Nursing Education and Civility in Nursing
What is Civility
Civility is a type of behavior
demonstrated in an encounter between two individuals who are not in agreement.
The dictionary defines civility as "polite, reasonable, and respectful
behavior toward another person (Civility, nd). The concept of civility includes
having respect for another's viewpoint, being willing to communicate openly and
honestly about the conflict, and having the mutual purpose of seeking some form
of agreement (Clark & Carosso, 2008)
Civility In Nursing Education
To illustrate the importance of civility in nursing education, incivility must be first understood. Incivility that occurs in aca demic settings has been defined as "rude or disruptive behavior often resulting in psychological or physiological distress for the people involved" (Clark, 2013, p. 98). Incivility in interactions between nurse educators and students is damaging to both parties' sense of self-worth and can create lasting effects.
Need of Civility In Nursing Education
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 tardiness or leaving class early, rude comments. participating in side conversations during class, and misusing technology during class (Clark & Springer, 2010). Researchers studied faculty incivility towards students in online nursing courses (Rieck & Crouch, 2007).
Students have cited incivility from faculty in the forms of
"unfairness, rigidity, insistence on conformity, and overt
discrimination" (Clark & Springer, 2010, p. 319). Incivility can occur
in the form of vertical violence towards 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 listen to an opposite viewpoint, having respect for the other individual, and finding some form of mutual agreement. In nursing education, 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 recommendations from
the Joint Commission and the Institute of Medicine (IOM) as an adjunct to
increasing patient safety (ANA, 2001; IOM, 2003; Woods , 2010). Nursing faculty
can demonstrate civility during encounters 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 environment to
facilitate learning
Impact of Civility In Nursing Education
Recent developments have included research studies on the impact of civility and in civility in nursing education. In 2001, a survey was conducted asking program directors of 611 nursing schools to describe problematic student behaviors. Three behaviors that were cited in all responses were inattentiveness in class, attendance problems, and lateness. Objectionable physical contact and verbal abuse towards faculty were also mentioned frequently (Lashley & DeMeneses, 2001).
The researchers recommended development strategy 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 physical and psychological results to occur in educators.
She questioned the effect that student incivility may have on faculty recruitment 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.
Impact of Incivility In Nursing Education
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 students to find 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 members of the dyad led to an uncivil response from the other and the cycle continued. Clark and Carosso (2005) 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 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.
Outputs of Civility In Nursing Education
Civility is an essential component in effective communication. There is much information that nurse educators must communicate to students during their progression to becoming safe and effective professional nurses. Providing instruction about civility in interactions and modeling 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 understanding of content and allow application of knowledge in an environment that promotes acceptance and understanding Incorporating civility into nursing education will allow students to practice communication 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 student input, and incorporation of opportunities for better communication between students and faculty (Clark, 2008), Civility awareness and training for both faculty and nursing students may be an important component in the development of safe Patient care and should be included during student and faculty orientation, faculty meetings, and at regular intervals throughout the curriculum.
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