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This study compared final year nursing students' error rate and use of strategies to maintain SA when undertaking specific nursing care in a simulated clinical environment pre and 10 weeks post a planned SA education intervention. Students were observed using a Performance Based Situation Awareness Observation Schedule (PBSAOS) undertaking two tasks in a simulated clinical environment pre and post the SA education. For task 1, post educational intervention, there was no significant increase in the error rate for any performance measures, and there were significant decreases in the error rates for three performance measures. For task 2, post educational intervention, there was a significant decrease in the error rate for two measures and a significant increase in the error rates for seven performance measures. In considering the overall group error rate when excluding uncompleted tasks, there was a significant (x =.0001) decrease in the error rate for task 1 post educational intervention (41.4% compared to 26.6%), and significant (x =.01) increase in the error for task 2 post educational intervention (39.6% compared to 47.3%). The findings of this study demonstrate that the implementation of an intervention designed to increase SA actually appear to have resulted in hyper-vigilance and subsequent noncompletion of required tasks.

Background: No instruments are currently available to assess nursing students' maintenance of situation awareness. The aim of this study was to develop and validate the Performance-Based Situation Awareness Observation Schedule for measuring nursing students' use of situation awareness. Method: Twelve expert clinicians participated in a qualitative, reiterative consensus-driven process to establish the content validity of the tool. The tool was then piloted during the delivery of a situation awareness education program for final-year nursing students. Cohen's kappa was used to assess the interrater reliability. Results: The resultant tool comprised 54 items, which captured strategies to maintain situation awareness and task errors that would infer the presence of situation awareness. The values obtained for Cohen's kappa indicated that the level of agreement was at least substantial for approximately 80% of the items. Conclusion: This study developed a valid and reliable tool to measure nursing students' use of situation awareness. [ J Nurs Educ. 2019;58(8):468–473.]

Purpose The purpose of this paper is to understand the perceptions and experiences of healthcare managers working within a community and ambulatory health service who manage poorly performing staff and, to identify the supports, and gaps in supports, that are available to these managers. Design/methodology/approach Data were collected via two focus groups using a semi-structured schedule. The data were transcribed, themed and conclusions summarised. Findings On analysis of the discussion of the line managers' experiences and perceptions of competence, six themes were identified, five themes common to both groups. When discussing the availability and gaps in supports available when managing poor performance, managers were aware of the majority of the supports available to them in the workplace but there was a disconnect between managers and the HR department. Research limitations/implications Though the results of this study are not generalisable, as the participants came from programs within a single hospital, they may be transferrable to other healthcare environments. Future research should attempt to replicate these findings using other research techniques. Practical implications The findings in this paper indicate that methods should be identified to build better relationships between managers and HR departments, develop clear management learning pathways, and to support managers to manage their emotional responses. These strategies will support organisations to achieve improved outcomes from the performance management processes. Originality/value This study contributes to the current literature by identifying key themes that may have an impact on the outcome of performance management processes. These themes would benefit from further exploration.