Abstract:
Introduction
Mixed Reality (MR) head-mounted displays may offer a cost-efficient, immersive alternative to conventional flight simulation displays, but adverse human factors, particularly cybersickness, visual fatigue, and ergonomic strain, can impair pilot performance and training effectiveness in safety-critical aviation contexts.
Methods
Using a systematic PRISMA-based review, we identified and synthesized evidence on human factors associated with MR/virtual reality (VR) HMD use in pilot training and analogous safety-critical simulation across 80 included sources. Human-factor drivers and mitigation strategies were synthesized into a dual-taxonomy, with mitigation approaches categorized into hardware, software, ergonomic, physiological, and psychological groups. Strategy viability was interpreted through a regulatory lens informed by aviation authority expectations.
Results
Cybersickness, visual strain, musculoskeletal fatigue, and sensory conflict were the most consistently reported issues. Strategies that preserved simulator fidelity, such as high-quality HMD selection, calibration, ergonomic setup, and structured onboarding, appeared more operationally suitable than approaches that altered realism or visual continuity, such as field-of-view restriction. Risk of bias appraisal identified recurring methodological limitations including convenience sampling, heterogeneous study designs, and limited preregistration, reducing confidence in the generalizability of some findings.
Discussion
Human factors remain a major barrier to MR HMD adoption in pilot training, while operational and regulatory constraints strongly shape which mitigation strategies are feasible and contextually suitable. Although much of the evidence base remains VR-derived, many findings appear transferable to MR due to shared HMD-mediated perceptual and ergonomic mechanisms. These findings provide guidance for developers, training providers, and regulators seeking to improve comfort and safety without undermining simulator fidelity.
