Gardner Aimee K, Kosemund Matthew, Martinez Joseph
From the Department of Surgery (A.K.G., M.K.), and Department of Emergency Medicine(M.K.), UT Southwestern Medical Center, Dallas, TX.
Simul Healthc. 2017 Feb;12(1):17-21. doi: 10.1097/SIH.0000000000000181.
Situational awareness (SA) describes a team's ability to perceive environmental elements, comprehend their meaning, and anticipate future events. Although SA is consistently described as a critical competency among surgical teams, there is a dearth of research identifying efficacious methods to assess and develop SA in such settings. The aim of this study was to investigate the feasibility of implementing an objective tool that has been used to measure SA in other intense and dynamic environments -the Situation Awareness Global Assessment Technique (SAGAT)-and to examine its ability to predict surgical trainee team performance.
Ten team-training sessions were conducted involving 2 standardized high-fidelity trauma simulation scenarios. Teams consisted of 4 or 5 participants, and roles were randomly assigned. Team situational awareness was assessed using the SAGAT method, which involves intermittent freezes to probe trainee awareness of the situation. Team performance was assessed using the Mayo High-Performance Teamwork Scale. Hierarchical regression was used to examine SA-performance relationships for each scenario.
Forty-three third-year medical students participated in the training sessions. Team SA ranged from 45% to 79% and 46% to 97% for the first and second scenarios, respectively. Additionally, team SA significantly predicted team performance for both the first scenario (F(1, 42)=19.57; P<0.001; R=0.30) and second scenario (F(1,42)=26.18, P<0.001; R=0.38).
The SAGAT is a valid, reliable tool for assessing surgical trainee SA. Information provided by the SAGAT can help diagnose team performance problems, inform debriefing discussion points, and inform curriculum development endeavors.
态势感知（SA）描述了团队感知环境要素、理解其含义并预测未来事件的能力。尽管态势感知一直被认为是手术团队的一项关键能力，但在确定评估和培养此类环境下态势感知的有效方法方面，研究却很匮乏。本研究的目的是探讨在其他高强度和动态环境中用于测量态势感知的一种客观工具——态势感知全局评估技术（SAGAT）的可行性，并检验其预测外科实习团队表现的能力。
进行了10次团队培训课程，涉及2个标准化的高保真创伤模拟场景。团队由4或5名参与者组成，角色随机分配。使用SAGAT方法评估团队态势感知，该方法包括间歇性冻结以探究学员对情况的感知。使用梅奥高效团队合作量表评估团队表现。采用分层回归分析每个场景下态势感知与表现之间的关系。
43名三年级医学生参加了培训课程。第一个场景中团队态势感知范围为45%至79%，第二个场景中为46%至97%。此外，在第一个场景（F(1, 42)=19.57；P<0.001；R=0.30）和第二个场景（F(1,42)=26.18，P<0.001；R=0.38）中，团队态势感知均显著预测了团队表现。
SAGAT是评估外科实习医生态势感知的有效、可靠工具。SAGAT提供的信息有助于诊断团队表现问题、为汇报讨论要点提供参考，并为课程开发工作提供参考。
