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

Purpose:   Compare faculty and student perceptions of and experience with incivility in nursing education at Hangzhou Nursing College (HNC) and the United States (U.S.).
Methods: The Incivility in Nursing Education (INE) survey includes quantitative and qualitative items to measure incivility in nursing education from both faculty and student perspectives. Two distinct sample populations completed the INE; 194 nursing faculty and 306 nursing students from the U.S. and 21 nursing faculty and 392 nursing students from HNC. Comparisons were made on quantitative and qualitative responses regarding perceptions of academic incivility between China and the U.S.
Results:   Nearly half (47%) of HNC respondents and 78.8% of U.S. respondents reported incivility as a moderate to serious problem and respondents from both countries identified students as more likely than faculty to behave uncivilly. Students from both countries differed in their perceptions of uncivil student behaviors. However faculty from both countries identified the same uncivil student behaviors including arriving late or leaving early from class, holding distracting conversations, and acting bored and apathetic. Respondents from both countries perceived incivility as a reciprocal process, cited stress as a major contributor, described in-class disruptions as the most frequent uncivil student behavior, and reported openly challenging faculty credibility as the most frequent threatening student behavior (U.S.=66.9%; HNC=60.5%). The most frequent uncivil faculty behaviors differed. U.S. students reported faculty intimidation as the most frequent uncivil faculty behavior while Chinese students reported faculty incompetence as the most frequent uncivil faculty behavior. Suggestions for prevention and intervention were similar for both countries including education and policy development.

Conclusion:  Chinese and U.S. student and faculty opinions about incivility in nursing education were similar in some cases and greatly divergent in others. Suggestions for remedies were similar, though implementation in two distinct cultures poses unique challenges.