Evaluation of the Effects of a Simulation-Based Training Program on Situation Awareness in Student Registered Nurse Anesthetists

Abstract

Situation awareness is a non-technical skill that has major implications in human behavior. Faults in situation awareness can increase chances for error to occur. In the field of nurse anesthesia, this is particularly relevant as decisions often have to be made rapidly in dynamic environments with an understanding of potential outcomes. In spite of this, standard methods to teach situation awareness to student registered nurse anesthetists (SRNAs) have not been established. The purpose of this pilot study was to evaluate the effects of a simulation-based training program on situation awareness in student registered nurse anesthetists.

A quasi-experimental design was used to demonstrate that a simulation-based training program including debriefing impacts situation awareness. The Anesthetists’ Non-Technical Skills (ANTS) System, a validated behavioral assessment tool, was applied to SRNAs in this study. SRNA perceptions of their situation awareness and the simulation-based training program were measured using questionnaires.

The results of the study yielded several statistically significant findings. First, SRNAs had increased understanding of the concept of situation awareness as it pertains to nurse anesthesia, from M = 3.1 (SD = 0.9) to M = 4.7 (SD = 0.5), t(8) = 4.603, P = .002. Second, SRNAs expressed increased ability to apply the non-technical skill of situation awareness to the intraoperative management of patients, from M = 2.7 (SD = 0.7) to M = 4.1 (SD = 0.9), t(8) = 4.914, P = .001. Third, there were statistically significant increases in ANTS scores for each element of situation awareness (Gathering Information, Recognizing and Understanding, and Anticipating) as well as in the total score. Total ANTS Scores increased from M = 7.3 (SD = 1.8) to M = 10.3 (SD = 1.0), t(8) = 4.47, P = .0023.

This study revealed that the simulation-based training program including debriefing improved situation awareness performance in SRNAs. Furthermore, the SRNAs perceived an improved understanding of situation awareness and its application to their practice. Future studies with larger sample sizes and control groups may help to strengthen the generalizability of the data which may benefit educators searching for ways to utilize simulation-based training to target non-technical skills in SRNAs.