Changing perspectives: enhancing learning efficacy with the after-action review in virtual reality training for police.

The After-Action Review (AAR) in Virtual Reality (VR) training for police provides new opportunities to enhance learning. We investigated whether perspectives (bird's eye & police officer, bird's eye & suspect, bird's eye) and line of fire displayed in the AAR impacted the officers' learning efficacy. A 3 x 2 ANOVA revealed a significant main effect of AAR perspectives. Post hoc pairwise comparisons showed that using a bird's eye view in combination with the suspect perspective elicits significantly greater learning efficacy compared to using a bird's eye view alone. Using the line of fire feature did not influence learning efficacy. Our findings show that the use of the suspect perspective during the AAR in VR training can support the learning efficacy of police officers.Practitioner summary: VR systems possess After-Action Review tools that provide objective performance feedback. This study found that reviewing a VR police training scenario from the bird's eye view in combination with the suspect perspective enhanced police officers' learning efficacy. Designing and applying the After-Action Review effectively can improve learning efficacy in VR.

No pain, no gain? The effects of adding a pain stimulus in virtual training for police officers.

Virtual training systems provide highly realistic training environments for police. This study assesses whether a pain stimulus can enhance the training responses and sense of the presence of these systems. Police officers (n = 219) were trained either with or without a pain stimulus in a 2D simulator (VirTra V-300) and a 3D virtual reality (VR) system. Two (training simulator) × 2 (pain stimulus) ANOVAs revealed a significant interaction effect for perceived stress (p = .010, ηp2 = .039). Post-hoc pairwise comparisons showed that VR provokes significantly higher levels of perceived stress compared to VirTra when no pain stimulus is used (p = .009). With a pain stimulus, VirTra training provokes significantly higher levels of perceived stress compared to VirTra training without a pain stimulus (p < .001). Sense of presence was unaffected by the pain stimulus in both training systems. Our results indicate that VR training appears sufficiently realistic without adding a pain stimulus. Practitioner summary: Virtual police training benefits from highly realistic training environments. This study found that adding a pain stimulus heightened perceived stress in a 2D simulator, whereas it influenced neither training responses nor sense of presence in a VR system. VR training appears sufficiently realistic without adding a pain stimulus.

Observational Behavior Assessment for Psychological Competencies in Police Officers: A Proposed Methodology for Instrument Development.

This paper proposes and showcases a methodology to develop an observational behavior assessment instrument to assess psychological competencies of police officers. We outline a step-by-step methodology for police organizations to measure and evaluate behavior in a meaningful way to assess these competencies. We illustrate the proposed methodology with a practical example. We posit that direct behavioral observation can be key in measuring the expression of psychological competence in practice, and that psychological competence in practice is what police organizations should care about. We hope this paper offers police organizations a methodology to perform scientifically informed observational behavior assessment of their police officers' psychological competencies and inspires additional research efforts into this important area.

Police Training in Practice: Organization and Delivery According to European Law Enforcement Agencies.

Police training plays a crucial role in the development of police officers. Because the training of police officers combines various educational components and is governed by organizational guidelines, police training is a complex, multifaceted topic. The current study investigates training at six European law enforcement agencies and aims to identify strengths and challenges of current training organization and practice. We interviewed a total of 16 police instructors and seven police coordinators with conceptual training tasks. A thematic analysis (Braun and Clarke, 2006; Terry et al., 2017) was conducted and results organized in the two main themes evident across all six law enforcement agencies: organization of training and delivery of training. Results show that governmental structures and police executive boards are seen as the primary authorities that define the training framework in which police instructors operate. These administrative structures regulate distant and immediate resources, such as available training time, training facilities, equipment, and personnel. Within the confines of available resources and predetermined training frameworks, results indicate that police instructors thoroughly enjoy teaching, creating supportive and motivating learning environments, and applying their personal learning perspectives to training. Nonetheless, police instructors are critical of the level of training they are able to achieve with the available resources.

Training for the job: evaluation of a self-defence training programme for correctional officers.

We investigated to what extent correctional officers were able to apply skills from their self-defence training in reality-based scenarios. Performance of nine self-defence skills were tested in different scenarios at three moments: before starting the self-defence training programme (Pre-test), halfway through (Post-test 1), and after (Post-test 2). Repeated measures analyses showed that performance on skills improved after the self-defence training. For each skill, however, there was a considerable number of correctional officers (range 4-73%) that showed insufficient performance on Post-test 2, indicating that after training they were not able to properly apply their skills in reality-based scenarios. Reality-based scenarios may be used to achieve fidelity in assessment of self-defence skills of correctional officers. Practitioner summary: Self-defence training for correctional officers must be representative for the work field. By including reality-based scenarios in assessment, this study determined that correctional officers were not able to properly apply their learned skills in realistic contexts. Reality-based scenarios seem fit to detect discrepancies between training and the work field. Abbreviations: DJI: Dutch National Agency for Correctional Insitutes; ICC: Intraclass Correlation Coefficient.

Professional development for sport psychology practice.

Applied sport psychology practice and research date back to the late 19th century. During this period investigators have largely examined the interventions practitioners employ to help athletes. More recently, researchers have begun addressing the person employing those interventions, including identifying their attributes and how they develop expertise, in recognition that practitioners are central to effective practice. Research focused on practitioners can inform educational and registration pathways, helping trainees to develop the knowledge, skills, and characteristics needed to meet their clients' needs. In this article major lines of inquiry in this area are reviewed. It is suggested that examining practitioner identity represents novel research that has educational and applied value.

Comparing a simplified FEM approach with the mass-spring model for surgery simulation.

Virtual reality based surgical simulators offer a very elegant approach to enhancing traditional training in endoscopic surgery. In this context a realistic soft tissue model is of central importance. The most accurate procedures for modeling elastic deformations of tissue use the Finite Element Method (FEM) to solve the governing mechanical equations. An alternative are mass-spring models which are a crude approximation of the real physical behavior. The main reason given when using the mass-spring approach is the computational complexity of FEM. In this study we show that an optimized linear FEM model requires computation time similar to the mass-spring approach, while giving better results.

Aiming at a far target under different viewing conditions: visual control in basketball jump shooting.

Most research on visual search in aiming at far targets assumes preprogrammed motor control implying that relevant visual information is detected prior to the final shooting or throwing movements. Eye movement data indirectly support this claim for stationary tasks. Using the basketball jump shot as experimental task we investigated whether in dynamic tasks in which the target can be seen until ball release, continuous, instead of preprogrammed, motor control is possible. We tested this with the temporal occlusion paradigm: 10 expert shooters took shots under four viewing conditions, namely, no vision, full vision, early vision (vision occluded during the final +/-350 ms before ball release), and late vision (vision occluded until these final +/-350 ms). Late-vision shooting appeared to be as good as shooting with full vision while early-vision performance was severely impaired. The results imply that the final shooting movements were controlled by continuous detection and use of visual information until ball release. The data further suggest that visual and movement control of aiming at a far target develop in close correspondence with the style of execution.

New understanding of atherosclerosis (clinically and experimentally) with evolving MRI technology in vivo.

Atherosclerosis and its thrombotic complications are the major cause of morbidity and mortality in industrialized countries. Despite advances in our understanding of the pathogenetic mechanisms and new treatment modalities, the absence of an adequate noninvasive method for early detection limits the prevention or treatment of patients with various degrees and localizations of atherothrombotic disease. High-resolution magnetic resonance (MR) has recently emerged as one of the most promising techniques for the noninvasive study of atherothrombotic disease. Most importantly, MR can be used to characterize plaque composition and monitor progression. Thus, MR opens new strategies, ranging from the screening of high-risk patients for early detection and treatment as well as the monitoring of target areas for pharmacological intervention.

Modelling of soft tissue deformation for laparoscopic surgery simulation.

Virtual reality based surgical simulator systems offer a very elegant solution to the development of endoscopic surgical trainers. While the graphical performance of commercial systems already makes PC-based simulators viable, the real-time simulation of soft tissue deformation is still the major obstacle in developing simulators for soft-tissue surgery. The goal of the present work is to develop a framework for the full-scale, real-time, finite element simulation of elastic tissue deformation in complex systems such as the human abdomen. The key for such a development is the proper formulation of the model, the development of scalable parallel solution algorithms, and special-purpose parallel hardware. The developed techniques will be used for the implementation of a gynecological laparoscopic VR-trainer system.

Mechanical modeling of soft biological tissues for application in virtual reality based laparoscopy simulators.

For application in a Virtual Reality (VR) based laparoscopic surgery simulator, computationally efficient algorithms for the description of the mechanical behavior of soft tissue have been developed. The explicit Finite Element Method has turned out to be a robust method for this purpose provided that absolute strain formulations are applied. Furthermore, a VR model of a uterus and its adnexe has been generated and simulation results are presented.

Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999.

BACKGROUND: Under the auspices of the College of American Pathologists, the current state of knowledge regarding pathologic prognostic factors (factors linked to outcome) and predictive factors (factors predicting response to therapy) in colorectal carcinoma was evaluated. A multidisciplinary group of clinical (including the disciplines of medical oncology, surgical oncology, and radiation oncology), pathologic, and statistical experts in colorectal cancer reviewed all relevant medical literature and stratified the reported prognostic factors into categories that reflected the strength of the published evidence demonstrating their prognostic value. Accordingly, the following categories of prognostic factors were defined. Category I includes factors definitively proven to be of prognostic import based on evidence from multiple statistically robust published trials and generally used in patient management. Category IIA includes factors extensively studied biologically and/or clinically and repeatedly shown to have prognostic value for outcome and/or predictive value for therapy that is of sufficient import to be included in the pathology report but that remains to be validated in statistically robust studies. Category IIB includes factors shown to be promising in multiple studies but lacking sufficient data for inclusion in category I or IIA. Category III includes factors not yet sufficiently studied to determine their prognostic value. Category IV includes factors well studied and shown to have no prognostic significance. MATERIALS AND METHODS: The medical literature was critically reviewed, and the analysis revealed specific points of variability in approach that prevented direct comparisons among published studies and compromised the quality of the collective data. Categories of variability recognized included the following: (1) methods of analysis, (2) interpretation of findings, (3) reporting of data, and (4) statistical evaluation. Additional points of variability within these categories were defined from the collective experience of the group. Reasons for the assignment of an individual prognostic factor to category I, II, III, or IV (categories defined by the level of scientific validation) were outlined with reference to the specific types of variability associated with the supportive data. For each factor and category of variability related to that factor, detailed recommendations for improvement were made. The recommendations were based on the following aims: (1) to increase the uniformity and completeness of pathologic evaluation of tumor specimens, (2) to enhance the quality of the data needed for definitive evaluation of the prognostic value of individual prognostic factors, and (3) ultimately, to improve patient care. RESULTS AND CONCLUSIONS: Factors that were determined to merit inclusion in category I were as follows: the local extent of tumor assessed pathologically (the pT category of the TNM staging system of the American Joint Committee on Cancer and the Union Internationale Contre le Cancer [AJCC/UICC]); regional lymph node metastasis (the pN category of the TNM staging system); blood or lymphatic vessel invasion; residual tumor following surgery with curative intent (the R classification of the AJCC/UICC staging system), especially as it relates to positive surgical margins; and preoperative elevation of carcinoembryonic antigen elevation (a factor established by laboratory medicine methods rather than anatomic pathology). Factors in category IIA included the following: tumor grade, radial margin status (for resection specimens with nonperitonealized surfaces), and residual tumor in the resection specimen following neoadjuvant therapy (the ypTNM category of the TNM staging system of the AJCC/UICC). (ABSTRACT TRUNCATED)

International Union Against Cancer. Classification of isolated tumor cells and micrometastasis.

BACKGROUND: Findings of isolated (disseminated or circulating) tumor cells (ITC) by immunocytochemistry and molecular pathology methods have led to varied interpretations and different applications of the TNM system. METHODS: An analysis of the relevant literature was undertaken. In addition, optional proposals for the classification of ITC, micrometastasis, and cytologic results in pleural and peritoneal washings are presented. RESULTS: Immunocytochemistry has a lower false-positive rate than nonmorphologic methods such as flow cytometry or the polymerase chain reaction; therefore the method(s) used always should be recorded. At the current time, the independent prognostic significance of ITC in regional lymph nodes and in the general circulation (blood, bone marrow, and other distant sites) is difficult to assess. To enable comparisons of treatment results and to avoid variation in staging, a finding of ITC should not be considered in the TNM and residual tumor (R) classifications, at least not at the current time. However, for future evaluation of their prognostic significance, the respective findings should be documented according to uniform criteria. CONCLUSIONS: ITC should be distinguished from micrometastasis. To investigate the independent prognostic significance of ITC and of positive lavage cytology, uniform data collection according to the proposed coding schema is recommended.

Virtual reality based surgery simulation for endoscopic gynaecology.

Virtual reality (VR) based surgical simulator systems offer very elegant possibilities to both enrich and enhance traditional education in endoscopic surgery. However, while a wide range of VR simulator systems have been proposed and realized in the past few years, most of these systems are far from able to provide a reasonably realistic surgical environment. We explore the basic approaches to the current limits of realism and ultimately seek to extend these based on our description and analysis of the most important components of a VR-based endoscopic simulator. The feasibility of the proposed techniques is demonstrated on a first modular prototype system implementing the basic algorithms for VR-training in gynaecologic laparoscopy.

Role of smooth muscle cell death in advanced coronary primary lesions: implications for plaque instability.

OBJECTIVE: Instability of coronary atheroma leads to the onset of acute coronary syndromes including myocardial infarction and death, as well as to the progression of the arteriosclerotic disease. As yet, the underlying factors and mechanisms causing plaque rupture are not completely understood. Since a low content of smooth muscle cells (SMCs) apparently plays a key role, the question points to the events leading to the loss of intimal SMCs. METHODS: We compared coronary atherectomy specimens from 25 patients with unstable angina to those from 25 patients with stable angina. Transmission electron microscopy was used to identify intimal cell population, to detect stage and cell type of apoptosis, and to differentiate between apoptosis and necrosis. RESULTS: Plaques associated with unstable angina contained more macrophages/lymphocytes and significantly less SMCs (P = 0.01), compared with stable angina plaques. Specific cell death forms, apoptosis and necrosis, were present in all coronary atheroma. As key findings, both the proportion of SMCs undergoing apoptosis and the frequency of cytoplasmic remnants of apoptotic SMCs (matrix vesicles) were significantly increased in unstable versus stable angina lesions (P = 0.002 and P = 0.002). In addition, cellular necrosis was more frequent in the first coronary atheroma group (P = 0.02). Positive correlations were found between the frequency of apoptotic cells and necrosis (r = 0.41, P = 0.04), and that of matrix vesicles and necrosis (r = 0.63, P = 0.001) only in plaques with unstable angina, but not in those with stable angina. CONCLUSIONS: Our data demonstrate that high cell death due to apoptosis and necrosis is a basic in situ feature found in advanced coronary primary lesions associated with unstable angina, possibly explaining their low density of (viable) SMCs. Thus, antagonization of intimal cell death should be considered in order to stabilize the intimal plaque texture of coronary atheroma with the ultimate goal to prevent plaque rupture.