Article Test

Background: Situational awareness involves the ability to recognise and interpret environmental cues and utilise this to predict future events. It is an important factor in the minimisation of human error in many settings, including healthcare. It is especially relevant within paramedic practice where the situation may be highly dynamic. Simulation-based education is increasingly used within paramedicine education and has been demonstrated as effective for the development of situational awareness in healthcare professionals.

Aims: The primary aim of this study was to evaluate the level of situational awareness in undergraduate paramedicine students during an immersive simulation compared to that during a more conventional, non-immersive scenario. A secondary aim was to examine student perceptions of situational awareness, as well as their experiences of the simulations in which they participated.

Methods: Third-year paramedicine students at an Australian university participated in two simulated emergency scenarios; one in an immersive setting, and one in a non-immersive environment. The Situation Awareness Global Assessment Technique was utilised to assess their level of situational awareness at various pre-determined points in each scenario. Subsequently, semi-structured interviews were utilised to examine student perceptions of situational awareness as well as their experiences of the simulations.

Results: Overall, students (n=18) demonstrated lower levels of situational awareness in the immersive simulation compared with the non-immersive simulation. Most errors occurred in the initial stages, within the ‘recognition’ component of situational awareness. Eight students participated in follow-up interviews, with the majority expressing that the immersive nature of the simulation adversely affected their scenario management. They reported difficulty in recall of basic knowledge, disorganisation of thoughts and clinical approach, and being able to concentrate only on one thing at a time.

Conclusion: Paramedicine students in our study demonstrated lower levels of situational awareness during an immersive simulated scenario compared with a conventional non-immersive setting, particularly in the initial ‘recognition’ stage of situational awareness. As a lack of situational awareness may contribute to healthcare errors, its assessment and development must be addressed within paramedicine education. The utilisation of immersive simulation in paramedicine curricula may play an important role in this area.