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Benner’s theory in an interactive patient care simulation. Nursing Education Perspectives, 27(1), 16–21.
Linn, M. C. (2006). The knowledge inte- gration perspective on learning and instruction. In R. Keith Sawyer (Ed.), The Cambridge handbook of the learning sciences (pp. 243–264). New York, NY: Cambridge University Press.
National League for Nursing. (2005). Core competencies of nurse educators. Retrieved from http://www.nln.org/profdev/pdf/
corecompetencies.pdf
Rowles, C. J. (2012). Strategies to promote crit- ical thinking and active learning. In D. M.
Billings & J. A. Halstead (Eds.), Teaching in nursing: A guide for faculty (4th ed., pp. 258–
284). St. Louis, MO: Elsevier Saunders.
Vicki Sullivan Hannah
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in nursing education. In 2001, a survey was conducted asking program directors of 611 nursing schools to describe problematic stu- dent behaviors. Three behaviors that were cited in all responses were inattentiveness in class, attendance problems, and lateness.
Objectionable physical contact and verbal abuse toward faculty were also mentioned frequently (Lashley & DeMeneses, 2001). The investigators recommended strategy devel- opment to decrease these behaviors, now seen as examples of incivility, as well as directing further attention to the topic of problematic behavior in nursing education.
Luparell (2004) further explored uncivil student behaviors noted by faculty that were similar in nature and caused negative physi- cal and psychological results to occur in educators. She questioned the effect that stu- dent incivility may have on faculty recruit- ment and retention in the face of a nursing shortage. In 2007, Luparell interviewed 21 faculty members to investigate the effects uncivil encounters with nursing students had on them. These uncivil encounters were on a continuum of relatively mild to highly aggressive. The faculty members reported short- and long-term effects, both physical and psychological. In addition, they included effects on their teaching abilities and an over- all negative effect on the teaching/learning process. A small number of faculty resigned from teaching and cited student behavior as a factor in their decision.
Incivility can be reciprocal between nursing students and faculty. Clark (2008) interviewed both faculty and nursing stu- dents to fi nd that civility was lacking on the part of both faculty and students in many interactions. She found that the occurrence of incivility on the part of one of the mem- bers of the dyad led to an uncivil response from the other and the cycle continued. Clark and Carnosso (2008) developed a concept analysis of civility concluding that civility is necessary to maintain safe and respectful teaching–learning experiences.
Civility in interactions between students and faculty in nursing education is inversely related to stress. In a conceptual model students is damaging to both parties’ sense
of self-worth and can create lasting effects. It has been cited as a barrier to education and can lead to violent behaviors (Clark, 2009;
Clark & Springer, 2010).
Incivility can occur during interactions between students and faculty, students and peers, or between students and staff nurses in the clinical setting. Examples of student incivility in the academic setting include tar- diness or leaving class early, rude comments, participating in side conversations dur- ing class, and misusing technology during class (Clark & Springer, 2010). Researchers studied faculty incivility toward students in online nursing courses (Rieck & Crouch, 2007). Students have cited incivility from faculty in the forms of “unfairness, rigid- ity, insistence on conformity, and overt dis- crimination” (Clark & Springer, 2010, p. 319).
Incivility can occur in the form of vertical violence toward nursing students in the clinical setting by staff nurses (Thomas &
Burk, 2009).
Civility is the practice of being fully present in an encounter with another whose views are not the same, being willing to lis- ten to an opposite viewpoint, having respect for the other individual, and fi nding some form of mutual agreement. In nursing edu- cation, civility between faculty and students is essential for student learning in both the classroom and clinical setting. The topic of civility can be found in the American Nurses Association Code of Ethics as well as in rec- ommendations from the Joint Commission and the Institute of Medicine (IOM) as an adjunct to increasing patient safety (ANA, 2001; IOM, 2003; Woods, 2010). Nursing fac- ulty can demonstrate civility during encoun- ters with students as a way of role modeling effective communication for students’ future patient interactions and as a way of fostering a culture of civility in the academic environ- ment to facilitate learning.
SYNOPSIS
Recent developments have included research studies on the impact of civility and incivility
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statements. Washington, DC: American Nurses Association.
Civility. (n.d.). Merriam-Webster. Retrieved from http://www.merriam-webster.com/
dictionary/civility
Clark, C. (2008). The dance of incivility in nursing education as described by nursing faculty and students. Advances in Nursing Science, 31(4), E37–E54. doi:10.1097/01.
ANS.0000341419.96338.a3
Clark, C. M. (2009). Faculty fi eld guide for promoting student civility in the class- room. Nurse Educator, 34(5), 194–197. doi:
10.1097/NNE.0b013e3181b2b589
Clark, C. M. (2013). National study on fac- ulty-to-faculty incivility: Strategies to foster collegiality and civility. Nurse Educator, 38(3), 98–102. doi:10.1097/
NNE.0b013e31828dc1b2
Clark, C. M., & Carnosso, J. (2008). Civility:
A concept analysis. The Journal of Theory Construction & Testing, 12(11), 11–15.
Clark, C. M., & Springer, P. J. (2010). Academic nurse leaders’ role in fostering a culture of civility in nursing education. Journal of Nursing Education, 49(6), 319–325. doi:
10.3928/01484834–20100224-01
Institute of Medicine (IOM). (2003). Health professions education: A bridge to quality.
Washington, DC: National Academy Press.
Lashley, F.R.., & DeMeneses, M. (2001).
Student civility in nursing programs:
A national survey. Journal of Professional Nursing, 17, 81–86.
Luparell, S. (2004). Faculty encounters with uncivil nursing students: An overview.
Journal of Professional Nursing, 20(1), 59–67.
doi:10.1016/j.profnurs.2003.12.007
Rieck, S., & Crouch, L. (2007). Connectiveness and civility in online learning. Nurse Education in Practice, 7(6), 425–432. doi:
10.1016/j.nepr.2007.06.006
Thomas, S. P., & Burk, R. (2009). Junior nursing students’ experiences of vertical violence during clinical rotations. Nursing Out- look, 57(4), 226–231. doi:10.1016/j.outlook .2008.08.004
Woods, M. S. (2010). Civil leadership: The fi nal step to achieving safety, quality, innovation, developed by Clark, both faculty stresses
related to arduous workloads and student stressors such as multiple role obligations contributed to uncivil exchanges (2008). As stress increased for either faculty or student, civil behaviors decreased. This atmosphere is not conducive to learning and may even prove dangerous if allowed to continue or escalate.
RECOMMENDATIONS
Civility is an essential component in effective communication. There is much information that nurse educators must communicate to students during their pro- gression to becoming safe and effective professional nurses. Providing instruction about civility in interactions and model- ing civility in communication allows both faculty and students to communicate needs and expectations openly and without fear or anxiety. Using civility in educational encounters by both faculty and students will improve the students’ understand- ing of content and allow application of knowledge in an environment that pro- motes acceptance and understanding.
Incorporating civility into nursing educa- tion will allow students to practice commu- nication skills that will serve them in their future encounters with patients. Strategies to promote civility awareness and usage among students and faculty include policy development for dealing with incivility, creation of classroom and communication expectation using both faculty and stu- dent input, and incorporation of opportu- nities for better communication between students and faculty (Clark, 2008). Civility awareness and training for both faculty and nursing students may be an impor- tant component in the development of safe patient care and should be included dur- ing student and faculty orientation, faculty meetings, and at regular intervals through- out the curriculum.
American Nurses Association (ANA). (2001).
Code of ethics for nurses with interpretive