ABSTRACT Faculty members complain about the rise of uncivil
behavior in their students, and students voice similar complaints about
faculty. Using an interpretive qualitative method for research, this
study examined student and faculty perceptions of incivility in nursing
education, possible causes of incivility, and potential remedies.
Narrative analysis yielded the following categories: in-class disruption
by students, out-of-class disruption by students, uncivil faculty
behaviors, and possible causes of incivility in nursing education. The
authors argue that further research is needed to increase awareness and
understanding about academic incivility, its impact, and its
psychological and social consequences.
Keywords Codes of Conduct--Incivility--Student
Behavior--Student-Faculty Relations
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CONNIE SEEMS TO CHALLENGE EVERYTHING HER NURSING PROFESSOR SAYS.
During small-group work, Connie text messages her friends and rarely
pays attention. The professor is impatient and uses harsh language with
Connie in front of other students.
THIS SCENARIO, a common one in many of today's nursing
programs, is typical of situations that are at best disparaging and,
under the worst circumstance, potentially violent. Evidence suggests
that incivility on American college campuses is a serious and growing
concern (1-8).
Fostering an atmosphere of civility on college campuses presents a
challenge. To be "civil" is to be polite, respectful, and
decent. Conversely, "incivility" is defined as speech or
action that is disrespectful or rude and ranges from insulting remarks
and verbal abuse to explosive, violent behavior (9). Academic incivility
is any speech or action that disrupts the harmony of the
teaching-learning environment. Some uncivil behaviors can be quite
disruptive and affect the academic environment so radically that
learning is effectively terminated (10). THIS ARTICLE reports on a study
of perceptions of nurse faculty and nursing students in one school of
nursing regarding incivility in nursing education, its possible causes,
and potential remedies.
Review of the Literature INCIVILITY IN HIGHER EDUCATION To create a
more civil society, Eberly urges Americans to elevate common good over
self-interest, to encourage wider civic participation, and to renew
social values (11). Carter believes that rudeness and disrespect are
"the merest scratch of the surface of [our societal] crisis"
(12, p. 16) and evidence of our nation's growing incivility.
According to Carter, selfishness and getting one's own needs met
are crowding into the social life of America, including our
nation's classrooms.
While academic incivility is not a new phenomenon, Braxton and
Bayer (2,3) suggest that it is on the rise, and that courtesy and
civility among faculty and students are fracturing and dissolving on
college campuses across the country. Faculty members complain about the
rise of uncivil behavior in their students (5,8,13,14), and students
voice similar complaints about faculty (1,2,15-17).
Education plays an important role in developing a civil society,
and higher education plays a special role in helping students develop a
sense of civic and social responsibility and learn ways to contribute to
the common good (18). In the United States, where public education is
integral to preparing citizens for employment and socioeconomic
mobility, education also accepts social responsibility for well-being in
civil society (19).
Many explanations for academic incivility have been suggested,
including exposure to violence, poor secondary school preparation,
changing student demographics, and inadequate parenting (2). Levine and
Cureton describe contemporary college students as distrustful of
leadership, lacking confidence in social institutions, and being ill
prepared for the rigors of academe (20). Braxton and Bayer indicate that
it is important to consider the changing demographics of students as
well as the impact of faculty behaviors (2,3).
Clearly, a safe teaching and learning environment is needed and
deserved. Incivility within the academic community is too damaging to
ignore, and even though acts of disrespect and harassment may be
reflective of a changing nation, such behaviors must be immediately and
effectively addressed (1,7,21).
INCIVILITY IN NURSING EDUCATION Further research in the area of
incivility in nursing education is needed. A qualitative study by
Luparell used a critical incident technique to conduct extensive
interviews with 21 nursing professors representing nine different
nursing programs in six states (5). Faculty described aggressive and
severe incidents of student incivility and reported being verbally
abused by students. As a consequence of significant and sustained
negative effects of these encounters, faculty reported losing sleep,
having interrupted sleep patterns, and experiencing a number of other
negative reactions to these encounters. Some faculty changed their
pedagogy and modified grading criteria to avoid further conflict with
students, and many harbored self-doubt about their teaching abilities
and assumed much of the blame for what occurred.
Thomas conducted extensive interviews with nursing students from a
variety of nursing programs across the country (14). These students
offered the opinion that faculty play a significant role in academic
incivility and provided examples of uncivil faculty behaviors. They
described themselves as being angry about unexpected changes in clinical
schedules, changes to the syllabus, and nurse faculty who "seem to
make up the rules as they go" (14, p. 19). Several common triggers
of their anger were identified, including perceptions of faculty
unfairness, rigidity, being overly critical of students, insistence on
conformity, and discrimination against nursing students based on gender,
race, and ethnicity.
Lashley and de Meneses surveyed 409 nursing programs in the United
States regarding the frequency of uncivil student behaviors (22).
Inattentiveness, absence from class, and tardiness were the most
frequently reported uncivil behaviors. Fewer than 50 percent of
respondents reported verbal abuse of faculty and student peers as a
problem. Forty-three percent indicated that disruptive behaviors had
increased over the last five years.
A plenary session panel at the National League for Nursing
Education Summit 2005 focused its attention on incivility in nursing
education, and a report on the panel discussion was published in Nursing
Education Perspectives (23). Clark, a panelist, reported on the use of
the Incivility in Nursing Education (INE) survey, which includes both
quantifiable and open-ended items (24). Clark and Springer used the INE
survey to investigate incivility in nursing education from both faculty
and student perspectives in a nursing program in the northwest United
States (17).
Findings from the pilot study revealed that both nursing faculty
and students viewed academic incivility as a moderate to serious
problem. Both groups reported similar behaviors as uncivil, and both
indicated a desire to learn more about the problem. The qualitative
comments were illuminating and form the basis for this article.
The Qualitative Study This study was conducted using quantitative
and qualitative methodologies to investigate the problem of incivility
in nursing education in a university environment from both student and
faculty perspectives. Its purpose was to consider possible causes of
incivility and to recommend potential remedies. The qualitative portion
of this study was developed to examine three research questions:
* How do nursing students and nurse faculty contribute to
incivility in nursing education?
* What are some of the causes of incivility in nursing education?
* What remedies might be effective in preventing or reducing
incivility in nursing education?
All faculty (n = 36) and students (n = 467) in the associate and
baccalaureate degree nursing programs of a metropolitan public
university received information about the study and were asked to
participate (17). Approval to conduct the study was obtained by the
university Institutional Review Board.
SURVEY INSTRUMENT All participants completed the Incivility in
Nursing Education survey, which included demographic questions,
quantitative items designed to measure faculty and student perceptions
of incivility in nursing education, and four open-ended questions used
to gather perceptions of faculty and students. This survey was developed
by modifying items from two instruments designed to measure faculty and
student incivility in higher education: 1) the Defining Classroom
Incivility survey designed by the Center for Survey Research at the
University of Indiana (25), and 2) the Student Classroom Incivility
Measure (known as the SCIM-Part C), where students are asked to rate
uncivil faculty behaviors in the classroom (4). After obtaining
permission, Clark developed the INE by modifying items from these
instruments to be more applicable to nursing education.
To establish initial content validity, faculty with experience in
student and faculty incivility reviewed the newly developed survey and
compared the content to themes found in the literature. Faculty and
students pilot tested the survey for readability, and revisions were
then made to the wording of questions.
PROCEDURE The researchers emailed faculty in the department of
nursing to invite them to participate in the study and request
permission to distribute surveys to their nursing students. Faculty
response was favorable; all agreed to assist in the distribution of the
survey to nursing students.
Clearly written instructions were provided with the surveys. During
a two-week period in October 2004, faculty self-administered their own
surveys and provided time during classes and clinicals for students to
complete their surveys. All participation was voluntary. All responses
were collected and placed in a large envelope, which was then given to a
research assistant to compile.
Fifteen of 36 nurse faculty (41.6 percent) and 168 of 467 nursing
students (35.9 percent) completed the qualitative parts of the survey.
An interpretive qualitative method was used to analyze the data from
narrative responses (26). Each researcher independently reviewed the
student and faculty comments to identify recurring responses and
organize them into themes. Areas of agreement and disagreement were
discussed and verbatim comments reviewed until both researchers were
comfortable that the analysis was a valid representation of the
comments.
Findings The first research question asked students and faculty how
each group contributes to incivility. Findings were grouped into two
themes: in-class disruption and out-of-class disruption. Table 1 lists
uncivil in-class student behaviors as identified by faculty; response
frequencies are provided in descending order.
With regard to in-class student disruption, respondents wrote about
disruptions in class, negative remarks, and other forms of student
incivility. Cited behaviors included challenging professors regarding
test scores in class, dominating class discussion, carrying on side
conversations that disturb other students, and sighing to express
displeasure with assignments. Students commented as follows:
* "Students are disruptive when they do not listen to faculty
and other students, text message their friends, and use cell phones
during class."
* "It is most frustrating when students challenge professors,
especially during class."
With regard to out-of-class disruption, respondents wrote about
discrediting faculty, complaining about faculty, and failing to use
appropriate communication channels. (See Table 2.) Uncivil behavior in
this category included students discrediting faculty knowledge, publicly
bad-mouthing professors, and turning in assignments late, without making
prior arrangements. Students commented as follows:
* "I hear students bad-mouthing professors between classes. I
don't think it's helpful to prejudice another student against
a professor in that way."
* "Students send inappropriate emails, are negative toward
faculty and other students, and sigh because they think that an
assignment is stupid."
The students identified six themes of uncivil faculty behaviors as
shown in Table 3. Comments referred to faculty condescension, poor
communication skills, and superior attitudes toward students. Uncivil
behavior included challenging students' knowledge or credibility in
front of others, demeaning the profession of nursing, and failure to
provide a respectful forum for discussing concerns. Students commented
as follows:
* "Some faculty make belittling comments and try to weed out
students. They are arrogant and show superiority over students."
* "Some faculty treat students like they are stupid and make
condescending, rude remarks."
The second research question asked students and faculty to suggest
possible causes for uncivil behavior in nursing education. Their
responses are presented in descending order in Table 4. Themes included
the high-stress environment of nursing education, faculty arrogance, and
a lack of immediacy in addressing incivility when it occurs. Students
commented as follows:
* "Faculty lose their patience and take out their personal
stress on students. They either do not deal with uncivil behaviors or
are overly harsh and demeaning."
* "Incompetent, rude professors encourage the same rude
behavior from students. If you can't teach, don't! Students
are frustrated by the lack of resources to report a rude, incompetent
professor, and fear retaliation if they go to the top to report it.
We've been told that it can cost us our degrees and that we'll
be flunked out if we speak up. This simply encourages incompetence and
incivility to continue."
* "Many students believe they can be as rude as they want
because they are paying customers."
The third research question asked students and faculty to suggest
possible remedies for incivility in nursing education. In many cases,
the respondents called for a swift, immediate response to incivility,
and some suggested a "zero tolerance" approach to the problem.
Several possible remedies were offered, including setting forth
standards and norms, strengthening university policies and support for
faculty, and enforcing campus codes of conduct. It was recommended that
incivility be addressed immediately and that open forums and mediation
panels be developed to resolve conflicts related to incivility. It was
also recommended that faculty and students learn conflict
negotiation/mediation skills.
Implications for Nursing Education and Research Nurse faculty and
students perceive incivility as a problem both in and out of the
classroom. Stress, disrespect, faculty arrogance, and a sense of student
entitlement contribute to incivility in nursing education. To deal
effectively deal with these issues, faculty and students must work
together with administrators to develop and implement comprehensive
codes of conduct and effective strategies to prevent incivility.
Further, they must craft remedies for effective intervention when
incivility occurs.
Standards and ethical principles that define the profession exist
to ensure that qualified, ethical nurses are graduated from nursing
programs. Nurse faculty and students must be accountable to these
standards and bear a shared responsibility to conduct themselves in an
ethical, professional manner. They must engage as partners in lively
dialogue to address these problems.
This study of incivility in nursing education is timely. Most
earlier studies on this topic have focused on the problem of student
incivility. These findings shed light on possible causes of incivility,
potential remedies, and how faculty, as well as students, contribute to
the problem. From the classroom to the practice setting, further
research is needed to address several topics:
* The nature of incivility and its impact on the educational
process and on the profession as a whole
* The relationships between student and faculty perceptions of
incivility and ways to effectively address the problem
* Whether there are gender differences in ways that faculty and
students experience incivility
* How civility experienced by students--or perpetrated by
students--affects patients
It is clear that uncivil encounters have a negative effect on the
academic environment and have the potential to disrupt the
teaching-learning environment. Greater awareness and understanding about
academic incivility, its impact, and its psychological and societal
consequences are needed.
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Cynthia M. Clark, PhD, RN, is associate professor, Department of
Nursing, Boise State University, Boise, Idaho. Pamela J. Springer, PhD,
RN, is professor and department chair, College of Nursing. Boise State
University. For more information, contact Dr. Clark at
cclark@boisestate.edu.
Table 1. In-Class Disruption by Students as Identified by Faculty
UNCIVIL STUDENT BEHAVIOR FREQUENCY OF RESPONSE
Disrupting others by talking in class 20
Making negative remarks/disrespectful
comments toward faculty 11
Leaving early or arriving late 9
Using cell phones 7
Sleeping/not paying attention 3
Bringing children to class 1
Wearing immodest attire 1
Coming to class unprepared 1
Table 2.
Out-of-Class Disruption by Students as Identified by Faculty
UNCIVIL STUDENT BEHAVIOR FREQUENCY OF RESPONSE
Verbally discrediting faculty 4
Turning in late assignments without
proper notification 2
Sending inappropriate emails to faculty 2
Not keeping scheduled appointments 1
Complaining about constructive feedback
from faculty 1
Stealing/driving too fast on campus 1
Making veiled threats toward faculty 1
Table 3. Uncivil Faculty Behaviors as Identified by Students
UNCIVIL FACULTY BEHAVIOR FREQUENCY OF RESPONSE
Making condescending remarks 26
Using poor teaching style or method 23
Using poor communication skills 19
Acting superior and arrogant 15
Criticizing students in front of peers 7
Threatening to fail students 7
Table 4. Possible Causes of Incivility in Nursing Education
as Identified by Students and Faculty
POSSIBLE CAUSE FREQUENCY OF RESPONSE
High-stress environment 10
Lack of professional, respectful
environment 9
Lack of faculty credibility and
responsiveness 8
Faculty arrogance 6
Sense of entitlement among students 3
Students not really interested in nursing 3
Not being clear about expectations 2
Competitiveness 2
Lack of immediacy to address incivility 2
Distance learning (virtual) environment 2
Lack of student preparation 1