A Simulation‐based Approach to Measuring Team Situational Awareness in Emergency Medicine: A Multicenter, Observational Study

Rosenman, Elizabeth D.; Dixon, Aurora J.; Webb, Jessica M.; Brolliar, Sarah; Golden, Simon J.; Jones, Kerin A.; Shah, Sachita; Grand, James A.; Kozlowski, Steve W. J.; Chao, Georgia T.; Fernandez, Rosemarie

doi:10.1111/acem.13257

Cited by 40 publications

(36 citation statements)

References 41 publications

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“…In contrast to our results, similar pediatric simulations have shown no relationship between SA as assessed by the SAGAT method and achievement of the goal of the scenario [24]. In another study, this skill correlated with the team's clinical performance but did not correlate with the team's perception of shared understanding, team leader effectiveness, or team experience-similar to our results [25]. There are tools to improve SA.…”

Section: Discussioncontrasting

confidence: 63%

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations

Łoś

Chmielewski

Łuczyński

2020

IJERPH

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Over the past decade, high-fidelity medical simulation has become an accepted and widely used teaching method in pediatrics. Both simulation and work in the real conditions of emergency departments are accompanied by stress that affects the executive functions of participants. One of the methods for reducing stress among medical students and healthcare professionals is the practice of mindfulness. The aim of this study was to examine whether executive functions, mindfulness, and stress are related to the technical and non-technical skills of medical students participating in medical simulations in pediatrics. The study included 153 final-year medical students. A total of 306 high-fidelity simulations of life-threatening situations involving children were conducted. Results: Stress and the coping mechanism of the participants were correlated to their skills during pediatric simulations. Some components of mindfulness, such as non-judgment and conscious action, were positively related to the skills of medical team leaders. Executive functions correlated with the non-technical skills and mindfulness of the medical students. Conclusions: Stress, mindfulness, and executive functions modeled the behavior and skills of medical students during pediatric simulations of life-threatening events. Further research in this area may prove whether mindfulness training will improve learning outcomes in pediatric emergency medicine.

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Section: Discussioncontrasting

confidence: 63%

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations

Łoś

Chmielewski

Łuczyński

2020

IJERPH

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“…In addition, team leaders were unable to confirm whether they had adhered fully to the protocol and often requested confirmation from others, which was frequently falsely positive. This loss of situational awareness is well documented [31,32,33,34), particularly when immersed in complex or perceived stressful clinical situations [35,36] as individuals focus on the minutiae rather than the overall event. This lack of insight whilst concerning, is in keeping with previous published studies that have found, those that underperform overestimate their performance and high performers underestimate theirs [37] illustrating that self-reporting is neither a suitable means of measuring the quality of resuscitation performance nor should it be relied upon when recording medical interventions in patient records.…”

Section: Discussionmentioning

confidence: 99%

Does electronic decision support influence advanced life support in simulated cardiac arrest?

Jones

Hayes

Williams

et al. 2019

British Journal of Cardiac Nursing

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In-hospital Cardiac arrest is common but despite mandatory resuscitation training for staff, the survival rates vary considerably. The reason for such variation is unclear but may relate to a number of human factors. Decision support systems and tools have been suggested as a means of reducing human errors and improve patient outcome. In this proof of concept study, we tested the use of such a device in a simulated environment Methods The aims of this study were firstly, to investigate if the introduction of an electronic decision support system (eDSS) influenced the delivery of advanced life support in a simulated cardiac arrest scenario and secondly, to explore the users' views on their performance both with and without the eDSS.

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“…For each participant and scenario, a composite SART score was computed using the following formula: SART Z U e (D e S ), where U summed the understanding representing familiarity and quality/quantity of the information being processed, D summed the attentional demand representing instability, variability, and complexity of the situation, and S summed the attentional supply representing perceived readiness for the activity, spare mental capacity, good concentration, and proper division of attention. The SA global assessment technique (SAGAT), 12 validated in many domains including health care, [13][14][15] was used to objectively quantify participants' SA. During each simulated scenario, participants were asked a number of SArelated questions, with at least 2 questions related to each of the displays (eg, Who are we treating?…”

Section: Quantification Of Situation Awarenessmentioning

confidence: 99%

Assessment of Radiation Therapy Technologists’ Workload and Situation Awareness: Monitoring 2 Versus 3 Collocated Display Monitors

Nuamah

Mosaly

Adams

et al. 2021

Advances in Radiation Oncology

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This study aimed to assess the effect of monitoring 2 versus 3 collocated displays on radiation therapist technologists' (RTTs) workload (WL) and situation awareness (SA) during routine treatment delivery tasks. Methods and Materials: Seven RTTs completed 4 simulated treatment delivery scenarios (2 scenarios per experimental condition; 2 vs 3 collocated displays) in a within-subject experiment. WL was subjectively measured using the National Aeronautics and Space Administration (NASA) Task Load Index, and objectively measured using eye activity measures. SA was subjectively measured using the SA rating technique, and objectively measured using the SA global assessment technique. Two-tailed paired t tests were conducted to test for differences in means when parametric assumptions were satisfied, otherwise Wilcoxon signed-rank tests were conducted. A .05 level of significance was applied to all statistical tests. Results: No statistically and clinically significant differences were observed between monitoring 2 versus 3 monitors on eye tracking measures (blink rate: 9.4 [4.8] vs 9.6 [4.0]; task evoked pupillary response: 0.16 [0.14] vs 0.21 [0.15]; NASA Task Load Index: 34.7 [19.8] vs 35.3 [20.4]; SA rating technique: 19.3 [6.2] vs 19.5 [7.0]; and SA global assessment technique scores: 100 [0] vs 100 [0]). Conclusions: Our preliminary findings suggest that monitoring 3 collocated displays by 1 RTT does not impact WL and SA compared with monitoring 2 collocated displays. Only 2 of many possible configurations were investigated. If institutions removed the 3rd display based on the results of this study, there could be unforeseen error(s) if that display helped in situations not assessed in this study.

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A Simulation‐based Approach to Measuring Team Situational Awareness in Emergency Medicine: A Multicenter, Observational Study

Cited by 40 publications

References 41 publications

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations

Does electronic decision support influence advanced life support in simulated cardiac arrest?

Assessment of Radiation Therapy Technologists’ Workload and Situation Awareness: Monitoring 2 Versus 3 Collocated Display Monitors

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