Proof-of-Concept Study: Feasibility of Using NeuroTargeted Training with fNIRS in High-Stake Simulations for Identifying and Bridging Cognitive Gaps

Abstract

The objective of this proof-of-concept study was to test the utility of NeuroTargeted Training (NTT), a new method using functional Near-Infrared Spectroscopy (fNIRS) to measure and enhance cognitive performance during simulator training. Traditional simulator training is limited to behavioral evaluations, without capturing the trainee's internal cognitive processes. NTT addresses this gap by comparing trainees’ brain activation patterns to those of experts, allowing for precise identification and remediation of cognitive performance gaps. Three studies were conducted with five participants. Expert neural benchmarks were established from a man overboard simulation. Novices were evaluated against these benchmarks using a Expert Reference Index (ERI), quantifying deviations from expert performance, and the NeuroTargeted Training methodology was compared with conventional evaluations. Personalized training, based on identified gaps, was conducted to align novice neural patterns with expert benchmarks. Significant differences were observed, particularly in the anterior insula and inferior frontal gyrus, with an ERI of 4.84. Cohen’s Kappa (.69) indicated moderate inter-rater reliability. Subsequent targeted training reduced the ERI by 27%, aligning novice neural patterns with experts. Without intervention, the ERI rose by 79%, indicating increased cognitive strain. These findings highlight NTT’s potential to enhance learning outcomes in high-stake exercises by providing insights into cognitive processes.