Qual Saf Health Care 13:i65-i71 doi:10.1136/qshc.2004.009951
  • Original Article

Objective measures of situation awareness in a simulated medical environment

  1. M C Wright,
  2. J M Taekman,
  3. M R Endsley*
  1. Department of Anesthesiology and the Duke University Human Simulation and Patient Safety Center, Duke University Medical Center, Durham, North Carolina, USA
  1. Correspondence to:
 Melanie C Wright PhD
 Department of Anesthesia, Box 3094, Duke University Medical Center, Durham, NC 27710 USA;


    One major limitation in the use of human patient simulators is a lack of objective, validated measures of human performance. Objective measures are necessary if simulators are to be used to evaluate the skills and training of medical practitioners and teams or to evaluate the impact of new processes or equipment design on overall system performance. Situation awareness (SA) refers to a person’s perception and understanding of their dynamic environment. This awareness and comprehension is critical in making correct decisions that ultimately lead to correct actions in medical care settings. An objective measure of SA may be more sensitive and diagnostic than traditional performance measures. This paper reviews a theory of SA and discusses the methods required for developing an objective measure of SA within the context of a simulated medical environment. Analysis and interpretation of SA data for both individual and team performance in health care are also presented.


    • * SA Technologies, Inc, Marietta, Georgia, USA

    • Work attributed to, and funded by the Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710 and SA Technologies, Inc., Marietta, GA.

    • Competing interests: MRE is the President of SA Technologies. SA Technologies markets software and user guides for the SAGAT.