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Virtual Reality (VR) and 360-degree video are set to become part of the future social environment, enriching and enhancing the way we share experiences and collaborate remotely. While Social VR applications are getting more momentum, most services regarding Social VR focus on animated avatars. In this demo, we present our efforts towards Social VR services based on photo-realistic video recordings. In this demo paper, we focus on two parts, the communication between multiple people (max 3) and the integration of new media formats to represent users as 3D point clouds. We enhance a green screen (chroma key) like cut-out of the person with depth data, allowing point cloud based rendering in the client. Further, the paper presents a user study with 54 people evaluating a three-people communication use case and a technical analysis to move towards 3D representations of users. This demo consists of two shared virtual environments to communicate and interact with others, i.e. i) a 360-degree virtual space with users being represented as 2D video streams (with the background removed) and ii) a 3D space with users being represented as point clouds (based on color and depth video data).

The goal of the present study was to investigate whether playing a serious game concerning natural and man-made risks leads to increased risk awareness and additional information search. As an experimental task, we developed a serious board game. Fifty-six students participated in the experiment; half of them played the serious game whereas the other half only filled in a questionnaire at pretest and posttest (after two weeks). Participants who had played the game were more aware of risks in their own environment. Furthermore, playing the serious game counterbalanced the decline in self-efficacy as seen in the control condition. In both conditions, participants gathered more information on natural risks. This positive effect in the control condition is probably a side effect of the method used: a reasonably elaborate questionnaire in combination with a delay of two weeks. In all, the results provide a positive basis for further development of the game and to use it on a larger scale to empower citizens to take more responsibility for their own safety.

This article describes the background, design, and practical application of the game-based evaluation model (GEM). The aim of this evaluation model is to measure the effectiveness of serious games in a practical way. GEM contains the methodology and indicators to be measured in validation research. Measuring generic learning and design indicators makes it possible to apply GEM on multiple games. Results provide insight in the reasons why serious games are effective. This evidence will help serious gaming designers to improve their games. Three empirical studies based on various serious games applied in different contexts show how GEM can be practically used and how these studies have contributed to the improvement of GEM.

Although serious games are more and more used for learning goals, high-quality empirical studies to prove the effectiveness of serious games are relatively scarce. In this paper, three empirical studies are presented that investigate the effectiveness of serious games as opposed to traditional classroom instruction on learning features as well as learning outcomes. All three studies used a similar longitudinal case-control study design and measured the same set of learning features (control, challenge, feedback, engagement and social interaction). Learning outcomes were measured by self-report and knowledge tests. Results of the three studies show that students that played the serious games scored higher on features associated with high-quality learning. Furthermore, the studies show that serious gaming is more effective on self-reported learning outcomes than traditional classroom instruction. Effects of serious gaming on the knowledge tests were not found. The studies serve as a first step to the development of a generic evaluation framework for serious gaming.

As the world in the 21st century has become more dynamic and unpredictable, the need for adaptive behavior in the military is of increasing importance. A serious game (SG) seems to be a suitable intervention for improving adaptability to prepare the military to deal with unpredictability. The purpose of this study is to explore the game design for enhancing adaptability of the military in an ill-structured complex decisionmaking context. We introduce rule changes in the game to stimulate learners’ sensitivity to detect the applied changes and to develop an appropriate strategy. The procedure of our SG intervention design and development is described within the framework of the Cognitive Flexibility Theory and that of Reversal Learning. The Job Oriented Training approach as well as rule change is embedded in the game structure. This paper summarizes the results of a pilot (n=12) with the game. The participants’ score, time spent to complete the game and adaptive performance score are described. Survey data shows players’ detection of rule change, their experience on difficulty, engagement, motivation, and concentration level of this game play. Finally, we discuss issues and future direction of this study.

Although serious games are more and more used for learning goals, high-quality empirical studies to prove the effectiveness of serious games are relatively scarce. In this paper, three empirical studies are presented that investigate the effectiveness of serious games as opposed to traditional classroom instruction on learning features as well as learning outcomes. All three studies used a similar longitudinal case-control study design and measured the same set of learning features (control, challenge, feedback, engagement and social interaction). Learning outcomes were measured by self-report and knowledge tests. Results of the three studies show that students that played the serious games scored higher on features associated with high-quality learning. Furthermore, the studies show that serious gaming is more effective on self-reported learning outcomes than traditional classroom instruction. Effects of serious gaming on the knowledge tests were not found. The studies serve as a first step to the development of a generic evaluation framework for serious gaming.

The importance of improving adaptive decision making for the military is ever increasing, particularly in operational environments that are unfamiliar, complex, and constantly changing. This paper presents the development and testing of a serious game for training military officers in adaptive decision making. Participants were to detect rule changes in the game world, and to adjust their decisions in accordance with these changes. In an explorative study, the effectiveness of the game was tested by using in-game and outgame measures. The findings on the in-game measure suggest that the game helps participants to detect rule changes and to adapt their decision making. Despite this effect, participants' cognitive flexibility did not increase based on the findings on the out-game measures. Discussions, future directions, and training implications for the Defense organization are described. Copyright 2017 by Human Factors and Ergonomics Society.

Personalisation can increase the learning efficacy of educational games by tailoring their content to the needs of the individual learner. This paper presents the Personalised Educational Game Architecture (PEGA). It uses a multi-agent organisation and an ontology to offer learners personalised training in a game environment. The multi-agent organisation's exibility enables adaptive automation; the instructor can decide to control only parts of the training, while leaving the rest to the intelligent agents.

Personalisation can increase the learning efficacy of educational games by tailoring their content to the needs of the individual learner. This paper presents the Personalised Educational Game Architecture (PEGA). It uses a multi-agent organisation and an ontology to offer learners personalised training in a game environment. The multi-agent organisation's exibility enables adaptive automation; the instructor can decide to control only parts of the training, while leaving the rest to the intelligent agents.

Containerization is the process of creating, packaging, distributing, deploying, and executing applications as self-contained units in a lightweight and standardized process execution environment known as a container. A container provides a standard format and interface to its container runtime environment and is portable across runtime environments. Because containers are, in principle, lightweight, they are very suitable to serve as the vehicle for the provision of packaged (micro)services. Docker is an open source product supporting the creation, management and deployment of containers. Docker has, since its public release in 2013, developed to the point where now it is a compelling solution for any distributed application-simulations built on the High Level Architecture included. This paper provides an overview of Docker and how it can be used in support of deploying and running HLA federations. Much of Docker can be used as is to provide real benefit in support of the management of HLA federations. However, there are use cases that require special consideration for how Docker is used, how federates are built, and how federations are composed. Antycip Simulation; Aptima; et al.; MAK Technologies; NATO Modelling and Simulation Group (NMSG); Pitch Technologies

Containerization is the process of creating, packaging, distributing, deploying, and executing applications as self-contained units in a lightweight and standardized process execution environment known as a container. A container provides a standard format and interface to its container runtime environment and is portable across runtime environments. Because containers are, in principle, lightweight, they are very suitable to serve as the vehicle for the provision of packaged (micro)services. Docker is an open source product supporting the creation, management and deployment of containers. Docker has, since its public release in 2013, developed to the point where now it is a compelling solution for any distributed application-simulations built on the High Level Architecture included. This paper provides an overview of Docker and how it can be used in support of deploying and running HLA federations. Much of Docker can be used as is to provide real benefit in support of the management of HLA federations. However, there are use cases that require special consideration for how Docker is used, how federates are built, and how federations are composed. Antycip Simulation; Aptima; et al.; MAK Technologies; NATO Modelling and Simulation Group (NMSG); Pitch Technologies

Background The application of digital games for training medical professionals is on the rise. So-called ‘serious’ games form training tools that provide a challenging simulated environment, ideal for future surgical training. Ultimately, serious games are directed at reducing medical error and subsequent healthcare costs. The aim was to review current serious games for training medical professionals and to evaluate the validity testing of such games. Methods PubMed, Embase, the Cochrane Database of Systematic Reviews, PsychInfo and CINAHL were searched using predefined inclusion criteria for available studies up to April 2012. The primary endpoint was validation according to current criteria. Results A total of 25 articles were identified, describing a total of 30 serious games. The games were divided into two categories: those developed for specific educational purposes (17) and commercial games also useful for developing skills relevant to medical personnel (13). Pooling of data was not performed owing to the heterogeneity of study designs and serious games. Six serious games were identified that had a process of validation. Of these six, three games were developed for team training in critical care and triage, and three were commercially available games applied to train laparoscopic psychomotor skills. None of the serious games had completed a full validation process for the purpose of use. Conclusion Blended and interactive learning by means of serious games may be applied to train both technical and non-technical skills relevant to the surgical field. Games developed or used for this purpose need validation before integration into surgical teaching curricula.

Changing image intensities causes problems for many computer vision applications operating in unconstrained environments. We propose generally applicable algorithms to correct for global differences in intensity between images recorded with a static or slowly moving camera, regardless of the cause of intensity variation. The proposed intensity correction is based on intensity quotient estimation. Various intensity estimation methods are compared. Usability is evaluated with background classification as example application. For this application we introduced the PIPE error measure evaluating performance and robustness to parameter setting. Our approach retains local intensity information, is always operational and can cope with fast changes in intensity. We show that for intensity estimation, robustness to outliers is essential for dynamic scenes. For image sequences with changing intensity, the best performing algorithm (MofQ) improves foreground-background classification results up to a factor two to four on real data.

Boys are disengaged from school and are rapidly becoming alienated. Video games show promise to engage boys in motivating and exciting ways. This paper explores the merits of game play, while discovering links between what boys learn in games and the standards that schools administer. Based on qualitative exploration with middle a high school boys, this study shows promise for video gaming as a tool that can be effectively mapped to the Common Core State and International Society for Technology in Education standards

Objective: Serious games are potentially powerful tools for residency training and increasingly attract attention from medical educators. At present, serious games have little evidence-based relations with competency-based medical education, which may impede their incorporation into residency training programs. The aim of this study was to identify highly valued entrustable professional activities (EPAs) to support designers in the development of new, serious games built on a valid needs-assessment. Materials and Methods: All 149 licensed medical specialists from seven specialties in one academic hospital participated in seven different Delphi expert panels. They filled out a two-round Delphi survey, aimed at identifying the most valuable EPAs in their respective curricula. Specialists were asked to name the most highly valued EPA in their area in the first Delphi round. In the second round, the generated responses were presented and ranked according to priority by the medical specialists. Results: Sixty-two EPAs were identified as valuable training subjects throughout five specialties. Eleven EPAs - "management of trauma patient," "chest tube placement," "laparoscopic cholecystectomy," "assessment of vital signs," "airway management," "induction of general anesthesia," "assessment of suicidal patient," "psychiatric assessment," "gastroscopy," "colonoscopy," and "resuscitation of emergency patients" - were consistently given a high score. Conclusions: The future medical specialist is an active learner, comfortable with digital techniques and learning strategies such as serious gaming. In order to maximize the impact and acceptance of new serious games, it is vital to select the most relevant training subjects. Although some serious games have already targeted top-priority EPAs, plenty of opportunities remain.

This article presents novel methods for representing and analyzing a special class of multiagent bargaining settings that feature multiple players, large action spaces, and a relationship among players' goals, tasks, and resources. We show how to reduce these interactions to a set of bilateral normal-form games in which the strategy space is significantly smaller than the original settingswhile still preserving much of their structural relationship. The method is demonstrated using the Colored Trails (CT) framework, which encompasses a broad family of games and has been used in many past studies. We define a set of heuristics (metastrategies) in multiplayer CT games that make varying assumptions about players' strategies, such as boundedly rational play and social preferences. We show how these CT settings can be decomposed into canonical bilateral games such as the Prisoners' Dilemma, Stag Hunt, and Ultimatum games in a way that significantly facilitates their analysis. We demonstrate the feasibility of this approach in separate CT settings involving one-shot and repeated bargaining scenarios, which are subsequently analyzed using evolutionary game-theoretic techniques. We provide a set of necessary conditions for CT games for allowing this decomposition. Our results have significance for multiagent systems researchers in mapping large multiplayer CT task settings to smaller, well-known bilateral normal-form games while preserving some of the structure of the original setting. © 2015 ACM.

This article describes the background, design, and practical application of the game-based evaluation model (GEM). The aim of this evaluation model is to measure the effectiveness of serious games in a practical way. GEM contains the methodology and indicators to be measured in validation research. Measuring generic learning and design indicators makes it possible to apply GEM on multiple games. Results provide insight in the reasons why serious games are effective. This evidence will help serious gaming designers to improve their games. Three empirical studies based on various serious games applied in different contexts show how GEM can be practically used and how these studies have contributed to the improvement of GEM.

Militaire missies vinden steeds vaker plaats in verstedelijkt gebied, in landen met minder bekende culturen en in regio’s met veel lokale groepen, die elk hun eigen belangen hebben. De hedendaagse militair moet complexe situaties snel kunnen analyseren en doorgronden. Een goede training in situatiebeoordeling, besluitvorming en communicatie is hiervoor onontbeerlijk. In huidige opleidingsprogramma’s wordt dit geoefend in simulaties met rollenspelers. Dit is niet altijd optimaal. Bovendien is de inzet van rollenspelers duur en moeilijk te organiseren. Gedragsmodellen bieden de mogelijkheid om simulatietraining systematischer, effectiever en efficiënter te maken. Maar wat zijn gedragsmodellen eigenlijk? Wat is er nodig om ze in te zetten voor militaire training, en welke mogelijkheden bieden ze voor Defensie?

Improving both efficiency and security in international supply chains requires a new approach in data sharing and control measures. Instead of managing supply chain risks individually, supply chain partners need to collaborate in order to exchange cargo information and implement control measures on the level of the entire supply chain. Governmental agencies, having access to this up-to-date and complete information, can implement alternative risk assessment policies, resulting in less disruptive ways of supervising entire trade lanes. However, this paradigm shift requires awareness of these supply chain visibility concepts and increased collaboration between partners in a value chain. In order to disseminate these new concepts and initiate cooperation between key stakeholders, a serious game called ‘The Chain Game’ was designed, implemented and evaluated. © IFIP International Federation for Information Processing 2015.

This article presents novel methods for representing and analyzing a special class of multiagent bargaining settings that feature multiple players, large action spaces, and a relationship among players’ goals, tasks, and resources. We show how to reduce these interactions to a set of bilateral normal-form games in which the strategy space is significantly smaller than the original settings while still preserving much of their structural relationship. The method is demonstrated using the Colored Trails (CT) framework, which encompasses a broad family of games and has been used in many past studies. We define a set of heuristics (metastrategies) in multiplayer CT games that make varying assumptions about players’ strategies, such as boundedly rational play and social preferences. We show how these CT settings can be decomposed into canonical bilateral games such as the Prisoners’ Dilemma, Stag Hunt, and Ultimatum games in a way that significantly facilitates their analysis. We demonstrate the feasibility of this approach in separate CT settings involving one-shot and repeated bargaining scenarios, which are subsequently analyzed using evolutionary game-theoretic techniques. We provide a set of necessary conditions for CT games for allowing this decomposition. Our results have significance for multiagent systems researchers in mapping large multiplayer CT task settings to smaller, well-known bilateral normal-form games while preserving some of the structure of the original setting.

Improving both efficiency and security in international supply chains requires a new approach in data sharing and control measures. Instead of managing supply chain risks individually, supply chain partners need to collaborate in order to exchange cargo information and implement control measures on the level of the entire supply chain. Governmental agencies, having access to this up-to-date and complete information, can implement alternative risk assessment policies, resulting in less disruptive ways of supervising entire trade lanes. However, this paradigm shift requires awareness of these supply chain visibility concepts and increased collaboration between partners in a value chain. In order to disseminate these new concepts and initiate cooperation between key stakeholders, a serious game called ‘The Chain Game’ was designed, implemented and evaluated. © IFIP International Federation for Information Processing 2015.

Current developments of virtual reality exposure therapy (VRET) system focus mainly on systems that can be used in health clinics under the direct supervision of a therapist. Offering patients however the possibility to do this treatment at home would make VRET more accessible. In this paper we therefore present a home-based VRET system for the treatment of social anxiety disorder. The system includes 19 exposure scenarios as well as a virtual health agent that guides the patients to various steps of therapy and explains how the system can be used. The presented design and techniques may form the bases for future home-based VRET systems. © Springer International Publishing Switzerland 2015.

This paper applies a Game-based Learning Evaluation Model (GEM) to assess whether the early warning - early action serious game "Ready!" is an effective component to add to existing Disaster Risk Reduction (DRR) training curricula, facilitated by NGO staff and applied at the community level. We developed a paper-based survey with 17 five-level Likert items and 15 open questions addressing the different GEM indicators to question 16 NGO staff, and used a simplified set of five questions with emoticons for 58 community people. The results showed that the staff saw great potential in embedding Ready! in DRR processes and that the community highly appreciated the game. The GEM was found to be a useful methodology to evaluate the effectiveness of this serious game. However, in the context of a lower educated and partly illiterate community, the importance of designing an individual, largely visual assessment instrument instead of a paper-based survey was acknowledged.

In order to achieve a further reduction of delivery time, costs and emissions of the hinterland transportation of containers, The Port of Rotterdam Authority aims to raise the utilization rate of inland barge and rail capacity. Efficient transport planning methods are essential to achieve this. Synchromodality is the flexible and sustainable deployment of different modes of transport in a network under the direction of a logistics service provider, so that the customer is offered an integrated solution for his (inland) transport. The concept of synchromodal inland container transportation is promising, but not operational yet, since stakeholders need to make the mind shift from traditional planning to network planning. In order to provide transport planners, transport sales persons, and the customer with insights in how synchromodal planning can improve the network’s performance and reduce the supply chain costs, we created a serious game called Synchro Mania. This paper describes the design and development of Synchro Mania and summarises the results of the game’s evaluation.

Objective : Serious games are potentially powerful tools for residency training and increasingly attract attention from medical educators. At present, serious games have little evidence-based relations with competency-based medical education, which may impede their incorporation into residency training programs. The aim of this study was to identify highly valued entrustable professional activities (EPAs) to support designers in the development of new, serious games built on a valid needs-assessment. Materials and Methods : All 149 licensed medical specialists from seven specialties in one academic hospital participated in seven different Delphi expert panels. They filled out a two-round Delphi survey, aimed at identifying the most valuable EPAs in their respective curricula. Specialists were asked to name the most highly valued EPA in their area in the first Delphi round. In the second round, the generated responses were presented and ranked according to priority by the medical specialists. Results : Sixty-two EPAs were identified as valuable training subjects throughout five specialties. Eleven EPAs—“management of trauma patient,” “chest tube placement,” “laparoscopic cholecystectomy,” “assessment of vital signs,” “airway management,” “induction of general anesthesia,” “assessment of suicidal patient,” “psychiatric assessment,” “gastroscopy,” “colonoscopy,” and “resuscitation of emergency patients”—were consistently given a high score. Conclusions : The future medical specialist is an active learner, comfortable with digital techniques and learning strategies such as serious gaming. In order to maximize the impact and acceptance of new serious games, it is vital to select the most relevant training subjects. Although some serious games have already targeted top-priority EPAs, plenty of opportunities remain.

Boys are disengaged from school and are rapidly becoming alienated. Video games show promise to engage boys in motivating and exciting ways. This paper explores the merits of game play, while discovering links between what boys learn in games and the standards that schools administer. Based on qualitative exploration with middle a high school boys, this study shows promise for video gaming as a tool that can be effectively mapped to the Common Core State and International Society for Technology in Education standards

This research is grounded in the issues of educating children living in remote and conflict areas, with a particular focus on innovative approaches to access via online and distance learning using ICT. Educational technology often focuses on giving resources and support for use by teachers, working within existing curricula and with a clear focus on evaluation. What does this mean for a situation where a teacher is unavailable, or unqualified? Is it possible to deliver the support professional teachers give within a digital learning environment? Can we evaluate children’s progress? And how do we use this information to help children when they do not know how to continue? ELearning Sudan (ELS) was developed as a game that enables children living in remote communities in Sudan aged 7-9, to autonomously learn mathematics covering the formal Accelerated Learning Programme (ALP) curriculum of three years. ELS is now in its second phase, with research from the first phase (and to date in the second) showing that these children were able to learn faster and achieve better results using the mathematics game than those enrolled in traditional education. The six-month pilot also showed that children can stay motivated over a longer period of time. Continuous assessment ensured that children could only progress to a next 'level' when they had mastered the previous one. Autonomous learning requires a specific pedagogical approach for children to be able to learn. This paper will describe how children were stimulated to engage actively with the game, and what the role of continuous assessment was to achieve this.

Background: Surgical errors result from faulty decision-making, misperceptions and the application of suboptimal problem-solving strategies, just as often as they result from technical failure. To date, surgical training curricula have focused mainly on the acquisition of technical skills. The aim of this review was to assess the validity of methods for improving situational awareness in the surgical theatre. Methods: A search was conducted in PubMed, Embase, the Cochrane Library and PsycINFO® using predefined inclusion criteria, up to June 2014. All study types were considered eligible. The primary endpoint was validity for improving situational awareness in the surgical theatre at individual or team level. Results: Nine articles were considered eligible.These evaluated surgical team crisis training in simulated environments for minimally invasive surgery (4) and open surgery (3), and training courses focused at training non-technical skills (2). Two studies showed that simulation-based surgical team crisis training has construct validity for assessing situational awareness in surgical trainees in minimally invasive surgery. None of the studies showed effectiveness of surgical crisis training on situational awareness in open surgery, whereas one showed face validity of a 2-day non-technical skills training course. Conclusion: To improve safety in the operating theatre, more attention to situational awareness is needed in surgical training. Fewstructured curricula have been developed and validation research remains limited. Strategies to improve situational awareness can be adopted from other industries.

Current developments of virtual reality exposure therapy (VRET) system focus mainly on systems that can be used in health clinics under the direct supervision of a therapist. Offering patients however the possibility to do this treatment at home would make VRET more accessible. In this paper we therefore present a home-based VRET system for the treatment of social anxiety disorder. The system includes 19 exposure scenarios as well as a virtual health agent that guides the patients to various steps of therapy and explains how the system can be used. The presented design and techniques may form the bases for future home-based VRET systems. © Springer International Publishing Switzerland 2015.

1 Inleiding 3 2 Ontwerpeisen voor de game 4 2.1 Doelen 4 2.2 Spelontwerp 4 3 Gameconcept 7 3.1 Game ontwerp – overall 7 3.2 Flow van het spel – acties 8 3.3 Flow van het spel – klanten 8 3.4 Flow van het spel - scores 9 3.5 Rondeverloop 9 3.6 Actiekaarten 9 3.7 KPI’s 9 4 Low-fi spel 10 4.1 Overall evaluatie 10 4.2 Feedback op de game 10 4.3 Ontwerp orderset 12 5 Programma van Eisen 15 5.1 Grafische user interface 15 5.2 Events 16 5.3 Speleracties 16 5.4 Klantmodel 18 5.5 Kostenmodel 18 5.6 Overigen 18 6 Screen designs 19 7 Actiekaarten 20

This research is grounded in the issues of educating children living in remote and conflict areas, with a particular focus on innovative approaches to access via online and distance learning using ICT. Educational technology often focuses on giving resources and support for use by teachers, working within existing curricula and with a clear focus on evaluation. What does this mean for a situation where a teacher is unavailable, or unqualified? Is it possible to deliver the support professional teachers give within a digital learning environment? Can we evaluate children’s progress? And how do we use this information to help children when they do not know how to continue? ELearning Sudan (ELS) was developed as a game that enables children living in remote communities in Sudan aged 7-9, to autonomously learn mathematics covering the formal Accelerated Learning Programme (ALP) curriculum of three years. ELS is now in its second phase, with research from the first phase (and to date in the second) showing that these children were able to learn faster and achieve better results using the mathematics game than those enrolled in traditional education. The six-month pilot also showed that children can stay motivated over a longer period of time. Continuous assessment ensured that children could only progress to a next 'level' when they had mastered the previous one. Autonomous learning requires a specific pedagogical approach for children to be able to learn. This paper will describe how children were stimulated to engage actively with the game, and what the role of continuous assessment was to achieve this.

In order to achieve a further reduction of delivery time, costs and emissions of the hinterland transportation of containers, The Port of Rotterdam Authority aims to raise the utilization rate of inland barge and rail capacity. Efficient transport planning methods are essential to achieve this. Synchromodality is the flexible and sustainable deployment of different modes of transport in a network under the direction of a logistics service provider, so that the customer is offered an integrated solution for his (inland) transport. The concept of synchromodal inland container transportation is promising, but not operational yet, since stakeholders need to make the mind shift from traditional planning to network planning. In order to provide transport planners, transport sales persons, and the customer with insights in how synchromodal planning can improve the network’s performance and reduce the supply chain costs, we created a serious game called Synchro Mania. This paper describes the design and development of Synchro Mania and summarises the results of the game’s evaluation.

Background: Surgical errors result from faulty decision-making, misperceptions and the application of suboptimal problem-solving strategies, just as often as they result from technical failure. To date, surgical training curricula have focused mainly on the acquisition of technical skills. The aim of this review was to assess the validity of methods for improving situational awareness in the surgical theatre. Methods: A search was conducted in PubMed, Embase, the Cochrane Library and PsycINFO® using predefined inclusion criteria, up to June 2014. All study types were considered eligible. The primary endpoint was validity for improving situational awareness in the surgical theatre at individual or team level. Results: Nine articles were considered eligible.These evaluated surgical team crisis training in simulated environments for minimally invasive surgery (4) and open surgery (3), and training courses focused at training non-technical skills (2). Two studies showed that simulation-based surgical team crisis training has construct validity for assessing situational awareness in surgical trainees in minimally invasive surgery. None of the studies showed effectiveness of surgical crisis training on situational awareness in open surgery, whereas one showed face validity of a 2-day non-technical skills training course. Conclusion: To improve safety in the operating theatre, more attention to situational awareness is needed in surgical training. Fewstructured curricula have been developed and validation research remains limited. Strategies to improve situational awareness can be adopted from other industries.

Militaire missies vinden steeds vaker plaats in verstedelijkt gebied, in landen met minder bekende culturen en in regio’s met veel lokale groepen, die elk hun eigen belangen hebben. De hedendaagse militair moet complexe situaties snel kunnen analyseren en doorgronden. Een goede training in situatiebeoordeling, besluitvorming en communicatie is hiervoor onontbeerlijk. In huidige opleidingsprogramma’s wordt dit geoefend in simulaties met rollenspelers. Dit is niet altijd optimaal. Bovendien is de inzet van rollenspelers duur en moeilijk te organiseren. Gedragsmodellen bieden de mogelijkheid om simulatietraining systematischer, effectiever en efficiënter te maken. Maar wat zijn gedragsmodellen eigenlijk? Wat is er nodig om ze in te zetten voor militaire training, en welke mogelijkheden bieden ze voor Defensie?

Objective: This article describes the design rationale behind a serious self-regulation game intervention. The aim of the game is to promote healthy dietary intake and physical activity among secondary vocational educational students in The Netherlands (approximately 16-20 years of age). Materials and methods: The game "Balance It" was developed according to an intervention mapping (IM) protocol. Following IM, we specified health promotion and usability objectives and linked these objectives to selected behavior change and persuasive methods. Accordingly, these methods were translated into a coherent intervention program. Results: The health behavior change objectives were derived from the determinants of the behavior and from Self-Regulation Theory (e.g., students are asked to set goals, monitor and evaluate their behavior, and create coping plans). Usability objectives were derived from the RE-AIM model (i.e., Reach, Effectiveness, Adoption, Implementation, and Maintenance). Next, behavior change and persuasive techniques were selected (e.g., goal setting and prompting, respectively) that did fit with the targeted change objectives and were translated in the design of a (mobile) serious self-regulation game intervention. Subsequently, three concept and usability tests were performed to improve intervention usability, and an evaluation plan was developed. Conclusions: The aim of this study was to provide a design rationale for game interventions targeting health-related behaviors. We developed a coherent program design in which both health behavior change and usability factors are addressed. The IM protocol can serve as a useful guide for decision making in program development and evaluation.

Virtual reality exposure therapy has been proposed as a viable alternative in the treatment of anxiety disorders, including social anxiety disorder. Therapists could benefit from extensive control of anxiety eliciting stimuli during virtual exposure. Two stimuli controls are studied in this study: the social dialogue situation, and the dialogue feedback responses (negative or positive) between a human and a virtual character. In the first study, 16 participants were exposed in three virtual reality scenarios: a neutral virtual world, blind date scenario, and job interview scenario. Results showed a significant difference between the three virtual scenarios in the level of self-reported anxiety and heart rate. In the second study, 24 participants were exposed to a job interview scenario in a virtual environment where the ratio between negative and positive dialogue feedback responses of a virtual character was systematically varied on-the-fly. Results yielded that within a dialogue the more positive dialogue feedback resulted in less self-reported anxiety, lower heart rate, and longer answers, while more negative dialogue feedback of the virtual character resulted in the opposite. The correlations between on the one hand the dialogue stressor ratio and on the other hand the means of SUD score, heart rate and audio length in the eight dialogue conditions showed a strong relationship: r(6) = 0.91, p = 0.002; r(6) = 0.76, p = 0.028 and r(6) = 20.94, p = 0.001 respectively. Furthermore, more anticipatory anxiety reported before exposure was found to coincide with more self-reported anxiety, and shorter answers during the virtual exposure. These results demonstrate that social dialogues in a virtual environment can be effectively manipulated for therapeutic purposes. © 2014 Hartanto et al.

This study investigated the effects of the gamification elements of scaffolding, score and hints on the user enjoyment and motivation of people of low literacy. In a four-condition within-subjects experiment, participants per-formed mental spatial ability tests with the aforementioned elements. Quantitative results were inconclusive, but post-test interviews provided insights on the limited effectiveness of the gamification elements. Complex questionnaire wording, high task difficulty, and an improperly situated task environment all contributed to ceiling effects in the influence of scaffolding. Score was found to be ineffective without proper contextualization connecting the numerical score to clearer performance measures. Finally, the underused hints functionality has indicated the need for adequate 'mixed initiative' support.

The Generic Methodology for Verification and Validation (GM-VV) is a generic and comprehensive methodology for structuring, organizing and managing the verification and validation (V&V) of M&S assets. The GM-VV is a new recommended practice within the Simulation Interoperability Standards Organization (SISO), which is the result of a joint development effort with NATO. The GM-VV provides a technical framework to efficiently develop arguments to justify why M&S assets are acceptable or unacceptable for a specific intended use. This argumentation supports M&S stakeholders in their acceptance decision-making process regarding the development, application and reuse of such M&S assets. The GM-VV technical framework assures that during the execution of the V&V work the decisions, actions, information and evidence underlying such acceptance arguments will be traceable, reproducible, transparent and documented. This paper is the last in a series of three papers that collectively describe and illustrate the complete GM-VV technical framework and its application. This third paper presents the tailoring framework and implementation guidance for the GM-VV towards M&S projects and organizations. This is illustrated with examples and lessons-learned from the establishment of the Dutch V&V expertise center Q-tility and the V&V case-studies conducted by this organization.

At the heart of tactical decision making and strategic decision making is 'situation assessment', the most 'intuitive' aspect of complex decision making. In training, it is also the most neglected. Particularly for developing situation assessment skills and the cognitive flexibility to apply those skills to situations previously un-encountered, substantial experience in essentially different settings is indispensable. Also, gaining competency in decision making requires tactically valid feedback. Both requirements makes serious gaming an attractive alternative to live training as it allows (a) to train more - by a far more short-cyclic approach; (b) to train less - by providing dedicated training by isolating competencies that need intensive training; (c) to train differently; by dedicated game-based training approaches. In this paper, we describe competencies in complex decision making, requirements for training and subsequently three training approaches that have been field-tested each in at least two domains. Copyright © 2014 Inderscience Enterprises Ltd.