Results
Increased levels of perceived pressure demonstrated an average decrease in marksmanship accuracy of 14.8%, together with a small increase in incorrect Decision Making (DM) and faster reaction Times (RT). Experience demonstrated a mitigating effect for pressure for marksmanship with a 1.1% increase for every one year of service but no effect on DM or RT. Training interventions utilizing a variety of early contextually relevant exposures to increased pressure improved performance over traditional training on average by 10.6%.

Conclusion
The outcomes illustrate the negative effect of pressure on marksmanship and UOF behaviours, and that early exposure to contextually relevant pressure may increase the transfer of training to real-world performance.

Effects of Intervention Strategies
The outcomes of intervention studies indicate that several intervention strategies may be effective in reducing the impact of high pressure conditions on marksmanship. Although there is limited data concerning the effectiveness of interventions, reality-based practices appeared to result in similar levels of effectiveness as did imagery and virtual reality–based interventions. A small but similar effect was associated with video based virtual training with an inverse relationship between effect of intervention and experience. When comparing the influence of experience in the context of these studies, the early exposure to contextually relevant stimuli, including the associated pressure, may provide a positive benefit in replicating experience that might be acquired in practice. This is especially evident when considering that the comparative results of the average intervention, incorporating contextually relevant pressure, is associated with an improvement in performance by 10.6%, or the equivalent 9.6 years of experience in service.

Differentiating the impact of reality-based training from imagery and emotionally based interventions also revealed a positive impact of intervention with the adverse impact of high pressure conditions reduced by 15% and 8% for mental imagery training (EI) and mental imagery and emotional training (EEI), respectively (Colin et al., 2014). However, it should be noted that two studies reported mixed results for interventions, one of which related to training Situational Awareness (SA, experience m = 6.09yrs) resulting in no significant changes to performance. However, training in mental imagery (MI, experience m = 15.11 years) was associated with a statistically significant, positive effect.

In combination, these results suggest that interventions may be more effective with inexperienced performers at the earlier stages of their career. However, the limited number of studies available, the lack of a standardised research design, variations in experience and the type of threat stimulus used, and the frequency and rate of exposure, make direct comparisons difficult in determining the optimal intervention strategy. Nevertheless, the results indicate that intervention strategies likely offer an improvement in performance, although further research is required to identify the optimal type and application of potential strategies.