfer of performance in simulators. APPLICATION: Potential applications of this research include the assessment of the importance of motion platforms in flight simulators, with a focus on the efficacy of incorporating disturbance cues during training.

[Psychophysiological methods to support pilots training in the flight simulator].

Psychophysiological methods to support pilots training in the flight simulator. Despite the fact that the pilot performance in commercial and state aviation has some differences the same methodology and training philosophy are used in the organization of flight simulator training. The article presents the results of adaptation of psychophysiological methods to support flight simulator training for pilots of civil aviation, developed for military pilots. It is shown that the existing system for assessing pilots training in flight simulator, which is one of the most important stages of flight training for aviation, is not a sufficient level of objectification. It has been suggested to use psychophysiological inflight monitoring for integrated assessment of skills development along with instructor's assessment. Psychophysiological monitoring included such indices as residual attention and stress index for assessing pilot physiological activity, which enables the instructor to choose the strategies for further training.

Should Charity Air Medical Organizations Require Commercial Certification of Their Pilots?

OBJECTIVE: Fixed wing medical transportation crashes operating under 14 CFR Part 91 show higher fatal outcomes than nonmedical Part 91 flights. Advanced certification may translate into increased safety, yet we know of no charity air medical transportation requiring such certification. Herein, in a retrospective study, we determined whether commercial certification is associated with a reduced fatality rate compared with the less stringent private pilot certificate and accident causes. METHODS: The National Transportation Safety Board accident database was queried for fatal accidents in single-engine aircraft occurring between 2002 and 2012. Poisson and proportion tests were used in statistical analyses. RESULTS: For the period spanning 2002-2012, commercial pilots showed a lower fatality rate. Under visual meteorologic conditions, aerodynamic stall was a frequent cause for fatal accidents affecting both airman cohorts equally. For operations in instrument meteorologic conditions, fatal accidents were most commonly attributed to instrument approach deficiency and spatial disorientation. At night, failure to maintain obstacle/terrain clearance was the most prevalent cause of fatal crashes. CONCLUSION: Our data suggest that charity air medical transportation organizations should encourage their pilots to acquire commercial certification. Furthermore, our study indicates areas in which general aviation training/currency should be directed to reduce fatal accidents.