Faculty encounters with uncivil nursing students: an overview

"It is Essentially About Treating Each Other Well": Insights from Faculty on Incivility in Nursing Education

STUDY BACKGROUND

Incivility in nursing educational institutions, which may be perpetrated by both students and faculty, is troubling given that such institutions have a mandate to prepare students for caring, relational nursing practice.

PURPOSE

The purpose of this study was to contribute to understanding nursing academic incivility through an examination of nursing faculty's perspectives on student and faculty incivility.

METHODS

The study was conducted using a mixed methods, descriptive, survey design with collection and analysis of quantitative and qualitative data. The sample consisted of 52 faculty members.

RESULTS

A large majority of faculty thought that incivility in the nursing academic environment is a problem, with most considering it to be a mild or moderate problem. Students acted unprofessionally by showing disrespect, displaying superiority, engaging in disruptive behaviors, or not taking responsibility for their role in their learning. Faculty acted unprofessionally by showing disrespect, displaying superiority, or not being supportive. Faculty perceived that stress, personality, failure to deal with incivility, and an attitude of entitlement contributed to incivility. They thought that educational interventions, policies, and an academic environment that is conducive to civility are needed to address the problem.

CONCLUSION

Until evidence is available to support the effectiveness of interventions for academic incivility, nursing educational institutions are encouraged to implement strategies suggested by faculty in this study.

An Evaluation of Uncivil Behaviors in Clinical Learning Environments from the Perspective of Nursing Students in Western Iran in 2020

Background: Uncivil behavior in clinical learning environments is a growing challenge that severely disrupts the teaching and learning process. Objectives: The aim of this study is to evaluate the incidence of uncivil behavior in clinical learning environments from the perspective of nursing students in western Iran. Methods: In this self-report descriptive cross-sectional study in the 2020 year, 135 undergraduate nursing students of semesters 3, 4, 6, and 8, who were taking training and internship courses, were enrolled. The standard UBCNE questionnaire with 20 questions based on the Likert scale and subscales of exclusionary, hostile/rude, and dismissive behaviors constituted research tools. Data were analyzed using SPSS version 21 and descriptive and inferential statistics. Results: 103 (76.3%) trainees and 32 (23.7%) interns with a mean age of 21.53 years (1.60) participated in this study. According to the results of the Kruskal-Wallis test, the mean scores of hostile/rude, exclusionary, and dismissive behaviors and the total score in different semesters were significantly different (P < 0.001). In terms of the semester, these behaviors had the highest rate in semester 6 students and the lowest in semester 8 students. There was no statistically significant relationship between gender and the mean incidence of these behaviors in students. Conclusions: The results show the students’ experience with different behaviors in clinical settings according to different contexts. Further research is required to understand these behaviors in clinical settings better and to provide strategies to minimize such behaviors.

Nursing faculty experiences with student incivility in South Korea: a qualitative study

BACKGROUND

Student academic incivility is a serious problem in nursing education because it negatively influences the learning process, wellbeing of faculty members, and faculty-student relationships. The aim of this study was to explore nursing faculty experiences related to student incivility in nursing education.

METHODS

We used an exploratory qualitative methodology and conducted in-depth interviews with 14 nursing faculty members working at 11 nursing universities in South Korea. A qualitative content analysis was carried out.

RESULTS

The six themes that emerged from the faculty experiences were nursing student indifference to teachers' expectations; ignoring behavioral standards in school life; differing responses to uncivil student behavior; self-reflection as a nursing educator; negative impact on faculty in a nursing education context; and awareness of civility in a nursing education context.

CONCLUSION

Dealing with student academic incivility in nursing education is one of the most challenging tasks for faculty members, and it should be managed to provide a comfortable learning environment. The present study delineated the uncivil behavior experienced by the faculty and their negative effects in the educational context and suggested alternatives to manage student incivility and foster a positive educational environment through the eyes of the faculty. The findings of this study suggest an evidence-based direction for fostering a culture of civility in nursing schools.

How Nursing Faculty Experience the Effects of Workplace Incivility

AIM

The purpose of this study was to describe nursing faculty experiences with workplace incivility and the effect it has on their health. This article reports results of the qualitative portion of a larger study.

BACKGROUND

Nursing faculty have reported the physical and psychological impact of incivility on their lives. The negative effects that workplace incivility, specifically, has on nursing faculty require ongoing research and attention.

METHOD

Using an electronic survey, 249 nursing faculty from one Southeastern US state responded to two open-ended questions about workplace incivility and its effects. Data were analyzed using qualitative content analysis.

RESULTS

Four categories related to experiences with workplace incivility emerged: the experience; personal and professional impact; a reciprocal, organizational culture problem; and survival.

CONCLUSION

Nursing faculty experiences with workplace incivility constitute an organizational culture problem with both personal and professional implications.

Nurse educators’ experiences with student incivility: a meta-synthesis of qualitative studies

This study aimed to synthesize the best available qualitative research evidence on nurse educators’ experiences with student incivility in undergraduate nursing classrooms. A meta-synthesis of qualitative evidence using thematic synthesis was conducted. A systematic search was performed of 12 databases for relevant literature published by March 31, 2019. Two reviewers independently conducted critical quality appraisals using the checklist for qualitative research developed by the Joanna Briggs Institute. Eleven studies that met the inclusion criteria were selected for review. From the pooled study findings, 26 descriptive themes were generated and categorized into the following 5 analytical themes: (1) factors contributing to student incivility, (2) management of student incivility, (3) impact: professional and personal damage, (4) impact: professional growth, and (5) initiatives for the future. Many nurse educators became confident in their role of providing accountability as both educators and gatekeepers and experienced professional growth. However, others experienced damage to their personal and professional life and lost their motivation to teach. Nurse educators recommended the following strategies for preventing or better managing student incivility: institutional efforts by the university, unified approaches for student incivility within a nursing program, a faculty-to-faculty network for mentoring, and better teaching and learning strategies for individual educators. These strategies would help all nurse educators experience professional growth by successfully preventing and managing student incivility.

Incivility and the clinical learner

The impact of incivility in terms of individual and team performance in clinical environments is increasingly acknowledged and supported by a growing evidence base. However, clinical environments are not just areas where patient care is delivered, they are also rich, key learning arenas for healthcare professionals. To date, the potential impact of incivility in clinical environments on healthcare professional learning and development has not been comprehensively explored. This article provides an overview of the physiological mechanisms that inhibit learning and memory recall in individuals experiencing or observing incivility and social stress. It establishes a clear need for focus on the impact of incivility on clinical learners and educators and further evidence for the need for clinical environments in which civility is firmly rooted into the pervading culture.

Faculty and Student Incivility in Undergraduate Nursing Education: An Integrative Review

BACKGROUND

Incivility is a critical issue in undergraduate nursing education. Uncivil acts in academia are increasing and have the potential to affect future nursing practice and patient safety outcomes.

METHOD

An integrative literature review was completed to describe faculty-to-student and student-to-faculty incivility in undergraduate nursing education.

RESULTS

Seventeen studies were included in the review. Four themes emerged from the data: (a) Detrimental to Health and Well-Being, (b) Disruption to the Teaching-Learning Environment, (c) Stress as a Catalyst, and (d) Incivility Incites Incivility.

CONCLUSION

The results support data that incivility has harmful physical and psychological effects on both faculty and students, and also disturbs the teaching-learning environment. Causes of un-civil acts have been highlighted to provide groundwork for schools of nursing to implement strategies for mitigating incivility. [J Nurs Educ. 2017;56(12):709-716.].

Constructive Feedback Teaching Strategy: A Multisite Study of Its Effectiveness

AIM

The study purpose was to describe students' perceptions of feedback after participating in a teaching strategy designed to foster a view of feedback as an opportunity for improvement.

BACKGROUND

Although delivering and receiving constructive feedback are essential to the role of the professional nurse, feedback has been identified as a trigger for incivility in academia and practice.

METHOD

Twelve nurse educators from the Quality and Safety Education for Nurses Academic Task Force, located at nine schools of nursing across the nation, implemented a presentation about giving and receiving constructive feedback in junior and senior courses.

RESULTS

Five hundred twenty-three students submitted a total of 985 posts or essays in response to viewing the presentation; seven themes were identified.

CONCLUSION

Viewing this teaching strategy enabled nursing students to develop an awareness of the opportunity that constructive feedback presents for professional development, self-improvement, teamwork and collaboration, and patient safety.

An Integrative Review of Cybercivility in Health Professions Education

Although incivility in higher education has been widely described, little evidence exists regarding incivility among health professions students in online environments. This study aims to integrate literature on cybercivility in health professions education. The extent to which health professions students and faculty experience cyberincivility, the direct and indirect effects and actions taken after cyberincivility, and themes that guide facilitation of cybercivility are discussed. Efforts to prevent cyberincivility can be achieved through focused education on cybercivility, development of clear policies related to its consequences, and formulation of guidelines for both student and faculty behavior online.

Factors contributing to incivility amongst students at a South African nursing school

BACKGROUND

This study determined the experiences of nurse educators of the factors contributing to the uncivil classroom behaviours of nursing students at a South African school of nursing.

OBJECTIVE

To describe what nurse educators consider to be factors contributing to incivility among nursing students in a South African nursing school.

METHOD

A qualitative descriptive design was used. Eleven nurse educators were purposively sampled for their experiences on the factors contributing to incivility. Individual face-to-face interviews were conducted until data saturation.

RESULTS

The data analysed indicated that the educators had varying but often similar perspectives on which factors contribute to incivility among nursing students. The three themes that emerged from the data were academic, psycho-pathological and social factors.The themes were discussed on the basis of their reported impact on classroom behaviour and the implications for the teaching and learning environment.

CONCLUSION

Conclusions were made that an educational screening system to identify committed students before admission into nursing education should be explored; that a support system should be explored for nurse educators to deal with incidents of uncivil behaviour, perhaps within policy frameworks in the nursing institution; that emotional support should be provided for students who may be experiencing difficulties adjusting to the rigours of post-secondary education; and that a forum should be set up for nurse educators to compare notes and share ideas on what works best in reducing the incidence of uncivil behaviours in the classroom setting.

A study of incivility in the Iranian nursing training system based on educators and students' experiences: a quantitative content analysis

BACKGROUND

It is absolutely essential to know the negative impacts incivility in students and educators may have on the creation of a suitable teaching-learning environment. Better education of to-be nurses would improve their service to patients and society in the future. There has been no research in Iran so far on this particular case. This study examines the experiences of uncivil or disrespectful behavior from the standpoint of educators and students.

METHODOLOGY & METHODS

A quantitative content analysis was carried out to study manuscripts presented in the form of open questionnaires. To this end, data produced from detailed answers from 640 students and educators were inputted into the computer and line-by-line and sentence-by-sentence coding was done. After that, implied codes were added, the categories were revealed, and finally counting frequency of code in categories was carried out.

RESULTS

The most important categories that students considered uncivil behavior were waste of class time, distraction, incompetence in managing the class, discrimination, bad assessment, insult and threat on behalf of the educators. In contrast to their view, what the educators thought of as disrespectful included class disorder, humiliation of other students, irregular attendance of classes, bad sitting postures, non-observance of Islamic standards, and coming unprepared to the class by students.

CONCLUSION

From the viewpoint of students and educators, incivility is present towards one another in the academic environment. This study determines the most important forms of the same from their stand point. Since disrespectful and threatening behavior has a significant impact on learning environment, we highly recommend a thorough examination to be carried out in future studies on the origin and the managing strategies of such behaviors.

Differences and commonalities in difficulties faced by clinical nursing educators and faculty in Japan: a qualitative cross-sectional study

Background

To clarify the current state of communication between clinical nursing educators and nursing faculty members and the perceived difficulties encountered while teaching nursing students in clinical training in Japan.

Methods

We collected data via focus group interviews with 14 clinical nursing educators, two nursing technical college teachers, and five university nursing faculty members. Interview transcripts were coded to express interview content as conclusions for each unit of meaning. Similar compiled content was categorized.

Results

Difficulties in providing clinical training mentioned by both clinical educators and faculty members were classified into four categories: “difficulties with directly exchanging opinions,” “mismatch between school-required teaching content and clinical teaching content,” “difficulties with handling students who demonstrate a low level of readiness for training,” and “human and time limitations in teaching.” In some categories, the opinions of educators matched those of the faculty members, whereas in others, the problems differed according to position.

Conclusions

The Japanese culture and working conditions may affect communication between clinical educators and faculty members; however, a direct “opinion exchange” between them is crucial for improving the clinical teaching environment in Japan.

Student perceptions of incivility in nursing education: implications for educators

This study explored the phenomenon of incivility in nursing education from the perspective of undergraduate nursing students and compared it to perspectives of educators as found in the literature. The sample consisted of 24 undergraduate junior and senior nursing students from four universities in the mid-Atlantic states. Data from four focus groups were transcribed and content analyzed to reveal themes and subthemes. Students perceived that incivility in nursing education exists. They shared a common view with findings in the literature regarding incivility from the faculty perspective. Notably, an emerging student view was that faculty may contribute to the escalating incivility in nursing education, and that student incivility is justified when faculty are seen as uncivil. The implications for educators, consistent with the literature, are that students want professors to maintain classroom decorum and set the example for civility.

Can't we all just get along? A primer on student incivility in nursing education

Student incivility is a growing problem in the academic nursing community. The purpose of this study was to identify factors associated with the increasing prevalence of incivility among nursing students. Various databases (Allied and Complimentary Medicine, Cumulative Index to Nursing and Allied Health Literature, and Ovid MEDLINE) were queried using the key words incivility, student incivility, nursing education, student-faculty relations, student aggression, and student violence. Both research- and non-research-based articles were selected for review. Also included among the references retrieved were articles pertaining to unethical conduct and disruptive behavior. Virtually all of the articles characterized incivility as the product of a symbiotic relationship between students and faculty. Fundamentally, incivility was found to be a multifaceted problem whose resolution is predicated on gaining a heightened understanding of the economic, sociological, and psychological underpinnings of disruptive behavior.

Incivility in Nursing: The Connection Between Academia and Clinical Settings

Incivility and bullying in nursing are complex problems that have garnered much attention in recent years. Emerging evidence suggests that incivility in the workplace has significant implications for nurses, patients, and health care organizations. Because today’s students are tomorrow’s colleagues, conversations regarding how to address incivility and bullying should include specific aspects of nursing academia and the preparation of new nurses.

Academic nurse leaders' role in fostering a culture of civility in nursing education

Academic incivility is disruptive behavior that substantially or repeatedly interferes with teaching and learning. Incivility on college campuses jeopardizes the welfare of all members of the academy. Academic nurse leaders play a critical role in preventing and addressing academic incivility because these behaviors can negatively affect learning and harm faculty-student relationships. Although studies on student and faculty incivility have been conducted in nursing education, there are no known studies regarding the perceptions of academic nurse leaders about this problem. This is the first known study to investigate the perceptions of 126 academic nurse leaders (deans, directors, and chairpersons) from 128 associate degree in nursing and bachelor of science nursing programs in a large western state. Academic nurse leaders responded to five open-ended questions regarding their perceptions of stressors that affect nursing faculty and students, the uncivil behaviors exhibited by both groups, and the role of leadership in preventing and addressing incivility in nursing education.

The dance of incivility in nursing education as described by nursing faculty and students

Uncivil and disruptive behaviors in nursing education are serious problems requiring ongoing attention and research. Academic incivility jeopardizes the welfare of faculty, students, and the campus community. This article describes a qualitative study involving 289 nursing faculty members and students from 41 states who responded to 4 open-ended questions included in the Incivility in Nursing Education survey. A conceptual model is introduced to illustrate the study findings. The model depicts how stress, attitude, and a lack of effective communication and intentional engagement may contribute to the "dance" of incivility in nursing education.

Connectiveness and civility in online learning

As the classroom shifts from teacher-centered to learner-centered and from face-to-face to online, nursing faculty members are challenged to promote a sense of connectiveness and social interaction. Making connectiveness more elusive is the perception of rude, impolite, or unkind communication. The purpose of this descriptive-exploratory study was to examine perceptions of connectiveness and civility in online nursing courses. Ninety-six students in four nursing programs participated in the study. Strategies that promote connectiveness with peers are in-person activities whenever possible and discussion assignments that include social activities. Timely feedback when responding to questions and prompt grading are important for student-to-instructor connectiveness. Thirty-five percent of the students encountered rude or unkind communication with peers, and 60% reported incivility from instructors. Their suggestions for effective handling of rude communication included addressing the behavior privately, giving guidance about netiquette, and defining what constitutes rude behavior.

Nurse teacherhood: Systematic descriptive review and content analysis

BACKGROUND

The concept of 'nurse teacherhood' is multidimensional. In this article, 'nurse teacherhood' includes nurse teachers' tasks and different multidimensional roles as well as their personal experiences of being a nurse teacher.

OBJECTIVES

The article examines the topics of nursing research concerning nurse teacherhood, the changes in these topics and the results reported from January 1990 to April 2004.

DESIGN AND METHOD

The material was obtained by conducting a systematic review, and it included nursing research papers and Finnish academic dissertations (N=207). The material was analysed by using content analysis.

RESULTS

The topics of the studies were divided into three thematic categories: the expansion of nurse teacherhood, the skills of nurse teacherhood and their development, nurse teacherhood and membership in working community. The number of studies on the first two themes had increased (1990-1994:43; 1995-1999:57; 2000-4/2004:65), while those on the third theme had decreased (1990-1994:18; 1995-1999:19; 2000-4/2004:5).

CONCLUSIONS

Nurse teacherhood has been studied actively during the past 15 years and approached from several perspectives. Most of the topics of the studies discussed the expansion of nurse teacherhood. The focus of the studies in different years varied depending on the kind of challenges posed to nurse teachers' work in each period of time.

The Effects of Student Incivility on Nursing Faculty

In this study, 21 nursing faculty who experienced uncivil encounters with nursing students were interviewed to determine what effects those encounters had on them. The uncivil encounters ranged from relatively mild to highly aggressive, including overt threats to the faculty members' well-being. The effects of the uncivil encounters on the nursing faculty involved were significant and included both short-term and long-term sequelae, such as physical and emotional reactions, decreased self-esteem, loss of confidence in their teaching abilities, significant time expenditures, and negative effects on the educational process. Three faculty members left nursing education and cited their interactions with students as an influential factor.

Workplace Incivility

The financial cost of workplace violence is 4.2 billion dollars a year. Workplace incivility may initiate a spiral that for 1,000 people a year ends in death at work. If an initial minor incident such as incivility could be mitigated, then the financial and human capital that could be realized by the healthcare organization is immense. This article is an in-depth look at the literature and theoretical frameworks related to workplace incivility.