Student and Faculty Perceptions of Civility in a Baccalaureate Nursing Program

Friday, 22 February 2019: 4:10 PM

Tracy L. Booth, EdD, BSN, RN
School of Nursing, University of Mary Hardin-Baylor, Belton, TX, USA

Background: Incivility is a current issue in nursing education. The literature supports nursing programs are struggling with civility and student-faculty relationships. These struggling student-faculty relationships influence the culture of the nursing program and the learning environment (Clark, Nguyen, & Barbosa-Leiker, 2014; Clark, Barbos-Leiker, Gill, & Nguyen, 2015; Clark, 2017; Jenkins, Kerber, & Woith, 2013). Often, student views of uncivil behaviors differ from faculty views. This incongruency contributes to the problem of incivility. Holtz, Rawl, & Draucker (2018) examined student perspectives of incivility and identified faculty behaviors in which students associated with incivility. Findings indicated students believe faculty behaviors representing incivility include judging or labeling, impeding student progress, picking on students, putting students on the spot, withholding instruction, and forcing students into no-win situations. Clark (2011) developed a survey, the Incivility in Nursing Education (INE) Survey to examine student and faculty views regarding uncivil behaviors. The survey results identified behaviors of incivility from student and faculty perspectives. Clark (2015) revised the instrument (INE-R) and conducted further psychometric testing to confirm the validity and reliability of the revised instrument.

Purpose: The purpose of this study was to examine perceptions of civility in an undergraduate nursing program. Exploring student and faculty views of civil and uncivil behaviors will assist faculty in communicating and interacting with students. Awareness and understanding of perceptions specific to this program will assist faculty to create a more civil culture and productive learning environment. Research questions for this study were:

RQ1: How do student and faculty views regarding uncivil behaviors differ?

RQ2: How are student and faculty views regarding uncivil behaviors similar?

Methods: This mixed methods study utilized The Incivility in Nursing Education-Revised (INE-R) instrument. The INE-R has established reliability and validity. The instrument includes 48 questions for response on a Likert-like scale and four open-ended questions. Participants were asked to rate their perception of behaviors as civil or uncivil, and to respond to the open-ended questions regarding their opinion about potential factors that contribute to a civil academic environment and ways to address incivility. The survey was administered electronically via Qualtrics, an online survey software. IRB approval was obtained.

Participants: Participants were students and faculty of an undergraduate baccalaureate-nursing program. An invitation for participation with informed consent was sent via e-mail. Participation in the study was voluntary for students and faculty. No personal identifying information was included in the demographic data component for students. The only identifier for faculty was that they are in the faculty role.

Data Analysis: After composite scores were calculated, a t-test was used to determine differences between groups on composite scores. Chi square was used to determine differences in subscale scores of low-level incivility factors and high-level incivility factors.

Results: Student and faculty views are statistically significantly different (p = .02, alpha = .05) in what they consider high-level uncivil student behaviors. Students and faculty have no statistically significant difference in their views of low-level uncivil student behaviors. Students and faculty have no statistically significant difference in their views of high-level uncivil faculty behaviors. Students and faculty have no statistically significant difference in their views of low-level uncivil faculty behaviors.

Discussion: Although students and faculty generally agree on student and faculty behaviors that demonstrate low-levels of incivility, there is a significant difference in student vs. faculty views of what student behaviors demonstrate high levels of incivility. Student behaviors defined as high-level uncivil behaviors on the INE-R includes cheating on exams, demanding a passing grade, sending rude e-mails, making discriminating comments, using profanity, threats of physical harm, property damage, and threatening statements about weapons. Findings from this study indicate that students consider these behaviors significantly less uncivil compared to faculty. Careful review of the data indicates that up to one-third of students do not consider these behaviors uncivil.

Recommendations: Early in the educational process, there is a need to transmit to the students the cultural values and beliefs regarding civility held by the faculty. By educating the students about faculty expectations, the students will be better equipped to fully engage in the educational process in a mutually agreed upon collegial manner. In addition, expectations regarding civility should be reinforced throughout the nursing curriculum. Developing professional values and behaviors is an important step in the nursing student’s journey towards professional nursing practice.

Conclusion: Awareness and understanding of similarities and differences in student and faculty views of uncivil behavior assists faculty and academic leaders to take steps to develop shared language, professional behaviors and expectations, and create a civil culture, which will contribute to a positive learning environment.


Clark, C. M. (2011). Pursuing a culture of civility: An intervention study in one program of nursing. Nurse Educator, 36(3), 98-102. doi:10.1097/nne.0b013e3182161238

Clark, C.M., Ngeyen, D.T., Barbosa-Leiker, C. (2014). Student perceptions of stress, coping, relationships, and academic incivility. Nurse Educator, 39(4), 170-174. doi:10.1097/NNE000000000000049

Clark, C.M., Barbosa-Leiker, C., Gill, L.M., & Nguyen, D. (2015). Revision and psychometric testing of the Incivility in Nursing Education (INE) survey: Introducing the INE-R. Journal of Nursing Education, 54(6), 306-315. doi: 10.3928/01-484834-20150515-01

Clark, C.M. (2017). An evidence-based approach to integrate civility, professionalism, and ethical practice into nursing curriculua. Nurse Educator, 42(3), 120-126. doi:10.97/NNE.0000000000000331

Holz, H.K., Rawl, S.M., & Drauker, C. (2018). Types of faculty incivility as viewed by students in bachelor of science in nursing programs. Nursing Education Perspectives, 39(2), 85-90. doi: 10.1097/01.NEP.0000000000000287

Jenkins, S.D., Kerber, C.S., & Woith, W.M. (2013). An intervention to promote civility among nursing students. Nursing Education Perspectives, 34(2), 95-100.

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