Situational awareness: a tacit yet viable concept

Parush, Avi

doi:10.1007/s12630-017-0905-1

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…However, it is clear that the responding surgeons completed setting specific activities designed to establish what should happen so that corrective or alternative actions could be initiated upon recognition of a discrepancy (ie, development and maintenance of situational awareness). 6 , 7 …”

Section: Discussionmentioning

confidence: 99%

Making Surgery as Safe as It Should Be: A Qualitative Study

Robinson

Beaumont

2023

American Journal of Medical Quality

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Existing literature supports the view that adverse outcomes from surgical interventions are more likely to be the result of degraded nontechnical skills (NTS) rather than the technical skills of surgeons. In the present context, NTS comprise the behaviors and cognitions deployed by surgeons to make decisions, maintain awareness of the operating environment, communicate with and lead supporting personnel. A contemporary safety thesis suggests that focusing on what makes things go right (eg, NTS) is far more productive than retrospective analysis (learning from mistakes). The present qualitative research explored how surgeons deploy NTS to facilitate safe and effective outcomes from surgical interventions. The thematic analysis revealed that this surgical cohort engaged specific self-regulated NTS along an intervention construct consisting of planning, implementation, monitoring progress, and deliberate learning through reflection during the preoperative, operative, and postoperative phases of care. Behaviors supporting these contentions were identified in the data and used to amplify use of the construct.

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Section: Discussionmentioning

confidence: 99%

Making Surgery as Safe as It Should Be: A Qualitative Study

Robinson

Beaumont

2023

American Journal of Medical Quality

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“…This randomized controlled intervention study demonstrates that a small educational intervention, consisting of a web module with follow-up group discussion in preparation for an in situ simulation session, may increase the positive effects of simulation based education. As Parush [ 49 ] describes, SA is a tacit viable concept, highly relevant in the clinical context since specific SA education effect task as well as team performance and to achieve high SA is a trainable skill for both novices and well experienced staff. Focusing on obtaining SA – that is, the process of how the team as a whole notice the situation (perception), understands how to interpret the situation (comprehension) and realizes how the situation is about to develop (projection) – was found to increase team performance.…”

Section: Discussionmentioning

confidence: 99%

Do team and task performance improve after training situation awareness? A randomized controlled study of interprofessional intensive care teams

Jönsson

Brulin

Härgestam

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background When working in complex environments with critically ill patients, team performance is influenced by situation awareness in teams. Moreover, improved situation awareness in the teams will probably improve team and task performance. The aim of this study is to evaluate an educational programme on situation awareness for interprofessional teams at the intensive care units using team and task performance as outcomes. Method Twenty interprofessional teams from the northern part of Sweden participated in this randomized controlled intervention study conducted in situ in two intensive care units. The study was based on three cases (cases 0, 1 and 2) with patients in a critical situation. The intervention group (n = 11) participated in a two-hour educational programme in situation awareness, including theory, practice, and reflection, while the control group (n = 9) performed the training without education in situation awareness. The outcomes were team performance (TEAM instrument), task performance (ABCDE checklist) and situation awareness (Situation Awareness Global Assessment Technique (SAGAT)). Generalized estimating equation were used to analyse the changes from case 0 to case 2, and from case 1 to case 2. Results Education in situation awareness in the intervention group improved TEAM leadership (p = 0.003), TEAM task management (p = 0.018) and TEAM total (p = 0.030) when comparing cases 1 and 2; these significant improvements were not found in the control group. No significant differences were observed in the SAGAT or the ABCDE checklist. Conclusions This intervention study shows that a 2-h education in situation awareness improved parts of team performance in an acute care situation. Team leadership and task management improved in the intervention group, which may indicate that the one or several of the components in situation awareness (perception, comprehension and projection) were improved. However, in the present study this potential increase in situation awareness was not detected with SAGAT. Further research is needed to evaluate how educational programs can be used to increase situation awareness in interprofessional ICU teams and to establish which components that are essential in these programs. Trial registration This randomized controlled trial was not registered as it does not report the results of health outcomes after a health care intervention on human participants.

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“…Although SA is generally understood to mean “to know what is going on”, it is difficult to precisely define, describe, and understand this concept for both laymen and professionals [ 13 ]. In the last two decades, the assessment of SA (and attempts to improve it) have sparked an interest in studying human behavior in teams.…”

Section: Discussionmentioning

confidence: 99%

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

Chmielewski

Łoś

Waszkiewicz

et al. 2021

JCM

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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.

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Situational awareness: a tacit yet viable concept

Cited by 5 publications

References 8 publications

Making Surgery as Safe as It Should Be: A Qualitative Study

Making Surgery as Safe as It Should Be: A Qualitative Study

Do team and task performance improve after training situation awareness? A randomized controlled study of interprofessional intensive care teams

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

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