Background: In-hospital cardiac arrests are a frequent occurrence and are associated with low survival rates. To improve patient outcomes and prevent neurological consequences, nurses must recognize early signs and symptoms of deterioration in the pre-cardiac arrest period. High situation awareness, i.e., an immediate understanding of the key elements of a situation, is essential for nurses to make informed decisions and take appropriate actions. Eye-tracking has emerged as a promising technology to assess nurses' visual attention in simulation. However, its relationship to situation awareness and the nursing role before cardiac arrest is not fully understood.

Aim: This study aimed to describe and compare role-based situation awareness and visual attention of nurses using eye-tracking during pre-cardiac arrest simulations.

Method: This study used a single-group observational design. Newly hired nurses participating in cardiac arrest simulations during an orientation program at a cardiology hospital in Montreal were recruited. Eye-tracking data were collected using Tobii Pro Glasses 3 during the minutes preceding the cardiac arrest. Fixations on key areas of interest (i.e., cardiac monitor, patient's head and chest) were compared with participants’ answers to a situation awareness questionnaire (SAGAT) after the simulations. Data were analyzed descriptively based on the participants’ roles in the simulation, which included designated nurses responsible for initial assessment and teammates assisting.

Results: Eye-tracking data revealed that designated nurses (n=12) looked at the patient more often and for longer than teammates (n=14). Similarly, situation awareness scores were higher for designated nurses (mean = 4.24, SD = 1.06) than for teammates (mean = 3.26, SD = 1.45). However, most participants did not recall the patient's respiratory rate and the cause of the cardiac arrest.

Conclusions: The study's findings suggest that there is a difference in the visual attention and situation awareness of nurses based on their roles, with both variables exhibiting a similar trend. While the results are promising, the limited sample size underscores the need for further research to explore the relationship between these variables. Additionally, the study revealed gaps in nurses' resuscitation education, indicating a need for interventions to address these deficiencies.