Exploring Situational Awareness in Emergency Medicine

Italics: North American equivalent.
PGY, postgraduate year; SA, situational awareness.

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Authors and Disclosures

David J Lowe^1,2, Alastair J Ireland¹, Al Ross³ and Jean Ker⁴

¹Department of Emergency, Glasgow Royal Infirmary, Glasgow, UK
²Department of Anaesthesia, Critical Care & Pain, University of Glasgow, Glasgow, UK
³Glasgow Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
⁴Clinical Skills Centre, College of Medicine, Dentistry and Nursing, University of Dundee, Dundee, UK

Correspondence to
Dr David J Lowe, Room 2.73, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow G31 2ER, UK; davidlowe@nhs.net

Contributors
DJL wrote the manuscript. AJI reviewed the manuscript for clinical context and novice to expertise development within the emergency department. AR reviewed the manuscript for human factors context. JK is MD supervisor and substantially reviewed the manuscript and educational context.

Competing interests
None declared.

Sidebar 1

Main Messages

• Situational Awareness is a core Non-Technical Skill for Emergency Physicians to develop, which will ensure that they deliver safe and effective care. Simply, it is being alert and maintaining a knowledge of what is happening around you.

• Emergency Physicians are challenged to maintain SA at an individual patient, team and departmental level as they progress in their training and responsibility. The development of strategies to maintain SA despite the biases, interruptions, distractions and volume of patients that characterise an ED requires an awareness of the cognitive processes that contribute to effective decision making.

• Progression to and achievement of expert SA is dependant on mentorship and feedback and a shared understanding required to facilitate these discussions. The proposed model provides a conceptual framework that describes the development of SA from novice to expert within the ED.

Sidebar 2

Current Research Questions

• How do we develop situational awareness in trainees, can it be taught?

• What tools/metrics should we use to assess situational awareness for clinicians?

• What are the key stages of development of situational awareness in clinicians?