A virtual reality cognitive health screening tool for aviation: Managing accident risk for older pilots

To address elevated risk for older pilots, we examined the efficacy of a virtual reality (VR) cognitive health screening tool (integrated into simulated flight scenarios) in identifying general aviation pilots who experienced a critical incident during flight in a full-scale Cessna 172 simulator. Performance data were obtained from 51 certified pilots (17–71 years). Machine learning classification algorithms, based on key data from the VR flight, were used to validate the utility of the screening tool for identifying pilot risk. The results showed that aviation-relevant cognitive factors obtained in the VR screening tool, including situation awareness and prospective memory, predicted risk of a critical incident with good sensitivity (0.83) and specificity (0.85), AUC = 0.82. These results support VR-based cognitive screening to identify at-risk older pilots. The present findings inform procedures for optimizing safety and reducing critical incidents at any point in the pilot lifespan and are timely in view of the impending pilot workforce shortage.