Nurse managers describe how crisis leadership training shaped emergency decisions

Nurse managers who completed a situational crisis leadership training program reported that it helped them structure their judgment during public health emergencies, according to a qualitative study published in BMC Medical Education.

The study explored how nurse managers experienced a training program grounded in Situational Leadership Theory, a framework that links leadership behavior with staff readiness and the demands of the task at hand. The researchers note that while this theory is established, little has been known about how nurse managers actually learn and apply such an approach in crisis contexts, where rapid decisions must be made under uncertainty while protecting patient safety and supporting frontline registered nurses.

To investigate this, the team conducted a descriptive qualitative study. They interviewed seventeen nurse managers who had participated in a situational crisis leadership learning program. The interviews covered five areas: contextual assessment, risk recognition, adaptive leadership behavior, patient safety management, and the transfer of learning into practice.

The interviews were audio-recorded, transcribed verbatim, and analyzed thematically, with Situational Leadership Theory guiding both data collection and interpretation. The researchers reported that data saturation was reached after fifteen interviews, and two additional interviews were conducted to confirm the stability of the coding structure.

From the analysis, four themes and nine subthemes emerged: structuring judgment under crisis pressure, scenario training and risk recognition, adapting leadership to support safer practice, and recalibrating leadership as conditions change.

Across these themes, participants described making greater use of structured contextual judgment in crisis response.

At the same time, the participants did not describe the training as a complete solution. They said they continued to encounter difficulties in adapting their leadership responses as conditions on the ground changed, which the researchers identified as an ongoing challenge rather than a resolved one.

In their conclusions, the authors stated that participants described the situational leadership-based crisis training as supporting structured contextual assessment and leadership adaptation during public health emergencies. They also noted that participants’ accounts suggest repeated practice and reflection may support ongoing crisis leadership development and safer nursing practice.

Because this was a qualitative study based on the experiences of seventeen nurse managers in a single training program, the findings reflect participants’ own accounts rather than measured effects on patient outcomes. The authors present the work as an exploration of how nurse managers learn and apply situational leadership in crisis settings, with the themes offering a basis for understanding how such training is experienced in practice.

Subject of Research: Nurse managers' experiences of situational crisis leadership training for public health emergency response

Article Title: Situational crisis leadership training for nurse managers in public health emergencies: a qualitative study

Article References: Shen, M., Feng, Z., Liu, F., & Lang, J. (2026). Situational crisis leadership training for nurse managers in public health emergencies: a qualitative study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10406-4

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10406-4

Keywords: nurse managers, crisis leadership, situational leadership theory, public health emergencies, qualitative study, thematic analysis, patient safety, leadership training, risk recognition, BMC Medical Education, Situational, crisis