Poster1-10: SITUATIONAL AWARENESS IN THE OPERATING ROOM: SURGICAL ADAPTATION OF THE SITUATION AWARENESS RATING TECHNIQUE (S-SART) AS AN ASSESSMENT TOOL FOR MEDICAL STUDENTS
Jie Jane Chen, BA1, Amy Evenson, MD, MPH2, Celeste Royce, MD2, Benjamin James, MD, MS2; 1Harvard Medical School, 2Beth Israel Deaconess Medical Center
Background: Situational awareness (SA) in the operating room (OR) is defined as perceiving, comprehending, and anticipating the implications of events. While SA often impacts team dynamics and patient care, there are few formal curricula on SA and limited data on validated tools to assess SA in the medical field.
Methods: We designed a survey to assess medical student SA using a modified version of the validated Situation Awareness Rating Technique (SART) from the aviation industry. In our modified surgical SART (S-SART), we adapted each question scenario for the OR, while maintaining original SART domains. Overall S-SART scores were calculated according to the original methodology: Situational Awareness = Understanding – (Attentional Demand – Attentional Supply). Each question along the 3 domains was scored from 1 to 7, with a highest possible S-SART score of 46. Clerkship students were surveyed during the first week of their Surgery and Obstetrics/Gynecology clerkships. Two-sample t-tests were conducted to determine differences in S-SART scores.
Results: Twenty-one students (52% ages 20-24; 57% male; 62% with mild or strong interest in a surgical career) completed the pre-rotation survey. Most students had not completed prior clerkships (81%) nor taken more than one year away during medical training for dual degree programs, research, or other reasons (86%). The mean S-SART score was 17.25 (SD=6.90). The highest individual dimension was in alertness (mean=5.55, SD=1.39), while the lowest was in OR familiarity (mean=3, SD=1.64). Students reported greater knowledge of the role of others (mean=4.48, SD=1.21) compared to their own role in the OR (mean=3.76, SD=1.14). Students age ≥25 had significantly higher S-SART scores compared to those age ≤24 (p=0.010). There was no difference in S-SART scores by sex (p=0.14), interest in a surgical career (p=0.59), completion of prior rotations (p=0.68), or time away during medical training (p=0.35).
Conclusions: Medical students have moderately low S-SART scores preceding surgical clerkships, and especially struggle with OR familiarity and knowledge of their OR role. Age, independent of prior rotation completion and dual degree training, was a predictor of S-SART scores. Overall, there is a need to improve SA through a formalized curriculum.