Defining and Measuring Incivility in Nursing Education
Table of Contents
There is a paucity of literature on the extent and impact of incivility in nursing academia. Contributing to this problem are the lack of a standardized definition of incivility and the lack of an established, psychometrically sound instrument with which incivility can be measured. The specific aims of this study are to: a) refine a definition of incivility within nursing academia, and b) begin item development for a psychometrically sound instrument by which to measure incivility. This work will contribute significantly to future intervention research that will aim to reduce incivility in nursing education or mediate its impact.
Both faculty and students perceive incivility as a moderate problem in nursing education. Behavior often has been used as a framework for discussing incivility. For example, nursing faculty have perceived a wide range of student behaviors as uncivil. These behaviors include lateness to, absence from or inattentiveness in class; dominating class discussion; using computers for non-class work; dishonesty and cheating; making disrespectful remarks; yelling at instructors, and making objectionable physical contact. Alternatively, students have reported faculty incivilities that include: canceling class without warning; being unprepared for class; disallowing open discussion; delivering fast-paced lectures; not being available outside of class; using vulgarity; belittling students; challenging colleagues' knowledge or credibility; and threatening physical harm.
Findings from the National Nurse Population Survey revealed of the 2.1% of nurses employed in academia, 13.9% reported that they were moderately or extremely dissatisfied with their jobs. Evidence suggested that unpleasant interactions with students affect faculty retention. Luparell found that uncivil encounters with students play a role in faculty decisions to leave teaching. Additionally, workplace incivility in general has been implicated in employees' ability to work together, absenteeism, reduced commitment to the organization, and decreased productivity
Before interventions can be identified to mediate incivility, a sound measure of incivility must be created. Most previous attempts to quantify incivility in higher education have employed survey methods, focusing on faculty and student experiences with a wide variety of specific behaviors. These measures of incivility are unidimensional, based solely on observable behaviors, and fail to account for the complexities of social roles, power issues, personal characteristics influencing responses, and various situational contexts. Scales offer a more precise method of measuring a phenomenon than do surveys
An exploratory design is being used to garner qualitative feedback on the definition of incivility and potential items for a measurement scale. The project is being conducted in two phases. The first is to refine the definition of incivility and the second to generate items for potential use in an incivility instrument.
The convenience sample consists of nurse educators from public, baccalaureate nursing programs in the northwestern United States whose names and email addresses are available on the Internet. Email lists of faculty will be developed and 100 faculty, comprised of equal proportions from each state, will be contacted for each phase of the study. A faculty list of 550 names from 5 states (DE, AR, MS, NE, and OR) was developed. States were selected based on: a) fairly dispersed area of the country and b) manageable number of schools accredited by CCNE (3-4 schools in each state). From each state 20% of the total names randomly selected.
Data will be collected on-line using the SNAP software because it permits construction of open ended questions and allows for free text feedback. Participant responses using the SNAP software are completely de-identified. For the first aim, feedback will be solicited from faculty in order to refine the definition of incivility that has been proposed. An e-mail inviting faculty to participate in the project will be sent with a direct link to the SNAP questionnaire embedded. Participants will be asked to provide free text feedback on incivility and the proposed definition of incivility. After initial refinement of the definition, the responding faculty will be contacted again and offered the opportunity to provide additional feedback. For the second aim, feedback will be solicited about potential instrument items. Additional sociological, higher education, and nursing education literature will be reviewed extensively. Based on the earlier definition work and the literature review, dimensions of incivility will be proposed and items related to each of the proposed dimensions will be generated. For each item, qualitative feedback will be sought regarding whether the item is appropriate to the definition provided. Participants will be asked to provide feedback with respect to relationship to incivility and clarity of each item, if there are major items missing, or if any items do not belong.
For both phases, a follow up email reminder with direct link to the SNAP questionnaire will be sent one week after the initial mailing. Three days after that, a final email reminder with direct questionnaire link will be sent. A thank you will be sent via email to all those who participate.