Currently, Endsley [16] has proposed a comprehensive model of situation awareness, which outlines how elements from the environment as well as cognition influence situation awareness and decision making. When considering the beneficial effects of these processes, situation awareness may provide the key to combining these processes and improving the cognition in older adults. Figure 1 provides our expanded situation awareness model, which depicts these multidimensional connections and the cognitive declines associated with them. The core of the situation awareness model has been expanded to further depict the relationship between conceptual representation and situation awareness as well as theories of cognitive aging. This model is designed to stimulate future research on age-appropriate training of situation awareness, which has the potential to reduce cognitive declines and lead to an increased functioning in everyday life.
Baltes and Baltes’ [2] theory of selective optimization with compensation proposes seven propositions for aging successfully, two of which directly relate to improvements that could be achieved from training situation awareness. Specifically, when considering the amount of latent reserve available in older adults, training situation awareness activates resources previously abandoned or negatively affected by new technology or changing environments. Through learning and practice, older adults may benefit from training to the same degree as younger adults [2]; however, reaching the same levels of performance outcomes (i.e., response speed and accuracy) as their younger counterparts may be unattainable. In addition, older adults’ preexisting knowledge can offset losses that occur in their reserve capacity. Improving situation awareness, especially Level 3, allows older adults to utilize this past knowledge.
Recently, researchers examining the effects of cognitive training with aged individuals have found that interventions significantly improve specific cognitive abilities, including processing speed, reasoning, and memory (e.g., [1, 49]). In addition, the use of the Visual-Motor Useful Field of View training has been an effective tool for improving the psychomotor skills of senior drivers, which is most likely indirectly training situation awareness [32]. By directly training the core variable situation awareness (bold square), this key component permeates all other variables in the model. The following recommendations for training provide insight into the effects of training situation awareness and potential benefits on everyday task performance.
When considering each of the three levels of situation awareness, Level 1 can be easily trained with multiple methodologies. In any situation, regardless of how simple or complex the task, a small, specific set of cues provides the most relevant information concerning the potential outcome. For example, new kitchen stoves provide cues regarding which burners are still hot even after the stove has been turned off. Individuals only need to be directed to these relevant as opposed to irrelevant cues. Specifically, the use of video training as well as in situ training (i.e., training conducted in one’s natural environment outside of laboratory settings) can be developed to explicitly or implicitly instruct older adults on relevant cues. Video training programs consist of real-time and slow motion clips that accurately and clearly depict the perceptual cues vital to enhancing situational awareness, whereas situ training allows individuals to actively perform during live situations. Based on the informational cues being highlighted during training, individuals can then begin to comprehend the outcome of interpreting those cues and decide more quickly and decisively an appropriate course of action. It is important to note that although sensory deficits (i.e., vision and hearing) naturally occur with aging, visual deficits generally do not negatively affect perception or limit the benefits in training situation awareness [4, 22]. Perception and situation awareness tap temporal-spatial abilities in which visual acuity, depth perception, and peripheral vision have no direct influence on performance outcomes. Declines in hearing, however, may negatively influence situation awareness when technological environments produce auditory signals that cue individuals to vital information.
The basis of situation awareness is to produce quick and accurate decisions during a variety of situations. Training Level 1 specifically addresses the attentional aspects of situation awareness as well as age-related differences in working memory. When only relevant cues are being processed, working memory executes cognitive operations more efficiently. Training Level 1 situation awareness may provide the greatest benefits for older adults’ cognition. For example, irrelevant environmental details have been identified as one category of “off-goal-path” thoughts [27]. Improvements in attending to essential cues can reduce the number of “off-goal-path” ideas that enter working memory thus directly addressing problems with disinhibition. In particular, video-based training can pause clips at specified moments or black out areas on each clip to restrict the visual access to different perceptual fields. These techniques may produce the most significant improvements in inhibition because of the lack of extraneous information.
Level 1 training may also be beneficial to declines in fluid intelligence. For the elderly, cooking or using a kitchen stove has in all actuality formed in crystallized intelligence; however, new technology may change appropriate perceptual cues and their locations. Problems may also occur in emergency situations where the elderly are required to make quick, accurate, and effective decisions, which tap into fluid intelligence. Serious injuries or declining performances may be reduced in situations that tax fluid intelligence if the elderly become actively aware of the use of advanced cue utilization and its influence on assessing the situation. Narrowing attentional focus to appropriate external cues will decrease errors in Level 1, which may otherwise occur in older adults suffering from deficits in fluid intelligence.
With the perception of essential cues enhancing Level 1 situation awareness, training must be extended to comprehending these cues (Level 2 situation awareness). To improve attention, processing, and working memory, older adults must learn how to effectively scan the environment. Faster response selection will reduce the temporal pressures that may exist in comprehension. Occluding or explicitly instructing older adults on appropriate cues (i.e., a red light on the stove) has little benefit if there is no understanding of what that means (i.e., the stove is still hot). By improving the comprehension of cues that may occur during unpredictable situations, older adults may then be able to make more accurate decisions from a seemingly infinite number of alternative responses. Specifically, the use of video-based training can provide a safe environment for examining the outcomes of effective and ineffective cue utilization, where in situ testing in some situations can be reasonably dangerous. By enhancing Level 2 situation awareness, accurate mental models are created when relevant cues are perceived, and appropriate leverage points become more apparent during predictable and unpredictable situations, which can limit the amount of danger that may exist in everyday activities.
When individuals have mastered Levels 1 and 2 situation awareness, their ability to project from past knowledge to current experiences is heightened (i.e., Level 3). However, training strategies that specifically enhance Level 3 situation awareness are more difficult to develop. Because Level 3 is based on past knowledge and defines expertise in dynamic situations, Level 3 situation awareness may not be trainable, only developing from years of deliberate practice and experience. Actively engaging the cognitive processing required for situation awareness to occur through video-based training of Levels 1 and 2 may initiate past experiences where Level 3 was necessary. The deliberate practice of Levels 1 and 2 will change situational processes from a conscious state to an unconscious, automatic process, which taps into Level 3. The attainment of Level 3 situation awareness and, more importantly, sustaining Level 3, could potentially be the most influential factor in decreasing age-related effects on cognition as it relies on fewer resources and activates processes sooner.
To test the idea of training older adults on situation awareness, a recent study [9] used a multidimensional, perceptual-cognitive skills training protocol with senior tennis players who had no cognitive impairments (n = 13) or mild levels of cognitive impairment (n = 14). Participants included senior male (n = 10, M = 62.5 years old, SD = 8.4) and female (n = 17, M = 56.6, SD = 8.5) tennis players over the age of 50. Players competed regularly in the United States Tennis Association (USTA) league tournaments; thus, each had a National Tennis Rating Program (NTRP) certified rating. The average experience level of the participants, according to the NTRP, was 3.17 (SD = 0.50), which categorizes them at the intermediate level. Before training, each participant was administered the Mini-Mental State Examination (MMSE; [21]) to test for cognitive impairments. Participants scoring between 20 and 24 points were considered to have mild levels of cognitive impairment, and those scoring 25 points or higher were considered noncognitively impaired. Participants were then individually pretested in a four-game singles match. Participants were randomly assigned to one of three groups as follows: (1) perceptual-cognitive skills training (PCST), (2) technique-footwork training (TFT), or (3) control. In the two training conditions, participants were provided with group-specific, standardized instructions on-court and with video to maximize the effects of training. Specifically, PCST consisted of developing the three levels of situation awareness, situational probabilities, player tendencies, anticipation, and decision making; whereas the TFT contained instructions regarding the improvement of groundstrokes, approach shots, volleys, overheads, serves, and return-of-serves as well as the corresponding footwork to assist efficiency and court coverage. The control group received no training. The PCST and TFT participants met on five consecutive days, whereas the control participants met only twice to complete pre-and posttesting.
Two experts on perceptual-cognitive skills, who also had extensive background in the game of tennis, examined relevant data from pre-and posttest video analysis. The two experts individually coded response speed, response accuracy, and performance decision making. Response speed was considered to be the time period from the point-of-contact to the completion of the participants’ first step in the correct direction of the ensuing shot. Response accuracy consisted of the percentage accuracy of on-court movement in relation to tracking toward the ensuing shot. Based on the accuracy of movement, participants were given one point for correctly moving in the appropriate direction and no points for moving in the wrong direction. Performance decision making was operationalized as the appropriateness of the participants’ shot selections according to court positioning, percentages, situation, and shot hit by the opponent. Participants received one point for choosing appropriate performance decisions and no points for inappropriate performance decisions. Inter-rater reliability scores for the points to be examined, response speed, response accuracy, and performance decision making all exceeded 98%.
The experimental design consisted of the three factors as follows: level of impairment (cognitive impairment, no impairment), training type (PCST, TFT, control), and test (pretest, posttest). The dependent measures were response speed, response accuracy, and decision making during singles match play situations. No significant differences were found between participants with cognitive impairments and those without cognitive impairments, as both groups benefited from PCST training. Findings indicated that noncognitively impaired participants who received PCST training (which included situation awareness) cut their response speeds nearly in half following training (pretest, 1,059 ms; posttest, 589 ms), allowing movements toward the intended shot as the ball crossed their opponent’s service line. This faster response occurred with enhanced response accuracy (pretest, 31%; posttest, 88%) as well. In addition, correct decisions more than doubled (pretest, 36%; posttest, 81%) during live on-court singles matches. Cognitively impaired senior tennis players who received PCST training showed as much benefit as noncognitively impaired players, responding more than twice as fast following training (pretest, 1,038 ms; posttest, 534 ms) and more than doubling their response accuracy (pretest: 32%, posttest: 88%) to shots hit during singles match situations. With regards to performance-based decisions, cognitively impaired participants also made twice as many appropriate decisions (pretest, 32%; posttest, 81%).
Participants receiving PCST training significantly improved response speed, response accuracy, and performance decision making from pre-to posttest when compared to the other two groups (TFT and control). On average, PCST participants improved their response speed by nearly a half second (pretest, 1,050 ms; posttest, 568 ms), whereas TFT (pretest, 1,140 ms; posttest, 1,200 ms) and control (pretest, 1,250 ms; posttest, 1,290 ms) participants made no improvements. PCST faster responses occurred with enhanced response accuracy (pretest, 31%; posttest, 88%) as opposed to the TFT (pretest, 22%; posttest, 21%) and control (pretest, 17%; posttest, 15%) groups. In addition, senior tennis players provided with PCST more than doubled the number of correct decisions (pretest, 35%; posttest, 81%) during live on-court singles matches, where players receiving TFT (pretest, 30%; posttest, 30%) and no training (pretest, 25%; posttest, 25%) made no improvements.
With only 3.50 h of training, improvements in the perception of relevant cues (Level 1) and the comprehension of these cues regarding the outcome of a situation (Level 2) were attained. The ability for such individuals to attain Level 3 situation awareness would require continued training as well as longitudinal data to support the maintenance of these skills. In addition, significant improvements in performance decision making indicated that multidimensional perceptual-cognitive training improved the availability of processing resources and overall cognitive processing speed. However, the lack of retention tests limits the interpretation of these findings. Further research should consider determining whether these improvements are true learning effects or merely transient training effects as well as the duration of each training session and the most effective length of training.
These findings lend clear evidence that such skills are trainable in older adults and are not limited to those who have achieved elite levels of expertise in their domain of interest [42]. For the senior tennis players in this study, especially those experiencing cognitive declines, cognitive functioning was expanded to include acquisition of new knowledge [3, 7, 8, 56]. If these improvements can occur in the dynamic situations that exist in singles tennis match play, valuable information for successful aging may transfer to everyday environments. Whether the training of perceptual-cognitive skills in dynamic sport domains can be implicitly learned in daily life situations (e.g., driving, falling incidents, obstacle avoidance, etc.) and still produce similar results, is an important consideration for future research. By cross-examining perceptual-cognitive skills in dynamic sport and life situations, a better understanding is gained regarding general or task-specific training. Although fitness training and cognitive training have enhanced cognitive vitality of older adults [1, 3, 11, 31, 37, 49], more research is needed on training dynamically based cognitive skills that enhance the cognitive functioning and performance of older adults in such environments.
Equally important to the improvements made by perceptual-cognitive training is the compounding effect physical activity has on cognitive functioning [37]. Colcombe and Kramer’s [11] meta-analytic examination of fitness effects on older adults’ cognitive functioning found that fitness training improved performance (0.5 SD) on tests of executive processes, regardless of cognitive task, training program or duration, or participants’ gender or age. In addition to executive processes, control processes and visuospatial processes also improved from increased physical activity, which are vital to and directly influence situation awareness. The combination of task-specific training of perceptual-cognitive skills and fitness training may significantly impact the maintenance of active lifestyles, physical and cognitive health, and overall quality of life.