Incivility in Nursing Education in China and the United States – Qualitative Aspects

Purpose: To examine nursing faculty and student perceptions of the factors that contribute to incivility in nursing education in Hangzhou Nursing College (HNC), the types of uncivil behaviors each group exhibits, and remedies for prevention and intervention.

Methods: Nineteen of 21 faculty respondents (90.5%) and 389 of 392 student respondents (99.2%) at HNC completed the qualitative portion of the Incivility in Nursing Education (INE) survey which measures why and how faculty and students contribute to incivility and asks for remedies to deal with the problem. Researchers from Boise State University (BSU) and HNC used an interpretive qualitative method to analyze the narrative responses. Both research teams extracted common themes and then sorted the themes into categories until saturation of the data was reached. Teleconferencing technology was used to discuss theme agreement and disagreement until both researcher teams were confident that the analysis was a valid representation of the respondents’ comments. Faculty and student responses were analyzed separately using this process.

Results:   Faculty and students from HNC reported incivility as a reciprocal and relational process influenced by stress, a lack of mutual respect, poor communication, and generational and environmental factors. The most frequently reported uncivil student behaviors included disruptive behaviors in class and behavior in response to faculty incivility. The most frequently reported uncivil faculty behavior included poor teaching methods and conflict and disrespect between faculty and students. Remedies included university policies, educational programs, open discussions, improved teaching methods, and expanded student choice.

Conclusion:  Student and faculty opinions about why and how faculty and students contribute to incivility and suggestions for remedies to address the problem were congruent. Remedies include the need for clear policies and behavioral expectations, improved teaching methods, and improvement in the quality of faculty and students.