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Updated: Jun 2, 2026

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects
Published on: September 18, 2012
Driving simulator sickness: an evidence-based review of the literature
Sherrilene Classen1, Megan Bewernitz, Orit Shechtman
1Department of Occupational Therapy, Institute for Mobility, Activity, and Participation, University of Florida, P.O. Box 100164, Gainesville, FL 32610-0164, USA. sclassen@phhp.ufl.edu
Objective:
Guided by the Occupational Therapy Practice Framework: Domain and Process (2nd edition; American Occupational Therapy Association, 2008), we conducted an evidence-based review on simulator sickness (SS).
Method:
We searched Web of Science, PubMed, SafetyLit, Google Scholar, and recently published literature. We used the American Academy of Neurology's classification criteria to extract data from 10 studies and assign each a level of 1-4, with "1" indicating the highest level of evidence. We grouped studies that addressed SS into client factors, context and environment factors, and activity demands.
Results:
Client factors (i.e., older clients [>70 yr; Level B], women [Level B]) and context/environment factors (e.g., refresh rates, scenario design and duration, simulator configuration, and calibration; Level B) probably increase the rates of SS, whereas activity demands (vection, speed of driving, and postural instability; Level C) possibly contribute to SS.
Conclusion:
We classified factors contributing to SS and identified the need for randomized trials to identify causes of SS.

