“Mutual Respect Would be a Good Starting Point:” Students’ Perspectives on Incivility in Nursing Education

Abstract

Background

Studies indicate that incivility is common in nursing education and perpetuated by both students and faculty. Academic incivility negatively affects the well-being of those involved, interferes with the teaching–learning process, and is antithetical to nursing as a caring profession. An understanding of academic incivility is essential to establish best practices to address this problem.

Purpose

The purpose of this study was to examine incivility in nursing academia from the perspective of baccalaureate nursing students.

Methods

The study was conducted using a cross-sectional design, with a mixed method questionnaire administered to 380 students. The quantitative data were analyzed descriptively and qualitative data through content analysis.

Results

The majority of students thought incivility is a mild to moderate problem in nursing education. They thought that students contribute to incivility by not taking responsibility (being unprepared and being disinterested) for their education and by not being professional (being disrespectful and being uncaring) and faculty contribute by not being good teachers (being authoritarian, treating students unfairly, having ineffective teaching methods) and not being professional (being disrespectful, lacking compassion).

Conclusion

Until evidence is available for effective measures to address incivility, nursing schools should consider adopting strategies for solutions as suggested by the students in this study.

Keywords

Incivility nursing education baccalaureate program mixed method design

Get full access to this article

View all access options for this article.

References

Altmiller

(2012). Student perceptions of incivility in nursing education: Implications for educators. Nursing Education Perspectives, 33, 15–20.

Anthony

Yastik

(2011). Nursing students’ experiences with incivility in clinical education. Journal of Nursing Education, 50(30), 140–144. doi:10.3928/01484834-20110131-04

Aul

(2017). Who’s uncivil to who? Perceptions of incivility in pre-licensure nursing programs. Nurse Education in Practice, 27(2017), 36–44. doi:10.1016/j.nepr.2017.08.016

Canadian Nurses Association. (2017). Code of ethics for registered nurses. Ottawa, ON: Author. Retrieved from https://www.cna-aiic.ca/html/en/Code-of-Ethics-2017-Edition/index.html

Canadian Nursing Students’ Association. (2005). Nursing students’ bill of rights and responsibilities. Retrieved from http://cnsa.ca/publication/nursing-students-bill-of-rights-and-responsibilities/

Clark

(2008a). The dance of incivility in nursing education as described by nursing faculty and students. Advances in Nursing Science, 31(4), E37–E54. doi:10.1097/01.ANS.0000341419.96338.a3

Clark

C. M.

(2008b). Faculty and student assessment of and experience with incivility in nursing education. Journal of Nursing Education, 47(10), 458–465. doi:10.3928/01484834-20081001-03

Clark

C. M.

(2008c). Student voices on faculty incivility in nursing education: A conceptual model. Nursing Education Perspectives, 29(5), 284–289.

Clark

(2008d). Student perspectives on faculty incivility in nursing education: An application of the concept of rankism. Nursing Outlook, 56(1), 4–8. doi:10.1016/j.outlook.2007.08.003

10.

Clark

C. M.

(2011). Pursuing a culture of civility: An intervention study in one program of nursing. Nurse Educator, 36(3), 98–102. doi:10.1097/NNE.0b013e3182161238

11.

Clark

C. M.

Ahten

S. M.

Macy

(2013). Using problem-based learning scenarios to prepare nursing students to address incivility. Clinical Simulation in Nursing, 9(3), e75–e83. doi:10.1016/j.ecns.2011.10.003

12.

Clark

C. M.

Ahten

Werth

(2012). Cyber-bullying and incivility in an online learning environment, part 2. Nurse Educator, 37(5), 192–197. doi:10.1097/NNE. 0b013e318262eb2b

13.

Clark

C. M.

Barbosa-Leiker

Gill

L. M.

Nguyen

(2015). Revision and psychometric testing of the incivility in nursing education (INE) survey: Introducing the INE-R. Journal of Nursing Education, 54(6), 306–315. doi:10.3928/01484834-20150515-01

14.

Clark

C. M.

Davis Kenaley

B. L.

(2011). Faculty empowerment of students to foster civility in nursing education: A merging of two conceptual models. Nursing Outlook, 59(3), 158–165. doi:10.1016/j.outlook. 2010.12.005

15.

Clark

C. M.

Farnsworth

Landrum

R. E.

(2009). Development and description of the Incivility in Nursing Education (INE) Survey. The Journal of Theory Construction and Testing, 13(1), 7–15.

16.

Clark

C. M.

Nguyen

D. T.

Barbosa-Leiker

(2014). Student perceptions of stress, coping, relationships, and academic civility: A longitudinal study. Nurse Educator, 39(4), 170–174. doi:10.1097/NNE.0000000000000049

17.

Clark

C. M.

Springer

P. J.

(2007a). Incivility in nursing education: A descriptive study of definitions and prevalence. Journal of Nursing Education, 46, 7–14.

18.

Clark

C. M.

Springer

P. J.

(2007b). Thoughts on incivility: Student and faculty perceptions of uncivil behavior in nursing education. Nursing Education Perspectives, 28(2), 93–97.

19.

Clark

C. M.

Springer

P. J.

(2010). Academic nurse leaders’ role in fostering a culture of civility in nursing education. Journal of Nursing Education, 49(6), 319–325. doi:10.3928/01484834-20100224-01

20.

Clark

C. M.

Werth

Ahten

(2012). Cyber-bullying and incivility in the online learning environment, part 1: Addressing faculty and student perceptions. Nurse Educator, 37(4), 150–156. doi:10.1097/NNE.0b01 3e31825a87e5

21.

Clarke

C. M.

Kane

D. J.

Rajacich

D. L.

Lafreniere

K. D.

(2012). Bullying in undergraduate clinical nursing education. Journal of Nursing Education, 51(5), 269–276. doi:10.3928/01484834-20120409-01

22.

College of Registered Nurses of British Columbia. (2013). Professional standards for registered nurses and nurse practitioners. Vancouver, BC: Author. Retrieved from https://www.crnbc.ca/Standards/Lists/StandardResources/128 ProfessionalStandards.pdf

23.

Cooper

J. R. M.

Walker

J. T.

Winters

Williams

P. R.

Askew

Robinson

J. C.

(2009). Nursing students’ perceptions of bullying behaviours by classmates. Issues in Educational Research, 19(3), 212–226.

24.

Condon

B. B.

(2015). Incivility as bullying in nursing education. Nursing Science Quarterly, 28(1), 21–26. doi:10.1177/0894318414558617

25.

Del Prato

(2013). Students’ voices: The lived experience of faculty incivility as a barrier to professional formation in associate degree nursing education. Nursing Education Today, 33(3), 286–290. doi:10.1016/j.nedt.2012.05.030

26.

Graneheim

U. H.

Lundman

(2003). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nursing Education Today, 24, 105–112. doi:10.1016/j.nedt.2003.10.001

27.

Hunt

Marini

Z. A.

(2012). Incivility in the practice environment: A perspective from clinical nursing teachers. Nurse Education in Practice, 12(2012), 366–370. doi:10.1016/j.nepe.2012.05.001

28.

Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. Washington, DC: National Academies. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK209880/pdf/Bookshelf_NBK209880.pdf

29.

Jenkins

S. D.

Kerber

C. S.

Woith

W. M.

(2013). An intervention to promote civility among nursing students. Nursing Education Perspectives, 34(2), 95–100.

30.

Kerber

Jenkins

Woith

Kim

M. J.

(2012). Journal clubs: A strategy to teach civility to nursing students. Journal of Nursing Education, 51(5), 277–282. doi:10.3928/01484834-20120323-02

31.

Knepp

K. A. F.

(2012). Understanding student and faculty incivility in higher education. The Journal of Effective Teaching, 12, 32–45.

32.

Lasiter

Marchiondo

(2012). Student narratives of faculty incivility. Nursing Outlook, 60, 121–126. doi:10.1016/j. outlook.2011.06.001

33.

Luparell

(2005). Why and how we should address student incivility in nursing programs. Annual Review of Nursing Education, 3, 23–36.

34.

Luparell

(2007). The effects of student incivility on nursing faculty. Journal of Nursing Education, 46(1), 15–19.

35.

Marchiondo

L. A.

Lasiter

(2010). Faculty incivility: Effects on program satisfaction of BSN students. Journal of Nursing Education, 49, 608–614. doi:10.3928/01484834-20100524-05

36.

Morse

J. M.

Niehaus

(2009). Mixed method design: Principles and procedures. London, England: Taylor & Francis

37.

Mott

(2014). Undergraduate nursing student experiences with faculty bullies. Nurse Educator, 39(3), 143–148. doi:10.1097/NNE.0000000000000038

38.

Parse

R. R.

(2014). The humanbecoming paradigm: A transformational worldview. Pittsburgh, PA: Discovery International.

39.

Randle

(2003). Bullying in the nursing profession. Journal of Advanced Nursing, 43(4), 395–401.

40.

Robinson

Griffiths

(2007). Nursing education and regulation: International profiles and perspectives. Retrieved from https://www.kcl.ac.uk/nursing/research/nnru/Publications/Reports/NurseEduProfiles.pdf

41.

Sandelowski

(2000). Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies. Research in Nursing & Health, 23, 246–255.

42.

Smith

C. R.

Gillespie

G. L.

Brown

K. C.

Grubb

P. L.

(2016). Seeing students squirm: Nursing students’ experiences of bullying behaviors during clinical rotations. Journal of Nursing Education, 55(9), 505–513. doi:10.3928/01484834-20160816-04

43.

Spunk

E. A.

LaSala

K. B.

Wilson

V. L.

(2014). Study incivility: Nursing faculty lived experience. Journal of Nursing Education and Practice, 4(9), 1–12. doi:10.5430/jnep.v4n9p1

44.

Suplee

P. D.

Lachman

V. D.

Siebert

Anselmi

K. K.

(2008). Managing nursing student incivility in the classroom, clinical setting, and on-line. Journal of Nursing Law, 12(2), 68–77. doi:10.1891/1073-7472.12.2.68

45.

Thomas

S. P.

(2003). Handling anger in the teacher-student relationship. Nursing Education Perspectives, 24(1), 17–24.

46.

Watson

(2012). Human caring science: A theory of nursing (2nd ed). Sudbury, MA: Jones & Bartlett.