title: Testing nursing students' clinical judgment in a patient deterioration simulation scenario: Development of a situation awareness instrument.
abstract: BACKGROUND
  Situation awareness may be used to operationalize nursing students' clinical judgment of patient deterioration simulation scenarios.
  
  
  OBJECTIVE
  To develop and test an instrument to measure bachelor-level nursing students' situation awareness in a patient deterioration simulation scenario, using the Situation Awareness Global Assessment Technique (SAGAT).
  
  
  METHODS
  Instrument development and validation.
  
  
  METHODS
  A faculty of nursing of a French-Canadian university.
  
  
  METHODS
  15 critical care experts and 234 bachelor-level nursing students from a critical care course.
  
  
  METHODS
  The queries were developed from evidence and guidelines regarding nurses' assessment and response to patient deterioration and an inventory of nursing diagnosis. After expert content validation, the instrument was administered to three cohorts of nursing students in a high-fidelity simulation with a scenario of hypovolemic hemorrhagic shock. Difficulty, discrimination, and fidelity indices were computed. The impact of the instrument on student's performance was assessed with a post-simulation survey.
  
  
  RESULTS
  The instrument comprised 31 queries, which obtained high content validity indices. Most showed satisfying difficulty, discrimination, and fidelity properties. Inadequate properties of the queries may be explained by the content of the simulation scenario, the assessment practices of nursing students, and their reliance on medical assistance. Students perceived that completing the instrument helped them realize what they forgot to assess in the simulation.
  
  
  CONCLUSIONS
  This instrument appears as a promising research tool, although it still needs to be tested with other populations and in other patient deterioration simulation scenarios.
authors.affiliation: Faculté des sciences infirmières, Université de Montréal, C.P. 6128, succ. Centre-Ville, Montréal, QC H3C 3J7, Canada. Electronic address: patrick.lavoie.1@umontreal.ca.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lavoie
authors.affiliation: Faculté des sciences infirmières, Université de Montréal, C.P. 6128, succ. Centre-Ville, Montréal, QC H3C 3J7, Canada. Electronic address: sylvie.cossette.inf@umontreal.ca.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Cossette
authors.affiliation: Faculté des sciences infirmières, Université de Montréal, C.P. 6128, succ. Centre-Ville, Montréal, QC H3C 3J7, Canada. Electronic address: jacinthe.pepin@umontreal.ca.
authors.forename: Jacinthe
authors.initials: J
authors.lastname: Pepin
mesh_terms: D000328:Adult; D001364:Awareness; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D008348:Manikins; D009726:Nurses; D009730:Nursing Assessment; D011792:Quebec; D013338:Students, Nursing; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Instrument validation; Nursing students; Patient deterioration; Reliability and validity; Research instrument; Simulations; Situation awareness; Test construction