LAUSR

Abstract Driver inexperience is one of the underlying reasons for the high risk of road crashes involving young drivers (the so-called “young driver problem”). The use of driving simulators for learner or novice drivers could mitigate this problem by enabling them to acquire driving experience without increasing the risk of a road crashes. Evidence of this beneficial effect should lead to expanded use simulators to train learner drivers. We undertook a systematic review of previous studies designed to determine whether the use of a driving simulator for passenger cars or motorcycles in young novice or learner drivers leads to a reduction in road crashes and/or traffic infractions, or to the acquisition of safer driving skills, compared to non-use of driving simulators. PubMed, Scopus and Web of Science databases were used for the literature search. A total of 2888 unique references were initially extracted, but only five of them met the inclusion criteria and were selected for review (two experimental studies with random assignment, one quasi-experiment study, and two cohort studies). Two authors independently extracted the information and assessed the quality of each study with the Jadad Scale, the Newcastle-Ottawa Scale and identification of biases. Heterogeneity among studies regarding the outcomes considered precluded a quantitative synthesis of the results. Overall, the quality of the studies was low, and the most frequent drawbacks were low power to detect significant differences, non-comparability of the intervention and control groups (because of nonrandom assignment, different drop-out rates and uncontrolled confounders) and classification bias (because of inadequate blinding and the use of self-reports for some outcomes). Furthermore, the results were inconsistent across studies regarding the major outcomes. Therefore, the results of our review do not provide evidence to support or refute the efficacy of training programs based on simulators for young learner or novice drivers in improving the safety of their driving styles. Additional studies are needed to overcome the limitations of research designs used thus far.