Incivility in nursing education: A systematic literature review

Raising nurse educators' awareness regarding caring pedagogical relationships' barriers to foster inclusive simulation settings: Insights from a phenomenological study

AIM

The purpose of this paper was to shed light on the main barriers to caring pedagogical relationships within simulation centers from the perspective of nursing students and offer targeted strategies to reduce these barriers.

BACKGROUND

A caring pedagogical relationship is a powerful strategy to foster students' learning within simulation settings. However, the development of this relationship could be hindered if nurse educators are not aware of its barriers. Hence, this could affect students' learning and well-being within this academic context. According to our knowledge, no previous research has addressed the question of the barriers to caring pedagogical relationships within the context of simulation.

DESIGN

This study employed a descriptive phenomenological method, entitled Relational Caring Inquiry, to collect and analyze data gathered from 19 students enrolled in an undergraduate nursing program.

RESULTS

This paper focuses on one eidos-theme that emerged from our data analysis and interpretation entitled "Educator's conscientization regarding barriers to the development of a caring pedagogical relationship". According to data analysis and interpretation, this eidos-theme was the most emphasized by research participants. It emerged from the following themes: (a) educators' dehumanizing practices, (b) disruptive and stressful academic context, (c) lack of educators' experiences and (d) educators' disinterest in students' learning.

CONCLUSIONS

Leaving caring pedagogical relationships' barriers unaddressed has shown adverse impacts on students' learning process and their mental and physical well-being. This paper brings to light the main barriers to caring pedagogical relationships and invites educators, managers and nurse leaders to be aware of these obstacles and collectively engage in humanizing nursing education. In other words, we emphasize the impact of these barriers on students' apprenticeship and suggest political actions to build caring and inclusive simulation environments.

STUDY REGISTRATION NUMBER

CERSES-19-050-D.

Stoicism and Cognitive Strategies for Nursing Professional Development

BACKGROUND

Nurse educators are experiencing a vocational crisis, and the unsustainable rate at which nurses are leaving the profession impacts the health of the nation. Nurse educators, including academic and professional development faculty and preceptors, need skills to manage the complex academic and clinical environments. This article describes the development of a course for nurse educators and preceptors around Stoicism and cognitive strategies, describes the perceived takeaways of one group of learners who experienced the course, and offers recommendations for the use of this content.

METHOD

This course was evaluated with survey data from 23 nurse educators for demographic information and use of strategies after an educational course.

RESULTS

Participants identified several specific takeaways from the training that could be incorporated into their personal, teaching, and clinical practices. Themes included emotional regulation, using the cognitive triangle, and managing stress in emotionally charged situations with patients and colleagues through creating a healthy emotional distance to better evaluate situations.

CONCLUSION

Stoicism and cognitive strategies are important additions to nurse educator personal and professional development. [J Contin Educ Nurs. 2024;55(8):378-386.].

Educator-to-student incivility in online nursing education during COVID-19 as reported by nursing students: A descriptive cross-sectional study

BACKGROUND

Educators' incivility in online nursing education is a serious academic issue; much of it is still unknown as it occurs in a less supervised environment.

AIM

This study examined variables and differences in educator-to-student incivility in online nursing education during COVID-19, as reported by nursing students.

METHODS

Utilizing the Incivility in Online Learning Environments (IOLE) online survey, a cross-sectional design was used to collect data in 2021 from a convenience sample of 163 nursing students studying in different universities in Jordan. Version 25 of the Statistical Package for the Social Sciences (SPSS) was used to generate descriptive and inferential statistics.

RESULTS

As reported by nursing students, there was a low degree of incivility among nursing educators in online nursing education, 45(range 23-92), and a moderate frequency in the past 12 months, 63(range 23-92). Around 37.00 % of students thought incivility in online nursing education was a mild problem. On a scale of 0-100, 63.00 % of the students reported the level of nursing educators' civility in online nursing education ranged from 50.00 % to 70.00 % (an average of 60.00 %). Differences in students' reporting of online nursing educators' incivility and its' frequencies were significantly influenced by students' grade point averages (GPA) and genders, respectively.

CONCLUSIONS

Although nursing students have a positive sense of civility among their nursing educators, incivility in online nursing education should be zero-level and disclosed and treated at its early signs.

Role Modeling of Professional Behavior in Nursing Education During the COVID-19 Pandemic: A Mixed Method Study

This study aimed to examine professional behavior as role models in nursing education during the COVID-19 pandemic perceived by nursing students. This study applied a mixed-method design using a sequential explanatory approach. A total of 120 nursing students participated in the self-reported questionnaire, and 10 were involved in semistructured individual interviews. The Professional Nurse Educator Role-Model questionnaire developed by the authors was used to collect quantitative data, and four open-ended questions modified from a previous study as the guideline in qualitative data collection. Quantitative data were analyzed using descriptive quantitative analysis. Open-ended questions were analyzed using thematic analysis. Quantitatively, students reported that excellent professional behaviors as role models were prevalent in nursing education (Mean 3.61 out of 4). Four themes from qualitative findings were revealed to complement the quantitative data, including teaching by example, altruism, efficiently performing, and effective communication. In conclusion, nurses as educators and clinicians could be students' professional role models, particularly in clinical settings during the COVID-19 pandemic. It is essential for nurse educators and clinicians to actively create a culture of professional nursing care for self and others during the pandemic to be present in wholeness and provide holistic care.

Applying intersectionality to address inequalities in nursing education

AIM

The aim of this paper is to discuss the significance of the intersectionality framework for addressing prejudices, racism and inequalities in nursing education and clinical learning environments.

BACKGROUND

Discrimination and racism against nursing students and educators based on their gender, ethnicity, race and social identities is well-documented in the nursing literature. Despite documented discrimination and incivility based on intersectional factors, it is reported that often nurse educators show limited interest in the culture, diverse experiences and values of nursing students with culturally and linguistically diverse backgrounds.

DESIGN

Discussion paper METHODS: The discussion was based on contemporary literature about intersectionality, discrimination and racism in nursing. We completed a cursory search of literature in nursing education journal and selected nursing and health science databases. This was not a formal literature review. Using a fictional example, the application of intersectionality to address inequalities in educational settings is illustrated.

RESULTS

Intersectionality is an invaluable tool for examining interwoven power relations and power struggles arising from racial, gender, ethnic, religious and sexuality and disability-related differences. Nurse educators, students and leaders should be more cognizant of their preconceived views, sociocultural stereotypes and varied forms of sociocultural oppression affecting their interactions with each other in clinical learning environments.

CONCLUSIONS

Incorporating intersectionality can address prejudices, racism and inequalities arising due to sociocultural, ethnic, power-related and intergenerational issues among educators, students and other personnel involved in creating clinical learning environments.

Trauma Informed Care for Nursing Action Bachelor of Science in Nursing Course

BACKGROUND

Nurses commonly experience psychological trauma with high risk for a host of mental health concerns such as suicide, depression, anxiety, and substance use disorders, as well as high rates of burnout and moral injury. Despite rigorous academic preparation, baccalaureate nursing education curricula lack content on the widespread effects of trauma.

METHOD

Using a trauma informed care (TIC) model, an innovative course called Trauma Informed Care for Nursing Action (TIC4NA) was created.

RESULTS

This course allows students to safely explore the profession of nursing to transform their learning about trauma related to patient care, the nursing community, and society.

CONCLUSION

TIC curriculum delivery offers supportive strategies to mitigate negative outcomes during nursing school. This content could have positive effects on nurse and nursing student retention as well as mitigating a barrage of negative outcomes for individual nurses and the nursing profession. [J Nurs Educ. 2024;63(4):233-240.].

Workplace incivility and the professional quality of life in nurses

BACKGROUND

Workplace Incivility is a common issue in the nursing profession. Nurses who are affected by such behaviors may experience distress.

OBJECTIVES

This study aimed to assess the relationship between workplace incivility and nurses' professional quality of life.

RESEARCH DESIGN

This cross-sectional correlational study was conducted in 2021 in "Tehran". Data were collected using a demographic questionnaire, the Nursing Incivility Scale (NIS), and the Professional Quality Of Life scale (ProQOL). Data analysis was performed through the Pearson correlation and multiple linear regression, using the SPSS v.16.

PARTICIPANTS AND RESEARCH CONTEXT

Participants were 200 nurses randomly recruited from selected hospitals of "TUMS".

ETHICAL CONSIDERATIONS

The study obtained research ethics approval and all participants were informed of the voluntary and anonymous nature of their participation.

FINDINGS

The mean age of participants was 32.30 ± 7.22, and 76.5% were female. There was a significant correlation between the professional quality of life and workplace incivility (r = -0.23, p = .001). Multiple regression analysis between the subscales of workplace incivility and professional quality of life demonstrated that the incivility from the supervisor (β = -0.29, p = .001) and incivility from patients (β = -0.27, p < .001) can predict the compassion satisfaction dimension. The incivility from the supervisor (β = 0.24, p = .001) and incivility from patients (β = 0.26, p < .001) can explain burnout. The incivility of the patients can explain secondary traumatic stress (β = 0.14, p = .02).

CONCLUSION

This study showed that workplace incivility is significantly related to professional quality of life. Therefore, the reduction of behaviors of incivility can lead to the improvement of the professional quality of life.

Promoting dignity in nursing education - How educators manoeuvre to promote dignity

BACKGROUND

Dignity is a core value in nursing. One of the objectives in nursing education is to promote dignity and contribute to the students' discovery of this value. Research shows that dignity in nursing education is threatened, due to lack of attention and an increasing problem with incivility.

PURPOSE

The study aims to explore how nursing educators experience their contribution in promoting dignity in nursing education.

METHOD

Five focus group conversations were conducted with nursing educators, and Gadamer's philosophical hermeneutics was chosen as the study's scientific theoretical approach.

FINDINGS

The educators experienced that they promoted dignity by safeguarding the dignity in the nursing profession in general, by promoting the dignity of the nursing students in particular, and through promoting dignity in challenging situations.

CONCLUSION

The study emphasizes the importance of promoting dignity in nursing education. It found that the nursing educators promoted dignity by safeguarding the dignity of both the nursing profession and the nursing students, and by manoeuvring judiciously between these two when there was disharmony between them. By manoeuvring challenging situations using discretion, the ethical demand will be given room. Dignity can then be fulfilled between people in harmony with professional, social and cultural norms, and in that way promote dignity in nursing education.

Strategies for transitioning from a clinical position to a faculty role

The nation faces a continued shortage of nurses that is projected to worsen in the next decade. The nursing shortage is fueled by a lack of faculty to educate nurses for entry into practice and advanced nursing practice positions. Many faculty enter academia after achieving expertise in a specialty area of clinical practice. These expert clinicians transition to novice faculty, a move that can be challenging and overwhelming. New faculty require guidance in understanding the various academic regulatory organizations; university structure, policies, and regulations; faculty responsibilities related to the university missions of teaching, service, practice, and scholarship; and face challenges with the need for new skills such as classroom management, curriculum development, and an understanding of the different culture and language of academia. The authors provide evidence from the literature and strategies and tips based on their experience for an expert clinician's successful transition from a clinical role to an academic position.

A Clinical Incivility Management Module for Nursing Students: A Quasi-Experimental Study

BACKGROUND

Incivility experienced by pre-licensure nursing students in clinical settings continues to grow. Interventions for clinical incivility to nursing students are needed. Our study aimed to examine the effects of a piloted two-hour interactive incivility management module on nursing students' perceived stress and general self-efficacy levels and preparedness for responding professionally to clinical incivility.

METHODS

A quasi-experimental post-test-only non-equivalent comparison design with control and experimental groups was used. Senior nursing students enrolled in a Bachelor of Science in Nursing program from a nursing college located in Seoul, South Korea, were recruited. The control group (n = 94) completed a self-administered online survey without the clinical incivility management module. The experimental group (n = 93) completed the same survey after receiving the clinical incivility management module. The two groups' survey data were compared; qualitative data from the experimental group's post-module debriefing session were also analyzed.

RESULTS

The prevalence of reported clinical incivility was 72.73% (n = 137 out of 187 participants). Clinical incivility experienced by the experimental group was significantly lower than that of the control group (z = -4.865, p < 0.001). However, there was no significant difference in stress levels and self-efficacy between the two groups. The mean score of the experimental group on preparedness for responding professionally to clinical incivility was statistically higher than the control group's mean score (z = -2.850, p = 0.004).

CONCLUSIONS

Interventions to prepare students for the experience of clinical incivility are useful; they can positively affect the students' ability to respond professionally.

The relationship among faculty-to-faculty incivility and job satisfaction or intent to leave in nursing programs in the United States

BACKGROUND

There have been numerous studies examining student-faculty and faculty-student incivility in nursing programs (Atmiller, 2012; Clark et al., 2021; Clark & Springer, 2010; Eka & Chambers, 2019; Tourangeau et al., 2014). Research on faculty-to-faculty incivility in nursing programs has been lacking.

PURPOSE

The purpose of this study was to determine if there was a relationship among faculty-to-faculty incivility, job satisfaction and intent to leave. Furthermore, this study examined the barriers to addressing incivility, the contributing factors to workplace incivility and strategies to improve workplace incivility.

METHODS

The initial sampling method used was a randomized stratified cluster sampling method. Due to a poor response rate the sampling process was changed to convenience sampling. The researcher collected data using The Workplace Incivility/Civility Survey. Additional questions were added to collect demographic data, incidences of incivility in the workplace, the physical and emotional response to these incidences, job satisfaction and intent to leave.

RESULTS

Data analysis showed that 50 % of the participants believe faculty-to-faculty incivility is a moderate to severe problem in their workplace. Furthermore, there is a negative correlation between faculty-to-faculty incivility and job satisfaction or faculty retention. Additional findings showed that 38.6 % of the participants had minimal to no confidence in addressing workplace incivility. Fear of professional or personal retaliation was the greatest barrier to addressing workplace incivility.

CONCLUSION

The current nursing faculty shortage has created a barrier to addressing the nursing workforce shortage. Universities and nursing programs need to address the factors that lead to decreased job satisfaction and faculty attrition with incivility being one of the factors.

American Academy of Nursing Expert Panel Consensus Statement on leveraging equity in policy to improve recognition and treatment of mental health, substance use disorders, and nurse suicide

Rates of nurse mental health and substance use disorders are high. Heightened by the COVID-19 pandemic, nurses are challenged to care for patients in ways that often jeopardize their own health and increase risks for their families. These trends exacerbate the epidemic of suicide in nursing underscored by several professional organization clarion calls to nurses' risk. Principles of health equity and trauma-informed care dictate urgent action. The purpose of this paper is to establish consensus among clinical and policy leaders from Expert Panels of the American Academy of Nursing about actions to address risks to mental health and factors contributing to nurse suicide. Recommendations for mitigating barriers drew from the CDC's 2022 Suicide Prevention Resource for Action strategies to guide the nursing community to inform policy, education, research, and clinical practice with the goals of greater health promotion, risk reduction, and sustainment of nurses' health and well-being are provided.

The link between workplace incivility, emotional exhaustion, and job embeddedness: examining the moderating role of power distance

Purpose

Integrating the conservation of resources theory, Hofstede's national culture theory and the cognitive-motivational-relational theory of emotions, the authors propose that power distance (as a moderator) and emotional exhaustion (as a mediator) play a role in the relationship between workplace incivility, emotional exhaustion and job embeddedness.

Design/methodology/approach

The data were collected in two stages using an online survey of 404 employees from three sectors, including hospitality, banking and manufacturing, in Indonesia. The authors tested a moderated mediation model using Hayes' macro PROCESS version 3.5.

Findings

Workplace incivility contributes to emotional exhaustion, which predicts job embeddedness. Emotional exhaustion also contributes to job embeddedness. In the moderation model, the authors found that the effect of workplace incivility on emotional exhaustion was more substantial for employees with high perceived power distance. Furthermore, power distance also played a moderating role in the relationship between emotional exhaustion and job embeddedness.

Practical implications

Since workplace incivility and job embeddedness differ across cultures, the results of this study contain practical management implications for Indonesian settings, especially the hospitality, manufacturing and banking sectors. The authors provide practical management implications for redesigning organizational culture to help employees avoid uncivil interactions in the workplace. The authors also provide implications concerning strategic managerial directions to improve communication and supervisors' skills at all levels of management.

Originality/value

This study is the first to introduce power distance as a complementary explanation for the relationship between workplace incivility, emotional exhaustion and job embeddedness while focusing on an Asian developing country.

Dignity at stake in educational relations - The significance of confirmation

INTRODUCTION

It is a goal in nursing education to promote students' dignity and facilitate this core value. Students' experience of dignity is shaped by the student-supervisor relationship. Literature shows limited knowledge about how nursing students experience their own dignity during education.

RESEARCH AIM

The aim of the study is to develop an understanding of how nursing students experience their own dignity in relation to supervisors, and what significance these experiences have in education.

RESEARCH DESIGN

Gadamer's philosophical hermeneutics was chosen as the approach, and narratives and qualitative interviews were conducted. The interpretation process was inspired by Fleming, Gaidys and Robbs.

PARTICIPANTS AND RESEARCH CONTEXT

Nineteen nursing students in the final year of their education were included in the study. They represented six different campuses at three different educational institutions. The qualitative interviews took place at the educational institutions.

ETHICAL CONSIDERATIONS

The research recommendations of the Declaration of Helsinki were followed. Access to the students was given by the educational institutions. All interested students signed a continuous informed consent.

FINDINGS

Students' dignity was at stake in encounters with supervisors during education. Decisive for experience of dignity was the supervisor's ability to confirm the student through acknowledgment, reassurance and seeing them as individuals. Experienced dignity had a crucial impact on students' life courage and their ability to be present.

DISCUSSION

The discussion emphasizes the vulnerable dignity of students, the importance of confirmation and the significance perceived dignity has.

CONCLUSION

Students' experiences tilted between perceived dignity and offense, and placed students' dignity in a vulnerable position. Crucial for perceived dignity was the confirmation the students received from their supervisors. Perceived dignity gave the students courage and increased their ability to be present, which provided better opportunities for learning and development.

The Relationship Between Workplace Incivility and Psychological Distress: The Moderating Role of Servant Leadership

BACKGROUND

The relationship between workplace incivility and psychological distress among nurses has been well-documented in the nursing literature. Management practices to reduce the negative impact are less clear. This study aimed to examine perceived servant leadership as a moderator between workplace incivility and psychological distress among nurses in Chinese hospitals.

METHODS

This study used a cross-sectional design and was conducted between September and October 2020. We recruited 1,604 nurses from 13 Chinese hospitals across different regions in China ranging from 18 to 55 years in age (M = 28.48 years, SD = 6.53 years). Multiple linear regression was used to analyze the data.

FINDINGS

The results showed that workplace incivility (β = 0.40, p < .001) and perceived servant leadership (β = -0.13, p < .001), as well as their interaction (β = -0.11, p = .002), predicted nurses' psychological distress. Perceived servant leadership moderates the relationship between workplace incivility and psychological distress.

CONCLUSIONS/APPLICATION TO PRACTICE

Servant leaders can create an ethical work climate, display empathy and compassion, and facilitate resilience. Our findings can assist hospital management with support from occupational health providers to recruit, train, and assess nursing supervisors. Also, occupational health providers in collaboration with nursing administration can monitor incivility, psychological distress, servant leadership levels, and impact.

Implementing Trauma-Informed Education Practices in Undergraduate Mental Health Nursing Education

BACKGROUND

Nursing students may have risk factors for trauma reactivation through learning activities conducted as part of their education and training. Trauma-informed education practices (TIEP) could help reduce this risk.

METHOD

Course policies, content, procedures, and support structures consistent with the tenets of TIEP were implemented in undergraduate mental health courses with traditional third-year nursing students at two universities.

RESULTS

Students responded positively to the implementation of TIEP. Most (92%) qualitative feedback students provided in formal evaluations was directly related to at least one principle of TIEP, most commonly "promoting social, emotional, and academic safety." Some students (39.3%) interpreted TIEP as demonstrations of "genuine" caring for the students as individuals and their own mental health.

CONCLUSION

Integrating TIEP into an undergraduate nursing mental health course is feasible and beneficial and allows faculty to role model skills and values central to nursing practice. [J Nurs Educ. 2021;60(12):707-711.].

The association between the practice environment and selected nurse educator outcomes in public nursing education institutions: A cross-sectional study

AIM

The purpose of this study is to describe the association between the practice environment and nurse educator outcomes (burnout, engagement, incivility, job satisfaction and intention to leave) in public nursing education institutions in the Gauteng province of South Africa.

BACKGROUND

The practice environment holds the most promise for recruiting and retaining a qualified and engaged nurse workforce; however, the association between the practice environment and nurse educator outcomes has been relatively unexplored.

DESIGN

Cross-sectional design.

METHODS

The Gauteng province was purposively selected, as it has the highest number of public nursing education institutions in South Africa. All-inclusive sampling was applied to public nursing educations institutions in Gauteng province (N = 6) and then to Heads of Department (N = 30; n = 17) and nurse educators (senior lecturers [N = 162; n = 45] and lecturers [N = 257; n = 80]). Data were collected during March to November 2018. The data were collected using the Practice Environment Scale of the Nursing Work Index; Maslach Burnout Inventory - Educators Survey; Utrecht Work Engagement Scale (UWES); Incivility in Nursing Education-Revised (INE-R); job satisfaction and Propensity to Leave Scale.

RESULTS

The results show that nurse educators are an aging population, with limited numbers having master's and doctoral qualifications. The most job dissatisfaction is regarding wages (M=2.0; SD 1.07); appreciation, recognition and rewards for good work (M=2.1; SD 1.01); and opportunities for advancement (M=2.2; SD 1.01). The nurse educators do not experience their public nursing education institutions as having a positive practice environment. Nurse educators experienced high levels of work engagement, moderate levels of burnout and low levels of incivility, that were highly correlated with the subscale of foundations of quality outcomes. They experienced moderate levels of job satisfaction but did not intend to leave their places of employment, which was highly correlated with the subscale of manager's ability, leadership and support.

CONCLUSIONS

A positive practice environment improves nurse educator outcomes. The subscale of foundations of quality outcomes and manager's ability, leadership and support had the most impact on nurse educator outcomes, thus quality teaching practices should be cultivated and recognised; and managers must have the necessary skill and knowledge to lead effectively, while also including nurse educators in decisions that impact them and involving them in the affairs of the nursing education institution. There is a shortage of qualified nurse educators globally and in South Africa and urgent attention must be given to factors that influence the recruitment and retention of nurse educators.

TWITTER ABSTRACT

The practice environment holds the most promise for recruiting and retaining a qualified and engaged nurse educator workforce, especially regarding foundations of quality outcomes and manager's ability, leadership and support.

The Importance of Meaningful Faculty Recognition in Creating a Healthy Academic Work Environment: A Mixed-Methods Study

AIM

The purpose of this study was to understand nursing faculty's perceptions of meaningful recognition and how it contributes to a caring academic climate.

BACKGROUND

A supportive, healthy work environment is critical in recruiting and retaining nursing faculty. Research on caring for faculty through meaningful recognition and the impact on the workplace climate is limited.

METHOD

The study employed a parallel mixed-methods design in which quantitative and qualitative findings were integrated into synthesized conclusions. A total of 193 full-time faculty participated in the survey portion of the study; 15 full- and part-time faculty participated in video-conferenced focus groups.

RESULTS

Results of this study demonstrated that meaningful recognition contributes to a caring workplace, motivates faculty work performance, and impacts faculty roles in positive ways.

CONCLUSION

For recognition to be meaningful, it must be genuine, aligned with faculty's perceptions of performance, commensurate with level of effort, and relevant to individuals.

Prevalence of incivility between ophthalmology and emergency medicine residents during interdepartmental consultations

OBJECTIVES

Since incivility is linked to adverse effects in patient care and health care worker well-being, evaluation of the prevalence of incivility during the formative years of residency training is warranted. The aim of this study was to determine the perceived presence and degree of incivility between emergency medicine (EM) and ophthalmology residents during emergency department (ED) consultations.

METHODS

We conducted a single-site, survey-based study, targeted to ophthalmology and EM residents. The survey we distributed included questions adapted from validated and widely used surveys measuring incivility in the workplace (Workplace Incivility Scale) and incivility within the ED.

RESULTS

Ophthalmology (13/15, 86.7%) and EM (42/48, 87.5%) residents participated, with an overall response rate of 55 of 63 (87.3%). Most residents (47/55, 85.5%) reported some degree of incivility during consultations, with a greater proportion of females reporting incivility (100%) than males (77.4%, p = 0.033). A total of 52.7% of respondents reported occurrence of incivility on a quarterly basis; 21.8% reported monthly, 10.9% weekly, and none daily. Incivilities were reported most commonly during nonurgent consults (85.5%). The two most common incivilities reported by trainees were when the other party paid little attention to their statements or opinions (80% of residents) or doubted their professional judgment (74.5% of residents). More female trainees reported jokes being told at their expense compared to males (15.8% vs. 0%, p = 0.049). Residents most often attributed incivility to stress (78.2%), loss of empathy/burnout (63.6%), or attempts to shift responsibility to another party (60.0%). Among EM residents surveyed, incivility was identified as occurring most often during consultations with surgical specialties.

CONCLUSIONS

Incivility during interdepartmental consultations between EM and ophthalmology is commonly reported by physicians-in-training. It occurs more often during consultations deemed as nonurgent and is more commonly reported by females. Given its associations with adverse outcomes, interventions to decrease incivility early in training may be warranted.

Incivility among Arabic-speaking nursing faculty: testing the psychometric properties of the Arabic version of incivility in nursing education-revised

OBJECTIVES

Civil environment in nursing education enhances achieving learning outcomes. Addressing incivility can be crucial to improve academic achievements. The purpose of this study was examining the psychometric properties of the Arabic version of the Incivility in Nursing Education-Revised scale regarding nursing faculty.

METHODS

This cross-sectional study conducted in five Arab countries using a convenience sampling strategy. Two hundred twenty-five Arab-speaking nursing faculty participated in this study.

RESULTS

Exploratory factor analysis confirmed the construct validity of the translated Arabic version of the Incivility in Nursing Education-Revised that are related to nursing faculty. Internal consistency was assessed using Cronbach's alpha and a coefficient of 0.867 indicated strong scale reliability.

CONCLUSION

The Arabic version of the Incivility in Nursing Education-Revised scale that is related to nursing faculty is a valid and reliable tool that can be used to evaluate incivility among Arab-speaking nursing faculty.

Faculty development workshop on gender-associated incivility in nursing education

BACKGROUND

Men comprise the minority of entry-level baccalaureate nursing students and are at increased risk of experiencing gender-associated incivility.

PROBLEM

Uncivil peer-to-peer behavior can negatively affect students' mental and physical well-being, and learning experience. Nursing faculty must be able to identify and address gender-associated incivility among students.

AIM

The purpose of this quality improvement program was to train nursing faculty to prevent, identify, and manage gender-associated incivility in the educational environment.

METHODS

A day-long interactive workshop utilizing trigger films, small group discussions, and interactive theater was developed to train nursing faculty to implement proactive and reactive techniques to address uncivil behavior which will enhance the learning environment for all students. Utilizing Kirkpatrick's Model of Evaluation, participants were surveyed at the conclusion of the workshop and four months postworkshop to evaluate their learning and its implementation.

RESULTS

Participants gained greater understanding of the impact of gender-associated incivility and felt both empowered and better prepared to manage gender-associated conflict.

CONCLUSION

Similar approaches may be useful for schools of nursing that wish to empower their nursing faculty to support an equitable nursing education environment free of gender-associated incivility.

Exploring faculty-to-faculty incivility among nursing faculty: Related factors, reasons and solutions

AIM

This study aimed to explore faculty-to-faculty incivility in university nursing programmes and to identify the perceptions of faculty regarding the reasons and solutions for incivility.

BACKGROUND

Incivility is a fundamental problem in nursing educational settings.

METHODS

This cross-sectional and analytic study comprised 330 faculty members from different schools of nursing in Turkey. A personal information form and the 12-item Incivility Scale were used to collect data. The data were analysed by using descriptive analysis, Mann-Whitney U and Kruskal-Wallis tests, Spearman's correlation test, linear regression tests and thematic analysis.

RESULTS

Faculty and research assistants who were single and holding master's degrees perceived high incivility (p < .05). There was also a significant, mildly negative relationship between age and incivility scores (r = -0.236). A strict hierarchical structure was revealed to also be a reason for incivility (p < .05).

CONCLUSION

Further research is needed to determine the effectiveness of the solutions for faculty-to-faculty incivility.

IMPLICATIONS FOR NURSING MANAGEMENT

This study can guide administrators regarding the causes and solutions of incivility within academic environments. By implementing strategies to increase awareness, administrators can become positive role models for faculty, providing a respectful and fair work environment to prevent incivility.

Gaslighting in nursing academia: A new or established covert form of bullying?

Gaslighting is an insidious, pernicious form of bullying that is gaining notoriety in nursing academia anecdotally. Attempting to identify the behaviors associated with gaslighting are difficult because of the subtle nature with which gaslighting is performed by the perpetrator. Traditional tools/models used for identifying bullying and horizontal violence are not sensitive enough to pick up gaslighting behaviors. Perpetual lies and mistruths, vexatious or frivolous complaints, praise and positive reinforcement, the use of blame or mobbing, and coercion are some of the tactics a gaslighter will use to create confusion and chaos for the gaslightee. The psychological harm for the gaslightee can lead to self-doubt, hypervigilance, depression, anxiety, addiction, and suicidal ideation as well as the physical symptoms associated with stress. Left with very few choices the gaslightee either adheres to the behavior or leaves. It is important to raise awareness and perhaps education and training of this form of bullying behavior because of the deleterious effects it has personally and professionally.

Experiences of undergraduate nursing students with faculty incivility in nursing classrooms: A meta-aggregation of qualitative studies

Faculty-to-student incivility can have detrimental impacts on both the individual students and the nursing profession. This study synthesized the current qualitative research evidence on the experiences of undergraduate nursing students with faculty incivility in nursing classrooms. A meta-aggregation approach was applied in a systematic review of qualitative studies based on the guideline of the Joanna Briggs Institute. The analysis of 11 qualitative studies identified four synthesized findings: (1) faculty incivility included a wide range of uncivil behaviors from disruptive to threatening behaviors, (2) pedagogical incompetence, including ineffective teaching, unresponsiveness, and unfairness, was perceived as uncivil, (3) faculty incivility negatively impacted on psychological well-being and learning, and (4) adaptation efforts included seeking support from family and friends and voicing the need for an official support system. Nursing faculty members need to be aware of the malicious impacts of faculty incivility, have formal teaching preparation, and develop pedagogical competency. The students and faculty members should be empowered by establishing official support systems for students and training faculty members to be role models for civility, respectively. Faculty perspectives of their incivility to students, interventions for cultivating faculty civility, and the long-term effects of faculty incivility are suggested as areas for further research.

Relationships among stress, resilience, and incivility in undergraduate nursing students and faculty during the COVID-19 pandemic: Policy implications for nurse leaders

BACKGROUND

Developing successful targeted interventions to reduce incivility for undergraduate nursing students and educators will require understanding the differences in their unique experiences. Although resilience may act as protective buffer against stressors, little is known about the relationships between stress, resilience, and perceptions of the frequency of incivility in the academic environment.

PURPOSE

The purpose of this study was to compare relationships among and differences between perceptions of incivility frequency and self-reported stress and resilience levels in undergraduate nursing students and faculty during the COVID-19 pandemic.

METHOD

A comparative descriptive and correlational research design was utilized. An online survey was used to collect data from undergraduate nursing students and faculty (n = 710) at one public university.

RESULTS

Students were significantly more stressed and less resilient than faculty. Faculty reported significantly greater low and high-level student and low-level faculty incivility behaviors than students.

CONCLUSION

Understanding student and faculty perceptions of uncivil behavior frequency occurring at the intersection of high stress and moderate resilience levels is key to the creation of targeted interventions and policy development.

A bibliometric analysis of workplace incivility in nursing

AIM

This research aims to present a general summary of researches on workplace incivility in nursing using bibliometric indicators.

BACKGROUND

Nurses regularly experience incivility from their working environment. However, evidence shows that it has significant potential for harmful consequences, both in terms of their health and in terms of productivity. Therefore, nursing and hospital managers have a crucial role in creation and maintenance of civil behaviour.

METHOD(S)

This research reports on a bibliometric analysis using a systematic review of academic literature on workplace incivility in nursing. A search of Web of Science databases was performed, and a total of 269 abstracts were investigated. Calculation of bibliometric indicator was done in Excel, and tag clouds had been created in VOSviewer.

RESULTS

Nursing incivility literature is growing, and the United States contributed the largest number of papers. Studies have been carried out on nurses working in hospitals and nursing students in general. Topics are mainly focused on the organisational consequences of uncivil behaviour.

CONCLUSION(S)

This study reveals that there are not enough studies on workplace incivility in nursing.

IMPLICATIONS FOR NURSING MANAGEMENT

As a result obtained from this research, it especially recommends health care and nursing managers to research some risky groups and subject less studied yet.

Midwifery students' experiences of bullying and workplace violence: A systematic review

BACKGROUND

Workplace violence directed at registered midwives in the maternity setting has been a recognised issue since the early 1990s. More recently it has become evident that midwifery students are also victims of bullying and harassment whilst on clinical placement. Due to the short and long-term impacts this has on students, it is likely to have a detrimental effect on the future and sustainability of the midwifery profession. As a basis for designing a response, it is important to understand what is currently known about this phenomenon.

AIM

To systematically review the literature to identify what is known about workplace violence and bullying experienced by midwifery students whilst on clinical placement.

METHOD

Reporting of this review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was undertaken of all primary research that focussed upon workplace violence and bullying involving midwifery students whilst on clinical placement, published between January 1990 and December 2019. Pre-defined terms were used to search the following five databases: CINAHL, Web of Science, MEDLINE, Embase, supplemented with Google Scholar. Additional manual searches of reference lists were conducted. An assessment of the quality of each eligible study was then undertaken using an appropriate mixed methods appraisal tool (MMAT). Extracted data were then synthesised using thematic synthesis.

FINDINGS

Nine articles met the criteria for inclusion in the review. Studies were primarily qualitative, with some reporting descriptive statistics that do not enable key issues such as prevalence to be reliably addressed. The synthesis identified four main themes that related to workplace violence and bullying of midwifery students whilst on clinical placement. Results were clustered around the role of power in bullying, prevalence and impacts, the culture of compliance, and the victim's response.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

A broader understanding of the nature of workplace violence and bullying and how it manifests itself is beginning to emerge, but more and higher quality research is required to establish an empirical base on which to design interventions. Studies suggest that bullying is common and has significant impacts at both a personal and professional level.  This strongly reinforces a need for greater policy and organisational responses to bullying in the clinical education context, in order to break the bullying cycle and ensure the midwives of the future remain in the profession and sustain the workforce.

Interprofessional perspectives on faculty-to-faculty incivility from nursing and social work

Healthcare delivery systems frequently require interprofessional collaboration between members of several health and social care professions. In the United States, two of the largest are nursing and social work. How these two professions address incivility between faculty members is not well understood. This paper describes the results of an examination of Faculty-to-Faculty Incivility (FFI) by both social work and nursing educators. National surveys of U.S. social work faculty (n = 216) and nursing faculty (n = 588) indicate common concerns between the two groups. Nursing and social work educators experience similar rates of behaviors that may be considered FFI, but social workers are more likely to identify these behaviors as uncivil. Data suggest that there are differences between nursing and social work faculty in their beliefs about the causes of FFI, and also in their reported barriers to addressing FFI in the workplace. The discussion highlights concerns that are common between the groups, contextual aspects that differ between the two professions, and ways in which interprofessional collaboration between nurses and social workers in academia and healthcare can help to address this problem among both groups.