Educating Nursing Students to Recognize and Report Negative Behavior in the Clinical Setting: A Feasibility Study

Purpose: While the clinical rotation provides an essential venue for socialization into the role of the professional nurse, socialization into a culture of abuse also begins at this time. The term “eating our young” has terrible connotations. Between 72-100% of students reported witnessing or experiencing negative behavior (NB). Clinical nurses are frequently identified as a major perpetrator of the NB experienced by students. Episodes of NB, verbal and physical, are under reported. Reasons for this is that being a recipient of violence was viewed as being part of the job and the student has a need to fit in.

The research question is: Are senior baccalaureate nursing students who participate in a training program for recognizing and reporting negative behavior better able to identify and more likely to report incidents of negative behavior in a clinical simulation exercise  than comparable senior baccalaureate nursing students who participate in a training program that addresses strategies for sleep and shift work? The aim of the study is to determine if senior nursing students who witness NB in a video that simulates a clinical experience are able to recognize the NB and to determine if they would report or ignore the NB.

Methods: A mixed method, two groups, randomly assigned, intervention trial will be utilized.   The intervention group which will attend a one-hour training program on recognition and reporting of NB while the control group will attend a one-hour session on sleep and shift work. Both groups will then view a simulated NB video and complete the study survey at the conclusion of the video. The independent variable is the NB training program. The dependent variable is the student’s identification of NB in the video.

Results: Demographics: No difference found between groups. Nominal and Interval data: Slight statistical difference found between groups in physical abuse. Both groups were able to recognize the verbal and physical negative behaviors however neither group identified the subtle/overt negative behaviors. Emerging themes were developed from the qualitative responses.

Conclusion: Education focusing on the subtle forms of negative behavior and continued need to report should be incorporated into nursing education curriculum to help break the cycle of violence identified as “eating our young”.