title: Use of human patient simulation and validation of the Team Situation Awareness Global Assessment Technique (TSAGAT): a multidisciplinary team assessment tool in trauma education.
abstract: OBJECTIVE
  Situation awareness (SA) is a vital construct for decision making in intense, dynamic environments such as trauma resuscitation. Human patient simulation (HPS) allows for a safe environment where individuals can develop these skills. Trauma resuscitation is performed by multidisciplinary teams that are traditionally difficult to globally assess. Our objective was to create and validate a novel tool to measure SA in multidisciplinary trauma teams using a HPS--the Team Situation Awareness Global Assessment Technique (TSAGAT).
  
  
  METHODS
  Memorial University Simulation Centre.
  
  
  METHODS
  Using HPS, 4 trauma teams completed 2 separate trauma scenarios. Student, junior resident, senior resident, and attending staff teams each had 3 members (trauma team leader, nurse, and airway manager). Individual SAGATs were developed by experts in each respective field and contained shared and complimentary knowledge questions. Teams were assessed with SAGAT in real time and with traditional checklists using video review. TSAGAT was calculated as the sum of individual SAGAT scores and was compared with the traditional checklist scores.
  
  
  RESULTS
  Shared, complimentary, and TSAGAT scores improved with increasing team experience. Differences between teams for TSAGAT and complimentary knowledge were statistically significant (p < 0.05). Mean checklist differences between teams also reached statistical significance (p < 0.05). TSAGAT scores correlated strongly with traditional checklist scores (Pearson correlation r = 0.996). Interrater reliability for the checklist tool was high (Pearson correlation r = 0.937).
  
  
  CONCLUSIONS
  TSAGAT is the first valid and reliable assessment tool incorporating SA and HPS for multidisciplinary team performance in trauma resuscitation. TSAGAT could compliment or improve on current assessment methods and curricula in trauma and critical care and provides a template for team assessment in other areas of surgical education.
authors.affiliation: Discipline of Surgery, Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Crozier
authors.affiliation: Discipline of Surgery, Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Heather Y
authors.initials: HY
authors.lastname: Ting
authors.affiliation: Discipline of Surgery, Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Darrell C
authors.initials: DC
authors.lastname: Boone
authors.affiliation: Discipline of Surgery, Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Noel B
authors.initials: NB
authors.lastname: O'Regan
authors.affiliation: Discipline of Surgery, Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bandrauk
authors.affiliation: Discipline of Surgery, Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Furey
authors.affiliation: Discipline of Surgery, Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Squires
authors.affiliation: Discipline of Surgery, Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Hapgood
authors.affiliation: Discipline of Surgery, Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Electronic address: mphogan74@gmail.com.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hogan
mesh_terms: D001364:Awareness; D057189:Checklist; D002983:Clinical Competence; D003422:Critical Care; D003657:Decision Making; D006801:Humans; D010347:Patient Care Planning; D010348:Patient Care Team; D016544:Patient Simulation; D014194:Traumatology / Q000193:education* / Q000458:organization & administration / Q000592:standards
keywords: Interpersonal and Communication Skills; Medical Knowledge; Patient Care; SAGAT; TSAGAT; human patient simulation; situation awareness; trauma team performance