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Aerospace Medical & Human Factors Research

Aerospace Medicine Technical Reports

2025 – Office of Aerospace Medicine Technical Reports, DOT/FAA/AM-
NumberReport Title
25/07Operational Human Factors Considerations for Head-Worn Display (HWD) Usage in Civil Aviation, ...

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

Tuesday, May 28, 2024

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

Tuesday, May 21, 2024

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

Wednesday, June 04, 2025
2024 – Office of Aerospace Medicine Technical Reports, DOT/FAA/AM-
NumberReport Title
24/03Postmortem Blood Genomics Biorepository, Abstract, Full Text(PDF, 656 KB)
24/04Medically Related Pilot Incapacitation Event Data Pathways for Safety Assurance in Part 121 Operations, Abstract, Full Text(PDF, 722 KB)
24/07Extended Reality in Flight Attendant Initial Training, Abstract, Full Text(PDF, 332 KB)
24/08Safety Implication of Respiratory Protection Mask Wear, Abstract, Full Text(PDF, 762 KB)
24/12A Qualitative Review of Extended Reality-Enabled Remote Collaboration: Human Factors Considerations and Implications for NAS Maintenance Practices, Abstract, Full Text(PDF, 1,122 KB)
24/18The Development and Implementation of a Safety Culture Survey for High-Performing Aviation Organizations, Abstract, Full Text(PDF, 630 KB)
24/21Federal Aviation Administration Aircraft Evaluation Division Operations and Human Factors Evaluation Aid for Enhanced Flight Vision Systems, Abstract, Full Text(PDF, 2,765 KB)
24/22Human Factors Analysis of Helicopter Air Ambulance Accidents, Incidents, and Events (2013-2023), Abstract, Full Text(PDF, 2,037 KB)
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