A Qualitative Review of Extended Reality-Enabled Remote Collaboration: Human Factors Considerations and Implications for NAS Maintenance Practices

FAA Office of Aerospace Medicine 
Civil Aerospace Medical Institute

Report No: DOT/FAA/AM-24/12

Title and Subtitle: A Qualitative Review of Extended Reality-Enabled Remote Collaboration: Human Factors Considerations and Implications for NAS Maintenance Practices

Report Date: June 2023

Authors: B. Torrence, J. Durham, R. DiDomenica, I. Choi, B. Tanner

...

Extended Reality in Flight Attendant Initial Training

FAA Office of Aerospace Medicine 
Civil Aerospace Medical Institute

Report No: DOT/FAA/AM-24/07

Title and Subtitle: Extended Reality in Flight Attendant Initial Training

Report Date: April 2024

Authors: L. L. Breeding, T. M. Phipps, D. B. Weed, M. S. Beben

Supplementary Notes: Author ORCIDs: Breeding (0000-0003-2740-2790), Phipps (0009-0009-1290-2048, Weed (0000-0002-5184-6933), Beben (0000-0003-0587-5984). Technical report DOI: https://doi.org/10.21949/1524430 Data Management Plan DOI: https://doi.org/10.21949/1529638.

The Federal Aviation Administration (FAA) funded this through the Research, Engineering, and Development (RE&D) program budget. The authors had no conflicts of interest to disclose. All authors read and approved this manuscript. This manuscript underwent external peer review. The Principal Investigator (PI; LLB) and sponsors (TMP and Sharon Tkach) conceived the project in collaboration with internal FAA sources. The PI acquired the data, performed the data analysis, and wrote the technical report with input from the coauthors. This document is disseminated under the sponsorship of the U.S. Department of Transportation in the interest of information exchange. The U.S. Government assumes no liability for the contents thereof.

Abstract:

Introduction: The purpose of this study was to determine if the addition of extended reality (XR) to an existing training program provided to new hire flight attendants improved training effectiveness in terms of cabin door procedures. Methods: This retrospective cohort study used preexisting flight attendant training data provided by a collaborating organization. The data were divided into two groups, the AQP-only control group, and the AQP+VR intervention group. The data represented training events (n = 13,525) spilt between AQP-only (n = 11,180) and AQP+VR (n = 2,345). The groups were compared in terms of cabin door training pass rates. Results. The observed training pass rate was 84% in the AQP group vs. 88% in the AQP+VR group. Conclusion: Supplemental XR training appeared to improve cabin door procedural training effectiveness, although there were some important study limitations resulting from the retrospective study design.

Key Words: Aviation safety, cabin door procedures, extended reality, virtual reality, flight attendants, training effectiveness

No. of Pages: 10

Safety Implication of Respiratory Protection Mask Wear

FAA Office of Aerospace Medicine 
Civil Aerospace Medical Institute

Report No: DOT/FAA/AM-24/08

Title and Subtitle: Safety Implication of Respiratory Protection Mask Wear

Report Date: May 9, 2024

Authors: Wigdan Farah, MBBS, MPH, Michael Wolf, MD, Mohamed F. Abusalih, MD, Bashar Hasan, M.D, Elizabeth H. Lees, D.O, Farah Fleti, M.D, Wiaam Y. Elkhatib, M.D, Bruce D. Johnson, PhD, Gary Toups, MD, M. Hassan Murad, MD, MPH

Abstract: Background: Widespread use of respiratory protection masks has become a critical component of public health interventions. This systematic review explores the acute physiological, cognitive, and psychological impacts associated with different types of masks.

Methods: A comprehensive search from 2000 to 2023 was conducted across multiple databases (MEDLINE, EMBASE, Cochrane databases, Scopus, and PubMed). An umbrella systematic overview was conducted for physiological outcomes, utilizing published systematic reviews. De novo systematic reviews were conducted for cognitive and psychological outcomes. Pairs of independent reviewers determined eligibility, extracted data, and assessed risk of bias. Certainty at an outcome level was appraised using the GRADE approach.

Results: The search resulted in 13,370 potential citations, leading to the inclusion of nine systematic reviews for physiological outcomes (87 primary studies) and 10 primary studies for cognitive and psychological outcomes (3,815 participants). Studies evaluating physiological outcomes demonstrated that various types of masks did not significantly impact heart rate, stroke volume, cardiac output, blood pressure, or respiratory rate during rest or exercise (low certainty for most outcomes). Mask use may be associated with modest but statistically significant changes in minute ventilation, tidal volume, oxygen saturation, maximal oxygen consumption (VO2max), carbon dioxide partial pressure, lactate levels, and exercise performance (low certainty for most outcomes). Studies evaluating cognitive outcomes showed mixed results. Some studies reported reduced mental workload, while others showed no significant effect or decreased performance. The impact on attention, errors, and reaction time was variable. These studies were small and at moderate to high risk of bias. Evidence was insufficient to estimate an effect of mask use on psychological outcomes (claustrophobia, depression, and anxiety) as these studies were small, non-longitudinal, and at high risk of bias.

Conclusion: This comprehensive overview provides insight into the multifaceted impact of respiratory protection mask use. The limited certainty in evidence warrants further research since mask use is crucial for public health recommendations and policy decisions related to respiratory protection measures.

Key Words: Respiratory protection, Face mask, Physiological impact, Cognitive impact, Psychological outcomes, Systematic review

No. of Pages: 43

Aerospace Medicine Technical Reports

Medically Related Pilot Incapacitation Event Data Pathways for Safety Assurance in Part 121 Operations

FAA Office of Aerospace Medicine 
Civil Aerospace Medical Institute 

Report No: DOT/FAA/AM-24/04

Title and Subtitle: Medically Related Pilot Incapacitation Event Data Pathways for Safety Assurance in Part 121 Operations

Report Date: February 2024

Authors: Lauren A. Collins, Dr. Valerie Gawron, Jason Reinhart

Abstract: MITRE was tasked...

Utility of Capillary Blood for Gene Expression Studies

FAA Office of Aerospace Medicine 
Civil Aerospace Medical Institute 

Report No: DOT/FAA/AM-23/35

Title and Subtitle: Utility of Capillary Blood for Gene Expression Studies

Report Date: 11/1/2023

Authors: Christopher J. Tracy (https://orcid.org/0000-0002-4532-3327)
David C. Hutchings (...

Safety Culture Assessment by FAA Aviation Safety Inspectors

FAA Office of Aerospace Medicine 
Civil Aerospace Medical Institute 

Report No: DOT/FAA/AM-23/39

Title and Subtitle: Safety Culture Assessment by FAA Aviation Safety Inspectors

Report Date: December 2023

Authors: Worthington, K. K., Gay, R., Hu, P. T.,Choi, I., Schroeder, D. J.

Abstract: The recent Department of Transportation (DOT)...

2022 Aerospace Medical Certification Statistical Handbook

FAA Office of Aerospace Medicine 
Civil Aerospace Medical Institute 

Report No: DOT/FAA/AM-23/38

Title and Subtitle: 2022 Aerospace Medical Certification Statistical Handbook

Report Date: November 2023

Authors: Skaggs VJ, Norris AI

Abstract: Introduction: The biennial Aerospace Medical Certification Statistical Handbook...

Risk Framework for Cabin Transmission of Infectious Diseases

FAA Office of Aerospace Medicine 
Civil Aerospace Medical Institute 

Report No: DOT/FAA/AM-23/30

Title and Subtitle: Risk Framework for Cabin Transmission of Infectious Diseases

Report Date: September 2023

Authors: Andy Anderegg, Nadya Huleatt, Gene Lin, Ilana Lisann, Rakhee Palekar Hamid Shirazi, Alex Wu

Abstract: The Federal Aviation...

Evaluation of Online Stress Management Training for Air Traffic Controllers: Comparing Training Effectiveness across Online and In-Person Formats

FAA Office of Aerospace Medicine 
Civil Aerospace Medical Institute 

Report No: DOT/FAA/AM-23/36

Title and Subtitle: Evaluation of Online Stress Management Training for Air Traffic Controllers: Comparing Training Effectiveness across Online and In-Person Formats

Report Date: November 2023

Authors: Torrence, B., Barrett, J., Ho, T.

Abstract:...