Simulator induced syndrome: evidence for long-term aftereffects.

Pilots have experienced various adverse symptoms hours and even days following flight simulator training. This study surveyed pilots undergoing simulator training in an attempt to provide an initial gauge of the extent, severity, and possible risk factors of long-term (greater than 1 day) simulator aftereffects. A three-part voluntary and anonymous questionnaire was used to gather data. We studied pilots of varying experience undergoing advanced flight training which included the use of flight simulators. Some 238 pilots participated in the study, and 196 completed the follow-up survey concerning long-term effects. Nine (4.6%) pilots experienced adverse symptoms 24 h or more after completion of their last simulator training, which they attributed to their recent simulator experience. Symptoms reported included: recurrent visual flashbacks, continued balance disturbance, and hand-eye discoordination. Three pilots (1.5%) reported difficulties flying aircraft. Pilot flight experience level, total simulator time, length of simulator session, and sex were not predictive of risk. This study suggests that long-term (greater than 1 day) adverse aftereffects may occur following simulator training.