Unpacking Situational Awareness in Emergency Medical Services: An Eye-Tracking Study of Visual Attention.

Situational awareness (SA) is critical for Emergency Medical Services (EMS) providers as they operate in high-stakes, dynamic environments requiring rapid information processing and decision-making. While prior research has explored SA challenges in EMS, little is known about how visual attention patterns influence SA and clinical performance. This study employs eye-tracking technology to objectively assess how EMS providers allocate their visual attention during simulated pediatric emergency scenarios in urban and rural settings. We investigate variations in visual attention across experience levels, team structures, and task roles and examine differences between high- and low-performing teams. Results reveal that high-performing teams demonstrate more frequent and evenly distributed visual scanning, whereas lower-performing teams exhibit a narrowed focus, increasing the risk of missing critical cues. Our findings underscore the need for training interventions and technology solutions to enhance SA and optimize EMS performance.