title: In-simulator training of driving abilities in a person with a traumatic brain injury.
abstract: OBJECTIVE
  This study reports the case of a 23-year-old woman (MC) who sustained a severe traumatic brain injury in 2004. After her accident, her driving license was revoked. Despite recovering normal neuropsychological functions in the following years, MC was unable to renew her license, failing four on-road evaluations assessing her fitness to drive.
  
  
  METHODS
  In hope of an eventual license renewal, MC went through an in-simulator training programme in the laboratory in 2009. The training programme aimed at improving features of MC's driving behaviour that were identified as being problematic in prior on-road evaluations. To do so, proper driving behaviour was reinforced via driving-specific feedback provided during the training sessions.
  
  
  RESULTS
  After 25 sessions in the simulator (over a period of 4 months), MC significantly improved various components of her driving. Notably, compared to early sessions, later ones were associated with a reduced cognitive load, less jerky speed profiles when stopping at intersections and better vehicle control and positioning. A 1-year retention test showed most of these improvements were consistent.
  
  
  CONCLUSIONS
  The learning principles underlying well conducted simulator-based education programmes have a strong scientific basis. A simulator training programme like this one represents a promising avenue for driving rehabilitation. It allows individuals without a driving license to practice and improve their skills in a safe and realistic environment.
authors.affiliation: Groupe de Recherche en Analyse du Mouvement et Ergonomie, Faculté de médecine, division de kinésiologie, Centre d'excellence sur le vieillissement de Québec, Hôpital Saint-Sacrement, 2300 rue de la Terrasse, Université Laval, Québec, QC, Canada. pierre-luc.gamache@psy.ulaval.ca
authors.forename: Pierre-Luc
authors.initials: PL
authors.lastname: Gamache
authors.forename: Martin
authors.initials: M
authors.lastname: Lavallière
authors.forename: Mathieu
authors.initials: M
authors.lastname: Tremblay
authors.forename: Martin
authors.initials: M
authors.lastname: Simoneau
authors.forename: Normand
authors.initials: N
authors.lastname: Teasdale
mesh_terms: D001288:Attention; D001334:Automobile Driving / Q000523:psychology*; D001930:Brain Injuries / Q000534:rehabilitation*; D002561:Cerebrovascular Disorders / Q000534:rehabilitation*; D003198:Computer Simulation; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008004:Licensure; D009483:Neuropsychological Tests; D055815:Young Adult