Situation awareness (SA) is a human factor of critical importance to patient safety. Simulation training aims to examine and debrief human factors; however, SA cannot be directly observed. This has led to the development of SA measurement tools. The Situation Present Assessment Method (SPAM) measures SA in real-time without the need to pause the scenario. The SPAM process involves the delivery of queries to the participant who must answer them accurately and quickly. The latency between the query being asked and answer being received represents SA.
Two query delivery procedures are described in the literature: query delivery by telephone and in person. These procedures were piloted in simulation teaching with final-year medical students. The scenarios were videotaped and reviewed by the investigators to evaluate each procedure. Our evaluation of the existing SPAM procedures led us to adapt the method by developing a bespoke application, which delivers queries via a personal digital assistant (PDA), calculates the latency data and presents it to the instructor.
Presented by telephone, queries tended to disrupt the 'flow' of the simulation. The 'in person' procedure was not disruptive; however, participants found it difficult to distinguish queries from other dialogue. The PDA represented a compromise between these two techniques: generating data without disrupting the scenario.
The use of SPAM is feasible in clinical simulation. By using handheld technology, SA data are made available to the instructor for use in debrief; this expands the utility of SPAM to the field of medical education.
"To achieve this we developed an iOS app called iSPAM, which delivers queries via an iPod Touch, accurately measuring the latency data, and presenting it to the instructor for use in debrief (Figure 1). This use of learning technology presented significant advantages over the existing procedures, which tended to distract the participant's attention from the scenario or be misinterpreted as hints (Shelton et al. 2013). "
[Show abstract][Hide abstract] ABSTRACT: Human factors play a significant part in clinical error. Situational awareness (SA) means being aware of one's surroundings, comprehending the present situation, and being able to predict outcomes. It is a key human skill that, when properly applied, is associated with reducing medical error: eye-tracking technology can be used to provide an objective and qualitative measure of the initial perception component of SA. Feedback from eye-tracking technology can be used to improve the understanding and teaching of SA in clinical contexts, and consequently, has potential for reducing clinician error and the concomitant adverse events.
Open Access Emergency Medicine 11/2013; 5:23. DOI:10.2147/OAEM.S53021
[Show abstract][Hide abstract] ABSTRACT: Qualitative research methods are a group of techniques designed to allow the researcher to understand phenomena in their natural setting. A wide range is used, including focus groups, interviews, observation, and discourse analysis techniques, which may be used within research approaches such as grounded theory or ethnography. Qualitative studies in the anaesthetic setting have been used to define excellence in anaesthesia, explore the reasons behind drug errors, investigate the acquisition of expertise and examine incentives for hand-hygiene in the operating theatre. Understanding how and why people act the way they do is essential for the advancement of anaesthetic practice, and rigorous, well-designed qualitative research can generate useful data and important insights. Meticulous social scientific methods, transparency, reproducibility and reflexivity are markers of quality in qualitative research. Tools such as the consolidated criteria for reporting qualitative research checklist and the critical appraisal skills programme are available to help authors, reviewers and readers unfamiliar with qualitative research assess its merits.
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