• Glenio B Mizubuti, E LimaLais H NLHNDepartment of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada., E LimaRodrigo MRMDepartment of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada., Adrienne K Ho, Rita de Cássia Rodrigues, Daniel Carlos Cagnolati, Victório Dos Santos Júnior, Elio B R Belfiore, Filipe N C Santos, Wai Shun Vincent Lam, Mandy Chu, Linda T C Korz, Adam Szulewski, Michael McMullen, Jessica Burjorjee, Devin Sydor, Kathleen Carten, Louie Wang, Rachel Phelan, Bethany Smethurst, Camilyn Cheng, Wilma M Hopman, and Anthony M-H Ho.
• Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada. gleniomizubuti@hotmail.com.
• Can J Anaesth. 2024 Sep 1; 71 (9): 122912371229-1237.

PurposeMedical errors may be occasionally explained by inattentional blindness (IB), i.e., failing to notice an event/object that is in plain sight. We aimed to determine whether age/experience, restfulness/fatigue, and previous exposure to simulation education may affect IB in the anesthetic/surgical setting.MethodsIn this multicentre/multinational study, a convenience sample of 280 anesthesiologists watched an attention-demanding video of a simulated trauma patient undergoing laparotomy and (independently/anonymously) recorded the abnormalities they noticed. The video contained four expected/common abnormalities (hypotension, tachycardia, hypoxia, hypothermia) and two prominently displayed unexpected/rare events (patient's head movement, leaky central venous line). We analyzed the participants' ability to notice the expected/unexpected events (primary outcome) and the proportion of expected/unexpected events according to age group and prior exposure to simulation education (secondary outcomes).ResultsAnesthesiologists across all ages noticed fewer unexpected/rare events than expected/common ones. Overall, younger anesthesiologists missed fewer common events than older participants did (P = 0.02). There was no consistent association between age and perception of unexpected/rare events (P = 0.28), although the youngest cohort (< 30 yr) outperformed the other age groups. Prior simulation education did not affect the proportion of misses for the unexpected/rare events but was associated with fewer misses for the expected/common events. Self-perceived restfulness did not impact perception of events.ConclusionAnesthesiologists noticed fewer unexpected/rare clinical events than expected/common ones in an attention-demanding video of a simulated trauma patient, in keeping with IB. Prior simulation training was associated with an improved ability to notice anticipated/expected events, but did not reduce IB. Our findings may have implications for understanding medical mishaps, and efforts to improve situational awareness, especially in acute perioperative and critical care settings.© 2024. Canadian Anesthesiologists' Society.

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