Mindfulness Is Related to the Situational Awareness of Medical Students Confronted with Life-Threatening Emergency Situations

Abstract

Background: Emergency medicine can impose a heavy psychological burden on healthcare workers. Stress experienced during life-threatening situations may disrupt situational awareness (SA), i.e., the perception of environmental elements with respect to time and space, the comprehension of their meaning, and the projection of their state into the near future. We aimed to investigate whether mindfulness (a special way of paying attention: conscious, non-judgmental, and oriented to the present moment) can be related to the SA levels among final-year medical students confronted with life-threatening situations during medical simulations. Methods: The simulations were constructed as high-fidelity scenarios in children and adults (ClinicalTrials.gov ID: NCT03761355). The components of mindfulness were assessed using the Five Facet Mindfulness Questionnaire. SA among students was assessed using The Situation Awareness Global Assessment Technique at three levels: (1) data, (2) comprehension, and (3) projection. Results: In total, 117 students were included. Level 1 SA positively correlated with the overall mindfulness score and its components, i.e., nonreactivity, conscious presence, and nonjudgment. Moreover, level 3 SA significantly correlated with the description, but not with the overall mindfulness score. A regression model showed that nonreactivity explained 34% of Level 1 of SA variability. The addition of conscious presence and nonjudgment into this model did not change its predictive value. Conclusions: nonreactivity a component of mindfulness of final-year medical students is related to the meticulous data collection of patients in life-threatening situations.

Shared Situational Awareness within the Hospital Emergency Context: A Scoping Review

“…Eight studies were included in the analysis of the current review. Seven of these studies employed an observational design [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. One was a randomized controlled intervention [ 18 ].…”

“…One was a randomized controlled intervention [ 18 ]. The results of this review showed that the term “shared situational awareness” in itself was not commonly used; instead “team situational awareness” was the most commonly used term [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. Further, the term “shared information” and shared mental model were used interchangeably with respect to team situational awareness [ 15 , 17 ].…”

“…Although, SSA is not globally used in the hospital emergency context [ 19 ], the review results revealed that Endsley’s frameworks [ 2 ] were the most used SA frameworks in the hospital emergency context. Four studies [ 11 , 12 , 15 , 18 ] employed the three-levels of Endsley’s framework [ 2 ], while one study has used one level of the framework [ 13 ]. According to Endsley’s framework [ 2 ], situational awareness components are Level 1: perception of the information present in the situation, Level 2: comprehension of what the information present in the situation means and, Level 3: projection of what might happen in the situation in the near future.…”

“…This review showed that Situation Awareness Global Assessment Technique (SAGAT) was the most common used technique [ 11 , 12 , 13 , 15 , 18 ]. SAGAT is a global technique designed by Endsley [ 1 ] to measure situational awareness.…”

“…Simulation allows the freezing of the scenario at a predetermined time while participants quickly answer questions related to the three levels of situation awareness (perception, comprehension, and projection). Four studies employed freezing activity [ 11 , 12 , 15 , 18 ]. Rosenman et al [ 13 ] only assessed the projection level of situational awareness, hence, no freeze technique was used, and the situational awareness questionnaire score was collected at the end of the simulated scenario.…”