Michael T. Curtis

Judicious use of simulation technology in continuing medical education

&NA; Use of simulation‐based training is fast becoming a vital source of experiential learning in medical education. Although simulation is a common tool for undergraduate and graduate medical education curricula, the utilization of simulation in continuing medical education (CME) is still an area of growth. As more CME programs turn to simulation to address their training needs, it is important to highlight concepts of simulation technology that can help to optimize learning outcomes. This article discusses the role of fidelity in medical simulation. It provides support from a cross section of simulation training domains for determining the appropriate levels of fidelity, and it offers guidelines for creating an optimal balance of skill practice and realism for efficient training outcomes. After defining fidelity, 3 dimensions of fidelity, drawn from the human factors literature, are discussed in terms of their relevance to medical simulation. From this, research‐based guidelines are provided to inform CME providers regarding the use of simulation in CME training.

The Visual Approach: Evaluating the Relative Impact of Perceptual and Conceptual Training

The design of optimal training for complex systems can be a difficult problem. Generally, one of three types of training is used to train for a specific task – procedural, conceptual or perceptual training. In aviation, procedural training has been the primary form of training. However, procedural training does not always train all the skills needed for effective flying. This study evaluates the impact of perceptual and conceptual training on a particular aviation maneuver, the visual approach. A visual approach is an approach and landing technique that can be executed under visual flight rules (VFR). In this approach, the pilot does not rely on his or her instrumentation to execute the approach. Rather, the pilot uses a visual out-thecockpit reference to the runway to safely guide the aircraft to the ground. There are two keys to achieving a stabilized approach. First is maintenance of glideslope. Glideslope is the angle at which the aircraft descends onto the runway. For commercial aircraft, the recommended glideslope is 3°, although this can differ for a non-standard approach. Second is an understanding of the concept of energy management. During an approach there are speed restrictions below certain altitudes. Improper management of factors like speed and/or altitude can lead to the aircraft being too high and/or too fast to complete the landing safely. The researchers developed two different training methods, one that focuses on perceptual discrimination and one that focuses on conceptual knowledge. Most perceptual training focuses on repeatedly exposing individuals to task-relevant perceptual stimuli. One alternative to strict exposure training to achieve perceptual learning is discrimination training (see, e.g., Curtis, Maraj, Ritman & Jenstch, 2010; Curtis, Schuster, Jentsch, Harper-Sciarini & Swanson, 2008). Discrimination training is a method in which individuals are presented with two stimuli either simultaneously or in succession. The task is to compare the images based on relevant cues and determine whether they are the same or different. Because the training is composed of comparisons between two images, the individual receives twice as much exposure to the stimuli in a fixed period of time. Further, the focus on comparison reduces memory load and simultaneously helps individuals develop strategies to identify relevant cues and ignore irrelevant ones. The second approach focused on conceptual training, which has been shown to be effective in training pilots for crew resource management (for a description of these programs, see Helmreich, Merritt, & Wilhelm, 1999) and automation (e.g., Boehm-Davis, Smith & Prada, 2009). The effectiveness of conceptual training in these instances may be due to the fact that the use of rote procedures may not adequately support the development of a robust mental model of the system. In fact, Sarter and Woods (1994) have demonstrated that errors often occur when the pilot does not understand how the system operates. Therefore, providing training that supplements procedures with precise information on how the system works should help to reduce errors and improve performance. The experiment examined the performance of pilots who received the perceptual discrimination training, conceptual training, or both forms of training against a control condition, where pilots did not receive any training. The results indicate that pilots who received the perceptual discrimination training or both the perceptual and conceptual training performed better on a perceptual evaluation task than pilots who received just the conceptual training. There were no significant performance differences on the conceptual evaluation task between the various training groups. This may be due to the high experience levels of the pilots who participated in this study. More experienced pilots are more likely to already have knowledge of the visual approach concepts included in the training; a significant effect might be observed with less experienced pilots. Overall the results support the notion that different types of training are more effective for specific types of performance and that the type of training delivered should be matched to the demands of the task.

Human Factors in Aviation: An Overview

This edited textbook is a fully updated and expanded version of the highly successful first edition of Human Factors in Aviation. Written for the widespread aviation community - students, engineers, scientists, pilots, managers, government personnel, etc., HFA offers a comprehensive overview of the topic, taking readers from the general to the specific, first covering broad issues, then the more specific topics of pilot performance, human factors in aircraft design, and vehicles and systems. The new editors offer essential breath of experience on aviation human factors from multiple perspectives (i.e. scientific research, regulation, funding agencies, technology, and implementation) as well as knowledge about the science. The contributors are experts in their fields. Topics carried over from the first edition are fully updated, several by new authors who are now at the fore of the field. New material - which represents 50% of the volume - focuses on the challenges facing aviation specialists today. One of the most significant developments in this decade has been NextGen, the Federal Aviation Administrations plan to modernize national airspace and to address the impact of air traffic growth by increasing airspace capacity and efficiency while simultaneously improving safety, environmental impacts and user access. NextGen issues are covered in full. Other new topics include: High Reliability Organizational Perspective, Situation Awareness & Workload in Aviation, Human Error Analysis, Human-System Risk Management, LOSA, NOSS and Unmanned Aircraft System. *Comprehensive text with up-to-date synthesis of primary source material that does not need to be supplemented *New edition thoroughly updated with 50% new material and full coverage of NexGen and other modern issues *Instructor website with test bank and image collection makes this the only text offering ancillary support *Liberal use of case examples exposes readers to real-world examples of dangers and solutionsPublisher Summary At any point in the history of human factors in aviation, one could characterize its current state at that time by the progress that had been made and by the opportunities that presented themselves for the future. Keeping this in mind, this chapter aims to provide a brief snapshot of aviation human factors. It first highlights a few brief themes that show the progress that has been made in aviation research. Following this, it discusses the opportunities that human factors professionals, pilots, instructors, maintenance personnel, air traffic controllers, and interested parties in general are presented with currently to drive future generations of aviation. The chapter orients the reader to the causes and effects that guide the cutting edge of the field now.

The influence of camouflage, obstruction, familiarity and spatial ability on target identification from an unmanned ground vehicle

The purpose of this study was to examine the effects of environmental and cognitive factors on the identification of targets from an unmanned ground vehicle (UGV). This was accomplished by manipulating obstruction, camouflage and familiarity of objects in the environment, while also measuring spatial ability. The effects of these variables on target identification were studied by measuring performance of participants that observed pre-recorded video from a 1:35 scaled military operations in urban terrain facility. Analyses indicated that a combination of camouflage and obstruction caused the most detrimental effects on performance, and that there were differences in the recognition of familiar and unfamiliar targets. Further analysis indicated that these detrimental effects could only be overcome with a combination of target familiarity and spatial ability. The findings highlight the degree to which environmental factors hinder performance and the need for a multidimensional approach for improving performance under these conditions. Areas in need of future research are also discussed. Practitioner Summary: Cognitive theory is applied to the problem of perception from UGVs. Results from an experimental study indicate that a combination of camouflage and obstruction caused the most detrimental effects on performance, with differences in the recognition of both familiar and unfamiliar targets. Familiarity and spatial ability interacted to predict the performance.

Effects of 2-Dimensional and 3-Dimensional Media Exposure Training in a Tank Recognition Task:

This investigation explores the differences between two types of military vehicle training: a current training method (2-dimensional, military-issued cards) and a novel method using 3-dimensional 1:35 scale models. Participant performance was tested in 3 areas: an identification task (can you name this vehicle?), a recognition task (have you seen this vehicle before?) and a friend/foe differentiation task. All three tasks were tested in both two dimensions (Training cards) and three dimensions (1:35 models). The performance results of the tasks support the integration of 3D training.

Familiarity and Expertise in the Recognition of Vehicles from an Unmanned Ground Vehicle

The purpose of this study was to examine the role of familiarity and expertise in remote perception from unmanned ground vehicles (UGVs). Fifty-two volunteers, of whom 23 were Army ROTC cadets, participated. They were first asked to identify vehicles on a written test, and scores from the test were used to predict the amount of information reported from a video recording, captured from a UGV camera, in a scaled MOUT facility. ROTC cadets are compared with the general subject pool in order to explore differences between civilian and military vehicle recognition. Results from a written vehicle recognition test indicate that all participants were most familiar with civilian vehicles and ROTC cadets were more familiar with military vehicles than the general population. Regression analyses revealed that both ROTC experience and vehicle familiarity were predictive of the amount of information correctly reported from the UGV camera video. We believe that training for expertise and motivation should be considered for future research.

Demonstration: Advancing Robotics Research Through the Use of a Scale Mout Facility

This demonstration serves as an introduction to the CARAT scale MOUT (Military Operation in Urban Terrain) facility developed at the Team Performance Laboratory (TPL) at the University of Central Florida (UCF). Advances in automated military vehicles require research to understand how best to allocate control of these vehicles. Whether, discussing uninhabited ground vehicles (UGVs) or air vehicles (UAVs), many questions still exist as to the optimum level of performance with respect to the ratio of human controls to vehicles. The scale MOUT facility at UCF allows researchers to investigate these issues without sacrificing large costly equipment and without requiring vast physical areas, within which to test such equipment. This demonstration provides an introduction to the scale MOUT facility, describes the basic need for this tool, presents its advantages over full size counterparts, as well as several other possible uses for the facility.

Simulation in aviation training

Contents: Introduction Part I Using Simulation for Training: Aircraft simulation and pilot training, Paul W. Caro Adopting the instructional science paradigm to encompass in virtual environments, D. Dorsey, G. Campbell and S. Russell Its not how much you have but how you use it: toward a rational use of simulation to support aviation training, Eduardo Salas, Clint A. Bowers and Lori Rhodenizer Rapidly reconfigurable event-set based line operational evaluation scenarios, Clint Bowers, Florian Jentsch, David Baker, Carolyn Prince and Eduardo Salas Simulation design for training and assessment, Stephen Alessi. Part II Simulation Fidelity: Quality criteria for simulator images: a literature review, Pieter Padmos and Maarten V. Milders Transfer of skill from a computer game trainer to flight, Daniel Gopher, Maya Weil and Tal Bareket Evidence for the validity of PC-based simulations in studying aircrew coordination, Florian Jentsch and Clint A. Bowers Fidelity and validity of simulator training, N. Dahlstrom, S. Dekker, R. van Winsen and J. Nyce. Part III Physiological Responses and Simulation Sickness: A literature survey for virtual environments: military flight simulator visual systems and simulator sickness, Randy Pausch, Thomas Crea and Matthew Conway Simulator sickness is polygenic and polysymptomatic: implications for research, Robert S. Kennedy and Jennifer E. Fowlkes Simulator platform motion: the need revisited, Judith BA rki-Cohen, Nancy N. Soja and Thomas Longridge. Part IV Simulation as Training and Method: Training high-performance skills: fallacies and guidelines, Walter Schneider Part-task training for tracking and manual control, Dennis C. Wightman and Gavan Lintern Transfer of landing skills in beginning flight training, Gavan Lintern, Stanley N. Roscoe, Jefferson M. Koonce and Leon D. Segal Individual and team decision making under stress: theoretical underpinnings, Janice A. Cannon-Bowers and Eduardo Salas Evaluating the effectiveness of flight simulators for training combat skills: a review, Herbert H. Bell and Wayne L. Waag. Part V Training Evaluation Using Simulation: Training effectiveness evaluation, R.T. Hays and M.J. Singer The reliability of instructor evaluations of crew performance: good news and not so good news, Michael T. Brannick, Carolyn Prince and Eduardo Salas Continuous concurrent feedback degrades skill learning: implications for training and simulation, Richard A. Schmidt and Gabriele Wulf Performance measurement in simulation-based training: a review and best practice, Eduardo Salas, Michael A. Rosen, Janet D. Held and Johnny J. Weissmuller. Part VI Simulation Beyond Aviation: The use of simulation for training teamwork skills in health care: how low can you go?, J.M. Beaubien and D.P. Baker The complexity of team training: what we have learned from aviation and its application to medicine, W.R. Hamman Constructs of simulation evaluation, Andrew Hale Feinstein and Hugh M. Cannon Games, motivation and learning: a research and practice model, Rosemary Garris, Robert Ahlers and James E. Driskell Name index.

Chapter 14 – Aviation Displays

Publisher Summary This chapter discusses how advances in display technology have altered the role of human information processing in the cockpit. It describes both, how these advances have improved pilot performance, and the emerging challenges that resulted. Finally, it discusses how recent aviation industry initiatives influence current and future display technologies. The information age has enabled the development and advancement of modern aviation displays. Provided that the human information processing limitations are considered when integrating different forms of information, the glass cockpit now serves to perform this integration automatically. Although there are obvious benefits associated with these display advances, poor consideration of the costs associated with different methods of integration will result in displays that tax individuals, the same if not more, than the traditional gauge displays of the past. Constant growth and shifting industry goals for the future, dictate that integration of flight critical information in displays, capitalize on the strengths and weaknesses of both the human and computer in the aviation system. It is important to realize that even when keeping human factors principles in mind for display design, errors will likely not cease to occur. Instead keeping human factors principles in mind for design will help to design systems that, through a process of addressing cost and benefit of design recommendations, will produce more optimally designed displays.

Perceptual CUE Effects on Distance Estimation from Different Relative Approach Heading

Dangers during the approach and landing phases of flight are still leading safety issues in aviation. In particular, inconsistent visual scenes have been associated with variations in pilot performance during visual approaches. While several factors have been identified as causes of such performance variation, such as impoverished visual cues and the geometrical ratio of the runway image, many other perceptual cues remain largely unexplored. This study examines how pilot performance in a visual approach task is affected by changes in the angle from centerline of the runway. Findings from this study will help determine the degree to which previously unexplored variables affect performance and help guide the development of future training for visual approach.