Incorporating Situation Awareness Within Prebriefing to Enhance Clinical Judgement

Abstract :

Introduction:
Situation awareness (SA) is linked with actionable decision-making and clinical judgment in nursing practice. The cognitive processes used in developing SA, outlined in Endsley’s (1995) model, is the framework underpinning this study and are interwoven into the National Council of State Boards of Nursing Clinical Judgment Measurement Model (NCJMM). Cultivating these cognitive processes through prebriefing and simulation designed to intentionally develop SA, is a recommended practice currently seen in aviation and military training.

Methods:
A quasi-experimental design was used to test the effectiveness of an intentional, structured prebriefing intervention designed to foster SA and implemented prior to high-fidelity manikin simulation in a study involving 130 traditional prelicensure nursing students.

Results:
The surprising difference in prelicensure nursing students’ SA during a simulation after participating in SA-focused prep work and prebriefing compared to customary prep work and prebriefing will be presented using the data from four instruments: the Situation Awareness Global Assessment Technique (SAGAT), the Situation Awareness Rating Tool (SART), the Lasater Clinical Judgment Rubric (LCJR) and the Prebriefing Experience Scale (PES). Implications of the results for simulation educators and their learners will be detailed.

Conclusions:
SA is inexorably linked with making good decisions informed by and resulting in clinical judgment in nursing practice. The cognitive processes used in developing SA in students is interwoven into the NCJMM, and using simulation to develop these skills is a recommended practice. This prebriefing intervention is a practical and useful way of incorporating SA within an impactful educational process to foster practice readiness.