Situation awareness and decision-making assessment of medical students in crisis management using key features questions
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Abstract
Objective: This study aimed to assess situation awareness and decision-making for perioperative crisis management in fifth-year medical students using key-features questions (KFQs) by applying the anesthetists’ non-technical skills and medical students’ non-technical skills framework as the key answers. Materials and Methods: Two-hundred and sixty 5th year medical students rotated to anesthesia clerkship from March 2013 to January 2014, all were assessed the approach to perioperative crisis management by KFQs. Two researchers made the scorecard and passing level to assess cognitive part of non-technical skills based on Anesthetists’ non-technical skills and Medical Students’ non-technical skills behavioral marker system. The KFQs answers were independently and retrospectively reviewed by 2 raters using the predefined scorecard. The answers that passed the passing standard for both raters were counted as passed. Results: Two-hundred and sixty KFQs answers were reviewed and scored. Two-hundred and eleven KFQs answers (81.2%) were able to pass the standard in level I of situation awareness; gathering information. While the level II (recognizing and understanding information) and III (anticipating) was reported as passed in 247 (95%) and 139 answers (53.5%) respectively. The passed answers for the decision-making category was 169 (65%), 77 (29.6%) and 134 (51.5%) for identifying options, balancing risks and selecting options and reviewing decisions respectively. The passed answers for escalating concerns was 62 (23.8%). Conclusions: Key-features questions can be used to assess cognitive parts of non-technical skills. Fifth-year medical students demonstrated sufficient level of situation awareness level I and II, while level III and all level of decision making are low.
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